What Type of Scar Do You Have? Understanding Atrophic, Hypertrophic and Keloid Scars

Not all scars are the same — and understanding which type you have is the essential first step in choosing an effective treatment. Different scar types form through distinct biological mechanisms and respond differently to treatment approaches. This guide explains the main categories of scars and what each one means for your treatment options.

Atrophic scars

Atrophic scars are characterised by a loss of tissue, resulting in a depression or pit in the skin surface. They occur when the body does not produce enough collagen during the healing process. The three main subtypes are:

• Ice pick scars: Narrow, deep pits that extend into the dermis. Most commonly associated with severe acne.
• Rolling scars: Broad depressions with sloping edges that give the skin an uneven, wave-like texture.
• Boxcar scars: Wider depressions with sharper, more defined edges, similar in appearance to chickenpox scars.

Atrophic scars are among the most challenging to treat because they involve a structural deficit in the skin. Natural treatments can improve their appearance and texture, but significant improvement often requires patience and consistency.

Hypertrophic scars

Hypertrophic scars are raised, firm, and discoloured — typically pink or red in darker skin tones — and remain confined to the boundaries of the original wound. They form when the body produces an excess of collagen during healing. Unlike keloid scars, hypertrophic scars do not extend beyond the wound margins and often improve naturally over time, particularly with consistent topical treatment and massage.

Keloid scars

Keloid scars are a more severe form of abnormal wound healing in which scar tissue grows beyond the original wound boundaries, sometimes significantly. They can be itchy, tender, and may continue to grow over time. Keloids are more common in people with darker skin tones and have a genetic component. They are among the most difficult scar types to treat and often require medical intervention in addition to topical care.

Post-inflammatory hyperpigmentation (PIH)

Technically not a scar in the structural sense, PIH is the darkening of skin that remains after an inflammatory wound — most commonly acne — has healed. It is caused by excess melanin production triggered by the inflammatory process. PIH responds well to natural treatments containing ingredients that regulate melanin production and support skin cell turnover.

Which treatment is right for your scar type?

For hypertrophic scars and PIH, consistent topical treatment with a natural scar oil is often very effective. Scarnil Skin Scar Remover is formulated to support the natural skin repair process, reduce discolouration, and soften raised scar tissue over time. For atrophic scars, it can improve surface texture and pigmentation, though deeper structural improvement may require additional professional treatment. For those also experiencing scalp scarring from injury or surgery, ZenGold Hair Growth Oil can be applied to support follicle recovery in affected areas.

Related guide: For a comprehensive overview, read our complete guide: Natural Scar Treatment in the UK: A Complete Guide to Fading Scars