RAG rating
Document type
Clinical policy
Hertfordshire and West Essex ICB
Output type
Clinical Policies & Evidence-based Interventions

Scar Revision

July 2022 v1.0


A scar is a mark that is left on the skin, after a wound or an injury to the surface of the skin has healed. Scarring on the skin is a natural process that can occur after a cut or injury, for example after a surgical procedure or burns. Scars form when collagen accumulates around the site of the wound or injury to heal the site. Scars are permanent but can fade over the proceeding 2 years. Treatment such as surgical revision or refashioning can be performed to minimise the appearance of the scars.


Scar revision or refashioning is not routinely commissioned except for adults and children with:

  • Scars that interfere with function - for example, severe post-surgical scars or those following burns or trauma resulting in physical disability due to contraction, tethering or recurrent breakdown (i.e. not cosmetic); 


  • Serious scarring of the face, including:
    • Significant keloid scarring
    • Scars that are ragged, or can otherwise be regarded as particularly disfiguring.


  • Keloid scars that result in physical distress due to significant pain or pruritis.

  • All requests for funding will need to be supported by photographic evidence.

  • Scar revision will only be offered after 2 years to allow the natural healing process to complete. 

Cosmetic scar revision for scars not on the face, including keloid scars, will not be funded unless the disfigurement can be regarded as particularly grave. Cases will be assessed on an individual basis via Individual Funding Request.

Keloid scars secondary to body piercing procedures will not normally be funded.

Where scars meet the criteria above and are the result of self-harm, treatment will only be funded when there has been a minimum period of three years where there has been no self-harm and where there is a supporting report from a psychiatrist or psychologist indicating that the behaviour would be unlikely to recur. It should be notes that these scars are very difficult to treat and usually the only achievable outcome is to make the scars resemble trauma or burns rather than be obviously due to self-harm.