Every surgical incision leaves a scar. That is not a failure of technique — it is a biological inevitability. But the final appearance of a scar is not fixed at the moment the wound closes. What happens in the weeks and months that follow has a significant influence on whether a scar settles flat, pale, and unobtrusive, or becomes raised, red, and wide. Good scar care is simple, inexpensive, and backed by solid evidence. The challenge is getting patients to do it consistently and for long enough.
Here is what I recommend to my patients, and why.
The First Six Weeks: 3M Micropore Tape
From the time the wound has healed and the skin is closed — typically two to three weeks after surgery — I ask all my patients to apply 3M micropore tape to their scar and to keep it there for at least six weeks. The specific tape matters: I recommend the tan-coloured 25 mm width, which conforms well to most scar shapes and is skin-toned enough to be reasonably discreet under clothing.
Micropore tape works through three distinct mechanisms, each of which contributes to a better scar outcome.
The first is splinting. Tension across a healing wound is one of the most important drivers of hypertrophic scarring: the mechanical force of the skin pulling in opposite directions stimulates the fibroblasts within the scar to produce more collagen. Tape applied along the length of the scar reduces this tension and, with it, the stimulus for excessive collagen deposition. A randomised controlled trial of paper tape following caesarean section found that 41% of unsupported scars became hypertrophic at twelve weeks, compared with none in the taped group. The evidence is clear.
The second mechanism is hydration. An immature scar heals better in a moist environment. Micropore tape acts as a partial occlusive dressing, reducing transepidermal water loss and keeping the surface of the scar hydrated. After a shower, the tape stays damp for a period rather than drying immediately, maintaining that moisture contact with the scar. It also traps the skin's natural oils beneath it, providing additional moisturisation throughout the day without any effort from the patient.
The third is sun protection. Ultraviolet light causes post-inflammatory hyperpigmentation in immature scars, turning them brown and making them far more visible than they would otherwise become. Micropore tape provides a physical barrier against UV exposure that, for scars in areas covered by the tape, is more reliable than sunscreen alone.
How to Change the Tape
The tape should be changed every ten to fourteen days, not more frequently. This interval matters. When tape is removed, a small amount of superficial skin cell exfoliation occurs — the outer layer of cells comes away with the adhesive. This is harmless at ten-to-fourteen-day intervals, when the skin has had time to recover. Change it more frequently and the repeated exfoliation begins to cause soreness, redness, and occasionally skin breakdown, which defeats the purpose. The tape is also most effective when it has been on long enough to work rather than being replaced before it has a chance to do so.
When removing the tape, do so slowly and parallel to the skin surface rather than pulling upward. This reduces the mechanical stress on the healing tissue.
After Six Weeks: Continue Tape or Move to Solution for Scars
After the initial six weeks, patients have two options. The simplest is to continue with micropore tape until the scar turns pale — typically somewhere between three and twelve months depending on the individual and the site of the scar. This is the approach I favour for patients who find the tape straightforward to manage and who have a scar in an area where continued tape wear is practical.
The alternative from six weeks onwards, or as an addition to continued taping, is Solution for Scars by Science of Skin. This is the only over-the-counter scar product I recommend, because it is the only one I am aware of with a genuine clinical evidence base. Its active ingredient is epigallocatechin gallate (EGCG), a green tea extract and potent antioxidant. In a controlled clinical study, topical EGCG applied to healing scars significantly reduced both scar thickness and redness compared with a placebo control after just two weeks of use. Laboratory data show a reduction in scar volume of up to 40%. The mechanism involves modulation of the inflammatory response within the healing wound, reducing the overactive fibroblast activity that drives hypertrophic change.
Some patients find it useful at the six-week mark to run their own informal comparison: micropore tape on one half of the scar, Solution for Scars on the other. After two weeks they can make a direct visual comparison and continue with whichever appears to be working better for them — or with both. This approach is entirely safe, and for patients who are uncertain which product suits them it removes the guesswork.
Silicone gel sheets and gel products are also widely used and have a reasonable evidence base. I do not discourage them. My preference for micropore tape in the early weeks is that it combines splinting with occlusion in a single product, is inexpensive, and most patients find it easy to use.
What Else Matters
Tape and topical products are the most controllable part of scar management, but other factors influence outcome. Sun exposure to an uncovered scar should be avoided for at least a year: ultraviolet light drives post-inflammatory hyperpigmentation, permanently darkening an immature scar in a way that is very difficult to reverse. When tape is in place it provides reliable physical UV protection. When it is not — during the change interval, or once taping has been discontinued — a high-factor sunscreen (SPF 50) should be applied to the scar before any sun exposure, including incidental daylight through a car window or a walk to the shops. This is particularly important during the first twelve months. Smoking impairs wound healing and degrades collagen quality — patients who smoke can expect slower scar maturation and a worse final result. Weight stability matters too: significant weight change stretches or relaxes scar tissue and can widen a scar that had been settling well.
The other thing worth emphasising is time. Scars typically look their worst at around three to four months, when they are at their most red, lumpy, and raised. This is the point at which many patients become alarmed, and it is also the point at which some abandon their scar care — which is precisely the wrong moment to do so. The scar is at peak metabolic activity, with the highest level of collagen production and vascular ingrowth, and this is when consistent management matters most. From this point, with continued tape use and sun protection, most scars progressively soften, flatten, and fade. Full maturation takes twelve to twenty-four months. The final result at two years bears little resemblance to what the scar looked like at four months.