How to Heal Cuts & Wounds to Minimize Scarring: A Dermatologist’s Guide

By Heather D. Rogers, MD, FAAD, Double Board-Certified Dermatologist

I get this same question from patients, friends and strangers every week. How do I get my skin to heal without a scar?

The truth is, it really depends on how deep the injury goes. If it's confined to the epidermis, the top layer of our skin, it can heal without a trace. But if the injury goes down into the dermis, you will have some kind of mark. What you do in the next few weeks can play a huge role in how visible that mark ends up being. 

The best thing you can do is keep the wound clean, moist, covered and protected from the sun while it heals. Here's exactly how I tell my patients to do it. 

Step 1: Clean the Wound Properly

Rinse the wound with cool water and gently clean the area with an antibacterial cleanser. I reach for Hibiclens in my own practice. It's a 4% chlorhexidine antiseptic wash used for skin and wound cleansing and in surgical settings. 

Step 2: Keep the Wound Moist, Don’t "Air It Out"

I know the instinct is to leave a wound uncovered so it can dry out and scab over. Resist it. You do not need to let a wound dry out or form a scab to heal. Moist wound healing helps wounds close faster and can help minimize scarring. That's been shown in the literature for decades now. Cover it with an occlusive ointment and a clean bandage.

What is the Best Ointment for Wound Healing? 

So what ointment actually belongs in your medicine cabinet? 

Aquaphor

Patients bring me Aquaphor constantly, so let's talk about it directly. It contains lanolin, which is sheep sebum, and lanolin allergy is more common than people realize. In a study of over a thousand Dutch children, 66% of those with eczema and 29% of those without eczema reacted to it on patch testing. I've also never seen data showing lanolin speeds healing over plain petrolatum for wound healing. So it's an allergen with no real upside and I don’t see a reason to add that potential allergen when plain petrolatum works. A 2013 study comparing Aquaphor to plain white petrolatum on surgical wounds found redness in 52% of Aquaphor-treated wounds versus 12% with plain petrolatum.

Neosporin and Polysporin

Neosporin and Polysporin are the other ones I get asked about constantly. Please throw them away. You do not need topical antibiotic ointments for most clean, minor wounds. Neomycin and bacitracin are consistently ranked among the top contact allergens tracked by the North American Contact Dermatitis Group, with sensitization rates in the range of 7 to 13% depending on the year and population studied. 

On top of that, resistant staph strains are common enough now that these ointments often aren't doing the antibacterial job you're counting on them for. An open wound absorbs more of whatever you put on it than intact skin does, which is exactly why I don't want you experimenting with allergens on raw skin. 

Vaseline

Plain Vaseline (petrolatum) is a perfectly good, low-risk choice for keeping a clean wound moist while it heals. It occludes the wound and prevents water loss while it heals. 

Restore Healing Balm

If you want a petroleum-free option then use my Restore Healing Balm, a castor seed oil and plant-based glycerin ointment I built specifically to protect and support healing skin. 

To learn more about each, check out my Dermatologist Explains: What Actually Helps Heal Skin - Neosporin vs Aquaphor vs Vaseline vs Restore Healing Balm blog. 

What if the Wound Looks Infected? 

Increasing redness, warmth, swelling, pain, pus or drainage can be signs of infection. If you're worried your wound is infected, clean daily with Hibiclens and use Restore Healing Balm, or ask for a prescription mupirocin (Bactroban), which carries a lower allergy and resistance risk than Neosporin or Polysporin.

How Long Should You Keep a Wound Covered?

As a general guide, I recommend

• Face: 7 days
  
• Arms and body: 2 weeks
  
• Legs and feet: 4 weeks
  

Keep the wound covered until the skin has closed and there is no more drainage. When in doubt, keep reapplying and rebandaging. Covered wounds also stay protected from UV, and sun exposure on healing skin can turn a faint mark into a hyperpigmented one.  

What Does Normal Wound Healing Look Like? 

As your wound heals, here’s what you may notice: 

• Early Healing: Redness, mild swelling and clear or slightly yellow drainage. It'll crust if it isn't kept moist.
  
• New Skin Forming: New tissue forms and pink skin starts closing the gap.
  
• Wound Closure: Once the wound has closed, the new skin may look pink. Some itching or tenderness can be normal. 
  
• Scar Remodeling: After the skin has fully closed, the scar continues to remodel. This is when treatments like silicone can come in. 

P: If anything looks off, don't wait it out. Increasing redness, warmth, swelling, worsening pain, pus or drainage, or a wound that isn’t closing are reasons to call your dermatologist or primary care doctor. 

Once the Wound is Closed: How to Minimize Scarring

Laser Treatment for Scars 

For surgical scars, I typically start laser treatments about a month after surgery on my patients. It’s typically considered cosmetic and may not be covered by insurance, but laser treatment can help reduce persistent redness and improve the appearance of a scar. 

Silicone Gel

Silicone gel (Dermatix, Kelo-Cote, Strataderm, ScarAway, Silagen) can help improve the appearance of scars and reduce the risk of raised or thickened scars. Once the wound is fully closed, apply it twice daily for up to 4 months after sutures come out.

Silicone Sheets

Silicone sheeting (Silagen, Cica Care, Scar FX, ScarAway, Retouch). Worn 12 to 24 hours a day for 3 to 6 months, it can help reduce your risk of a thickened or raised scar. Cut it slightly larger than the scar and replace it as it starts to lift. This is my favorite for body scars. 

Micropore Paper Tape

Taping the scar for up to 6 months post-surgery can help reduce the risk of thickening. Use skin-colored tape a bit larger than the scar and swap it out as needed.

Sunscreen

Once the wound has fully closed, protect the scar from the sun. UV exposure can darken healing skin and make hyperpigmentation more noticeable and longer-lasting. 

Scar treatments I don’t recommend

Onion Extract Scar Gels Like Mederma

Onion extract (Mederma, Derma E Scar gel) hasn't shown meaningful improvement over plain petrolatum in studies, and one study found more scar redness with its use.

Vitamin E Oil

I don’t recommend vitamin E oil for scars either. The evidence that it improves scar appearance is limited and topical vitamin E can cause skin irritation or allergic contact dermatitis. Just say no.

Good luck and happy healing. 

Frequently Asked Questions About Wound Healing and Scarring

Should you keep a wound moist or let it dry out?

Moist wound healing helps wounds close faster and can help minimize scarring. Cover the wound with an occlusive ointment and a clean bandage rather than letting it dry out and scab over.

How long should you keep a wound covered?

As a general guide, I tell my patients to keep wounds on the face covered for about 7 days, the arms and body for about 2 weeks, and the legs and feet for about 4 weeks. Keep the wound covered until the skin has closed and there is no more drainage.

What ointment should you use to keep a wound moist?

Plain Vaseline (petrolatum) is a good, low-risk choice for keeping a clean wound moist while it heals. It occludes the wound and prevents water loss while the skin heals. If you want a petroleum-free option, use my Restore Healing Balm, a castor seed oil and plant-based glycerin ointment I built specifically to protect and support healing skin. 

Should you put Neosporin or Polysporin on a wound?

You do not need topical antibiotic ointments like Neosporin or Polysporin for most clean, minor wounds. Neomycin and bacitracin can cause allergic contact dermatitis, which is why I don't recommend putting these ingredients on raw, healing skin when you don't need them.

When should you start using silicone on a scar?

Start silicone gel or silicone sheeting once the wound has fully closed. Silicone can help improve the appearance of scars and reduce the risk of raised or thickened scars.

About the Author: Dr. Heather D. Rogers, MD

Dr. Heather D. Rogers, MD is a double board-certified procedural dermatologist and Mohs surgeon and the co-founder of Modern Dermatology in Seattle, where she sees patients full-time. She is nationally recognized for her expertise in skin health, aging, and skin cancer prevention, and for her clear, evidence-based skincare guidance. Dr. Rogers serves on the American Academy of Dermatology Media Team, the Credo Beauty Council, the Sorette for Motherhood Scientific Advisory Board, and the NewBeauty Brain Trust.

She is the founder of Doctor Rogers Skincare, a dermatologist-developed line reflecting her less-is-more, science-backed approach to healthy skin. Dr. Rogers is a graduate of Stanford University, the University of Washington School of Medicine, and completed her dermatology training at Columbia University Medical Center.

Instagram: @drheatherrogers
Practice: mdinseattle.com
Skincare: doctorrogers.com

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