While everyone acknowledges that incisions and scars take time to heal and look better, the natural history of this process confuses most patients. Immediately after surgery or a laceration repair, the skin edges and scar line looks great and has a natural color. This will continue to look this way before it changes for the worse in the next few weeks. This is because healing involves the growing in of new blood vessels around and into the incision line/scar to carry nutrients to build collagen to mend the wound edges together. In the beginning this is known as inflammation which takes weeks to appear so on the outside. That is why incision and scars, which looked so good in the first few weeks, turn red, darker and more ugly as the blood vessels multiply and grow into the injured tissues. Patients often think this is a sign of infection or scar worsening, which it is not. It is a natural process. Only when the wound edges have grown back together sufficiently (months), do the blood vessels recede and the scar color starts to improve. Scar eventually turn white or have matured when all the blood vessels have returned to normal numbers. (up to one year) Some hastening of the red color fading can be done with certain pulsed light and laser therapies.
Dr. Barry Eppley