Scar creams: which one for each type of scar
Which scar cream do I need for my scar?
There is no single scar cream that works for everything: the right product depends on the stage of healing your skin is in. For an open wound you use a healing cream that stimulates new tissue (centella asiatica); on freshly closed, irritated skin you use a barrier repair cream (panthenol, madecassoside); and for an already formed scar that is raised or red, the standard is silicone in a patch or gel, not a cream.
Quick summary
- Open wound: healing cream with centella asiatica (blastoestimulina-type products).
- Closed but irritated skin: repair cream with panthenol or copper-zinc sulphate.
- New scar (0–6 months): silicone — it is the only first-line option with solid evidence.
- Hypertrophic or keloid scar: silicone patch, pressure and patience; medical review.
- Old scar (>2 years): limited room for improvement with topical products.
- Sun protection: SPF 50 on the scar for 12 months. This is not optional.
I start here because this is the mistake I see most often: people applying a barrier repair cream to a three‑month‑old raised scar expecting it to flatten. That product is doing its job — hydrating — but it is not what that scar needed.
How skin heals: the three phases that decide what to use
- Inflammatory phase (days 1–5): your body cleans the area. Here you focus on proper hygiene and, if the wound is open, a healing cream.
- Proliferative phase (days 5–21): new tissue forms and the wound closes. This is where products with centella asiatica do their work.
- Remodelling phase (month 1 to month 24): collagen reorganises. This is the only phase in which you can change the final appearance of the scar, and this is where silicone comes in.
This timeline explains the key message of this article: the time to act on a scar is within the first 6 months after closure, not two years later when you finally decide to do something.
Types of scars and what each one needs
- Normotrophic scar: flat and skin‑coloured. It only needs moisturising and sun protection.
- Hypertrophic: raised and red, but staying within the original wound edges. Silicone used consistently.
- Keloid: grows beyond the original border, often with a family tendency. Silicone plus medical assessment: it may need intralesional corticosteroid.
- Atróphic: sunken (typical of acne or chickenpox). Topicals add little; this is dermatology and aesthetic medicine territory.
- Recent surgical scar: silicone from the moment stitches are removed and skin is closed.
- Hyperpigmented: darker than surrounding skin. Here high‑factor SPF is decisive; lightening agents come afterwards.
Silicone patches: why they are first line
Silicone is the only topical treatment for scars that international guidelines list as first line, both for prevention and treatment of hypertrophic scars and keloids. Its mechanism is not to "penetrate": it works by occlusion and hydration of the stratum corneum, which modulates fibroblast activity and reduces excessive collagen production.
What you can realistically expect: the scar flattens, loses that intense red colour and becomes more flexible. What you cannot expect: for it to disappear. A scar is permanent tissue; the goal is for it to be as discreet as possible.
Mepiform or Trofolastin: which should I choose?
This is the question I get most often on this topic, so let us go straight to it:
- Mepiform: self‑adhesive silicone dressing, very thin and flexible, adapts well to areas that move and can be cut to size. It lasts several days with washes in between. My choice for scars over joints, abdomen or areas that rub against clothing.
- Trofolastin reductor: polyurethane dressing with a silicone layer, slightly stiffer with a good pressure effect. Very useful on straight, flat scars, typically surgical ones. It usually works out cheaper per piece.
- The uncomfortable truth: both work and current evidence does not clearly favour one over the other. What really drives results is how many hours per day you wear it, not the brand name.
- If the area is hard to cover (face, neck, fingers): a silicone gel is better than a patch because it dries into an invisible film.
For gel, Strata Triz gel 20 g is the one I dispense most often: you apply a very thin layer, it dries in minutes and you can put make‑up over it. The 10 g size works well for small scars or as a trial.
If your scar is on the breast after surgery, Trofolastin mamario comes pre‑shaped for that area, which saves quite a bit of cutting and adjusting.
How do you use silicone patches correctly?
Wait until fully closed
The skin must be closed, with no scab or stitches. Never on an open wound.
Clean, dry skin with no creams
No oils or moisturisers underneath: they stop it sticking properly and cancel out the occlusive effect.
Cut with a margin
It should cover the whole scar plus a few millimetres of healthy skin around it.
12–24 hours per day
This point decides your result. Less than 12 hours daily gives much poorer outcomes.
Wash the patch daily
Mild soap and water, air dry and reuse. Each dressing lasts between 7 and 14 days.
Keep going for 3 to 6 months
A minimum of 8–12 weeks before judging results; up to 6 months for hypertrophic scars.
A small detail that changes results and costs nothing: apply SPF 50 on the scar during the first year, whenever you are not wearing the patch. UV radiation on remodelling tissue is what leaves those dark, permanent marks over time.
Quick guide according to your situation
- Open wound, not yet closed: healing cream with centella asiatica — I explain this in more detail in my guide on blastoestimulina‑type products and alternatives.
- Freshly closed surgical scar: Trofolastin or Mepiform, start now and continue for 3–6 months.
- Scar on face, neck or fingers: Strata Triz gel.
- Scar starting to raise and redden: start silicone now; do not wait to see if it settles by itself.
- Keloid with previous history: silicone plus an appointment with dermatology.
- Scar older than two years: adjust expectations; discuss options in clinic if it really bothers you.
Pharmacist recommendations
If you remember just one idea: with scars timing matters more than product choice. Silicone in the first six months, worn many hours per day, plus high‑factor sun protection for a year. With that you are already doing about 80% of what can be done at home.
I also tell everyone this: if it is a scar that worries you because of where it is or because you have had a keloid before, do not manage it entirely on your own. Write to us or come into the pharmacy so we can look at it together — sometimes the right answer is to refer you on, and I am here for that as well.
A hug from Cantabria,
Jorge Peláez
Pharmacist no. 1383
Mepiform, Trofolastin or gel: which for each type of scar
| Product | Format | Best for | Daily use |
|---|---|---|---|
| Mepiform | Self-adhesive silicone dressing | Areas with movement, can be cut to size | 12-24 h |
| Trofolastin reductor | Polyurethane + silicone dressing | Straight surgical scar | 12-24 h |
| Strata Triz gel 20 g | Silicone gel | Face, neck, fingers | 2 times a day |
| Mepiform 10x18 | Large dressing | Extensive scars | 12-24 h |
| Strata Triz gel 10 g | Silicone gel | Small scars or trial use | 2 times a day |
Frequently asked questions
Scientific references
