Silicone, sun protection and time are supported by evidence. Most of what is sold alongside them is not.
A scar is red and raised for 4–8 weeks, gradually pales over 3–6 months, and reaches its final appearance at 12–18 months. Judging a scar at month two is judging it during its worst phase.
Silicone sheets or gel applied daily for 8–12 weeks flatten and pale scars measurably. Sun protection is equally important: UV on a young scar causes permanent hyperpigmentation. Massage after the wound is closed helps break down collagen bundles.
Vitamin E oil has no reliable evidence and causes contact dermatitis in a minority. Onion extract creams perform little better than moisturiser in trials. Expensive scar kits usually sell silicone at a premium — buy the silicone.
Raised, itchy, spreading scars — hypertrophic or keloid — respond to steroid injection, and earlier is better. If a scar is thickening at week six rather than settling, contact the clinic instead of waiting.
Keep scars out of direct sun for six months, and use SPF 50 on them for a year.