Raised Scar Treatment Borciani London
Raised scars are referred to as ‘hypertrophic’, they are often post-surgical or from an accident. They can look uneven, lumpy and feel quite fibrous.
Hypertrophic scars can often be mistaken for Keloid scars, there are a few distinct differences in these, Keloid scars will grow outside of the border of the scar, they tend to be almost blister like in appearance and are more common on darker skin tones.
Hypertrophic scars can be severely raised but only in the scar tissue itself.
Raised scars respond very well to CO2 laser and Cortisone Therapy, we would only recommend Cortisone for Keloid scars.
What causes raised scars?
When the skin is damaged, a complex cascade of processes begins immediately. Each stage has a vital role in repair, and many of the treatments we use in aesthetics aim to mimic or stimulate parts of this natural healing cycle.
How the Skin Heals After Injury
1. Hemostasis (seconds to minutes)
The body’s first priority is to stop bleeding. Clotting factors are rapidly sent to the wound, forming a plug that seals the damaged vessels and prevents blood loss.
2. Scab Formation
As the clot dries, it hardens into a scab. This acts as a temporary barrier, protecting the wound from infection while the underlying tissue begins to repair.
3. Inflammation (hours to days)
An immune response follows. White blood cells flood the area to destroy bacteria, clear away debris and reduce the risk of infection. This stage is often visible as redness, warmth and swelling.
4. Proliferation (days to weeks)
This is one of the most important stages — and the one many advanced skin treatments try to replicate. Fibroblasts produce new collagen to strengthen and repair tissue, while skin cells migrate across the wound to form fresh skin.
5. Angiogenesis
New blood vessels grow to deliver oxygen and nutrients to the healing tissue. This is why raised scars sometimes appear red or show visible blood vessels.
6. Remodelling (months to years)
Initially, the body produces type III collagen, which is weaker and more fibrous. Over time, this is remodelled into type I collagen, which more closely resembles normal skin and is much stronger.
Raised scars form:
If the body produces too much type III collagen, the balance is disrupted.
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Raised (hypertrophic) scars can contain up to 3 times more collagen than normal skin.
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Keloid scars can contain 20 times more collagen, extending beyond the original wound’s borders.
This excess collagen explains why raised and keloid scars look and behave so differently from flat scars — and why targeted treatments are often needed to remodel them.
CO2 Laser
This is the gold standard for reducing scars, by choosing cooler settings we are able to reduce the chances of PIH. We will also combine with a course of Cyspera to reduce the pigmentation.
Cortisone Therapy
Cortisone therapy is excellent for reducing raised or keloid scars and can be delivered via injection or cortisone strips. The combination of CO2 laser and Cortisone provides the best outcome for raised scars
Nano Fractional laser
Skin resurfacing improves skin texture by creating micro-dermal wounds with minimal impact on the epidermis. As the skin heals, it naturally boosts collagen and elastin production.
Let us know what works for you
It’s really important that you feel as comfortable as possible when you visit the clinic, our first session is usually a consultation and these are very informal – during this time we will assess your scars and talk through the treatment options and likely outcomes and perform any necessary patch tests.
You are welcome to bring a friend or family member to your appointment and they can be present during the consultation, but we often find that people are more open and able to talk freely when it is just the patient and practitioner in the room.
We do understand that you may be nervous and possible triggered so please do let us know if you have any anxiety and how we can best manage this for you. Please try not to worry too much ahead of time, we really have seen every type of scar and our only goal is to improve your scars without judgement.
THESE RESULTS SHOW HOW DIFFERENT PEOPLE RESPOND TO TREATMENT, SOME ARE ONLY PART WAY THROUGH THEIR SESSIONS
Raised scars before and after treatment
Am I a good candidate?
The ideal candidate is anyone over 18 who would like to reduce their scars, it is important to have a realistic expectation of the outcome and to be patient with the results. Regenerating skin is a complex process.
For safety reasons, you may not be able to get this treatment if you have/are:
- If you are under 18
- If you are pregnant or breastfeeding
- If you are in an active harm cycle
- Treating over tattoos or permanent makeup – but please check with us
- Excessively tanned – recent sun exposure
We will have an informal consultation with you to assess your scars and explain the treatments in detail, we can then recommend a treatment plan that fits with your lifestyle.
Can I remove scars?
In some cases yes absolutely, this will depend on the scar and a number of factors. Larger, older scars can be reduced are not often possible to remove completely. Acne scars can be softened out very well using Co2 laser and needling. Large Self Harm scars can be reduced and some will disappear. Red scars can be reduced with a vascular laser and pigmented, dark scars can respond well to laser, melanin inhibitors and peels.
What will it look like afterwards?
Following ablative treatments such as CO2, the skin will be quite red for around 7-10 days and form a sandpaper layer that will shed after a week. The needling and Nano Fractional options will have far less downtime and the Quadrostar Pro has almost zero.
How can I prepare for the treatment?
We ask that you stay out of the sun for 4 weeks prior and do not use any self tanning products for 2 weeks to avoid any pigmentation issues. Please also avoid any active products such as retinols/acids on the area.
I'm quite nervous about showing my scars
This is absolutely normal and to be expected. For a lot of our patients, it’s the first time that someone has really seen their scars and examined them and this can make you feel self conscious.
We really do appreciate that this can be difficult and please just let us know if at any time you are feeling nervous or anxious or anything that will make you feel more at ease.
The consultations and treatments will be very informal and a time for you to ask any questions that you have.
What improvements will I see?
This is quite difficult to predict as scars can respond differently in different people. With CO2 sessions, you can see a softening from the first session although we tend to see the real changes at the 3rd session as skin takes a few months to rebuild.
Reducing the redness in new scars can happen quite quickly, often with a very noticeable change after the first or second session
The average scar reduction is between 35%-80% and of course this will depend on the severity and type of scar.
How many sessions will I need?
This is a very difficult thing to predict as there are a number of factors such as the age and severity of the scar, skin tone, age of the patient etc. We generally need between 5-10 session for softening and reducing the scars and 2-3 for camouflage.
How often can I have treatments?
CO2 treatments are a minimum of 4 weeks apart but can be as long as needed, this will make no difference to how effective the treatment is. Quadrostar Pro and needling can be 3 weeks apart.
Are treatments safe for everyone?
The treatments are generally very well tolerated. We will patch test the CO2 to check for any pigmentation issues as this is a risk for Fitzpatrick IV and higher, we will likely use alternative methods and prep with a melanin inhibitor to reduce any post inflammatory hyperpigmentation.
There are a few general contraindications, pregnancy & breastfeeding, use of Accutane in the last 12 months and some auto-immune conditions. We will cover these off in your consultation or do contact us at
What is the cost?
The price will depend on the number of scars and size of area we are covering, prices generally start at £350 per session.
