Raised scars such as keloids and hypertrophic scars develop when the skin produces excess collagen during wound healing. While these scars are not harmful, many people actively seek ways to flatten keloid scars, improve comfort, and restore skin appearance. This article explores natural scar flattening methods alongside clinically proven keloid treatment options, helping you understand what works, what doesn’t, and when medical care may be needed.

Keloid vs. Hypertrophic Scars: Why They Form

Hypertrophic scars remain confined to the original wound and may flatten over time, while keloids grow beyond the wound edges and tend to persist or worsen. Research shows both scar types are driven by chronic inflammation in the deeper layers of the skin, leading to excessive collagen production. Treatments that reduce inflammation and regulate collagen are therefore the most effective.

Natural Scar Flattening: What Helps at Home

Many people first try natural approaches to flatten keloid scars. These methods can support skin health, but expectations should be realistic.

Scar massage and moisturization may improve softness and reduce discomfort, but massage alone does not reliably flatten raised scars. Similarly, popular remedies such as aloe vera, vitamin E, and onion extract have not demonstrated consistent clinical effectiveness for flattening keloid or hypertrophic scars (Mafong & Ashinoff, 2000).

Sun protection is important, as UV exposure can worsen scar color and thickness, but sunscreen alone does not flatten scars.

Key takeaway: Natural methods are generally safe and low-cost, but they have low success rates for flattening established keloids.

Silicone Therapy: The Gold Standard Non-Invasive Option

Among non-medical treatments, silicone therapy stands out as the most evidence-backed option. Silicone sheets and gels are widely recommended as first-line treatment for hypertrophic scars and keloids.

Clinical studies show silicone therapy can reduce scar height, redness, itching, and firmness by improving skin hydration and regulating fibroblast activity (de Oliveira & Gold, 2020). Systematic reviews also report statistically significant reductions in scar thickness with consistent use (O’Brien & Jones, 2006).

RejuvaSkin’s Scar Fx Silicone Sheets align with dermatology guidelines and offer a comfortable, reusable option for daily wear:
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Effectiveness: Moderate to high with consistent use
Safety: Very high, suitable for long-term use
Cost: Low to moderate compared to in-office procedures

Medical Keloid Treatment Options

When scars remain raised, painful, or continue to grow, medical treatments may be appropriate.

Corticosteroid Injections

Intralesional corticosteroid injections are one of the most commonly used medical treatments for keloids. They work by reducing inflammation and suppressing excess collagen production. Studies show flattening in approximately 50–80% of cases, although recurrence is possible (Gupta & Sharma, 2011).

Potential side effects include skin thinning or pigment changes, which is why injections are typically performed by dermatology professionals.

Laser Treatments

Laser therapy—especially pulsed-dye lasers—targets scar blood vessels and inflammation, helping reduce thickness, redness, and itching. Evidence consistently shows better results when laser therapy is combined with corticosteroid injections rather than used alone (Son et al., 2014).

Recent randomized trials demonstrate improved scar flattening and higher patient satisfaction with combination laser-steroid therapy (Rutnin et al., 2025).

Effectiveness: High, especially in combination therapies
Safety: Moderate, requires professional care
Cost: Higher due to in-office treatments

Natural vs. Medical Scar Flattening: What to Choose?

Natural scar flattening methods are best suited for comfort and prevention, but they rarely flatten keloids on their own. Silicone therapy offers the best balance of effectiveness, safety, and affordability, making it an ideal first step. For stubborn or symptomatic scars, medical treatments—particularly combination approaches—provide the highest likelihood of meaningful flattening.

If you’re looking to flatten keloid scars, start with consistent silicone therapy, such as RejuvaSkin Scar Fx Silicone Sheets. Natural remedies may support skin health, but science shows silicone-based products and medical interventions deliver the most reliable results. Early, consistent care can significantly improve outcomes and reduce the need for invasive treatments.

Works Cited

• de Oliveira, G. V., & Gold, M. (2020). Silicone sheets and new gels to treat hypertrophic scars and keloids. Dermatologic Therapy. Link
  

• O’Brien, L., & Jones, D. J. (2006). Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews. Link
  

• Mafong, E. A., & Ashinoff, R. (2000). Treatment of hypertrophic scars and keloids: A review. Aesthetic Surgery Journal. Link
  

• Gupta, S., & Sharma, V. K. (2011). Standard guidelines of care: Keloids and hypertrophic scars. Indian Journal of Dermatology. Link
  

• Rutnin, S., et al. (2025). Efficacy of combined pulsed dye laser and corticosteroids. Journal of Cosmetic Dermatology. Link
  

• Son, I., et al. (2014). Laser combined with corticosteroid therapy for keloids. Annals of Dermatology. Link