Long, linear scars on the arms, wrists, or thighs can be a burden on the mind, both for the individual and their loved ones. Many people cannot let go of long sleeves even in hot summer to cover self-harm scars. Can these hesitation wounds truly be erased? To answer directly, even if it takes time, there are reported cases where consistent laser treatment improves them to a level where they are barely noticeable.
Some individuals visit our clinic after experiencing self-harm due to various reasons such as depression, academic stress, or peer relationships, and are left with scars. Self-harm scars often appear as long, straight lines in specific areas like the wrist, making them easily visible to others and thus a burden on daily life. In this article, we will summarize the characteristics of self-harm scars and how surgical and laser treatments differ.
What do self-harm scars look like?
The most prominent feature of hesitation wounds is the presence of multiple long, linear lacerations arranged in parallel. Slightly raised white scars are most commonly observed, while early scars that have recently formed appear reddish. Depending on one's constitution, they may remain as keloids, and brown pigmentation may also appear in the injured area.
The depth of the scars also varies from shallow to deep. It is rare for them to occur only once, so the accumulation of multiple scars is also a common characteristic of self-harm scars.
Self-harm scars are often not single scars but rather multiple scars of varying depths and ages overlapping. Therefore, a staged approach tailored to the condition is needed rather than a single method.
The treatment direction changes depending on whether it is an early, reddish scar or an old, hardened white scar. If you have similar concerns, it may be helpful to also look at Principles of Red Acne Scar Management or Characteristics of Keloid Scars.
What happens with surgical treatment?
There are two main methods for treating self-harm scars: surgical treatment and laser treatment. Surgical methods include skin grafting and suturing.
However, if hesitation wounds are treated surgically, there is a possibility that the sutured area may reopen, in which case the scar could become aesthetically worse. Unless ligaments or muscles are also damaged, surgery is usually not very helpful.
Of course, depending on the shape and location of the scar, Surgical Scar Revision may be considered. The appropriate method will be determined by considering the depth and location of the scar, along with the skin condition.
Why laser treatment is fundamental
For these reasons, laser treatment can be considered the most fundamental method for self-harm scars. The principle is to create microscopic injuries in the scar area with a laser, inducing new skin regeneration.
Commonly used lasers are devices with strong regenerative power, such as StarLux and Ultrapulse Encore. Repeated treatment with regenerative lasers gradually fades the scars, and with sufficient time, they are reported to improve to a level that is barely visible to the naked eye.
Depending on the shape and condition of the scar, combining PicoWay Laser, Vbeam Prima, or Subcision can achieve better synergy. For scars with a strong keloid tendency, Triamcinolone Scar Injection may be combined, and for regenerative laser types, Pinhole for Burn & Surgical Scar may also be considered.
For inquiries, please contact us via chat for self-harm scar treatment methods
Surgery vs. Laser: What's the difference?
The differences between the two methods are summarized at a glance below.
| Category | Surgical Treatment | Laser Treatment |
|---|---|---|
| Method | Scar removal by skin grafting, suturing | Inducing skin regeneration after micro-injury |
| Suitable cases | Limited, e.g., accompanied by ligament, muscle damage | Most self-harm scars |
| Considerations | Possibility of suture site reopening | Requires repeated treatments and a long period |
| Recovery direction | New scars may form | Gradually fades |
In the clinic, we often find that many individuals are better suited for consistent regenerative laser treatment than for surgery.
Treatment period and mindset
The principle of scar treatment may seem simple. However, unlike what it appears, experience and know-how are very important in scar treatment, and even with excellent equipment, it can take time for effects to appear.
Key points particularly important in treating hesitation wounds are as follows:
- Even for one or two scars, a treatment period of 1-2 years may be necessary.
- Patience and perseverance to complete the treatment are most important.
- Self-harm during treatment can render previous treatments meaningless.
- If necessary, we recommend combining psychiatric treatment with dermatological scar treatment.
- It is advantageous to start early, even if not urgent, for recovery.
Treatment duration varies greatly among individuals, ranging from several months to several years. Therefore, we recommend approaching it with the mindset of slowly erasing a depressive past and preparing for a brighter future.
Since the shape and depth of self-harm scars differ for each person, the most accurate treatment direction for you can only be determined after directly assessing your condition.
For inquiries, please contact us via chat for treatment direction tailored to your scar condition
Sang-Joo Lee, Chief Director (MD, PhD, Yonsei University College of Medicine and Graduate School; Completed Dermatology Residency at Severance Hospital; President of the Korean Dermatological Association) Chief Director Sang-Joo Lee's Profile First Published 2023-11-06 / Last Reviewed 2026-06-16
Scar patterns and recovery speed vary by individual. Please consult with medical staff for an accurate diagnosis and treatment plan.