Trigger warning: This article contains references to self-harm.

Despite many mental health issues finding more acceptance in recent years, there is unfortunately still some stigma surrounding self-harm. At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about self-harm — whether for yourself or someone else — we are here to help.

We’re opening up the conversation on how to handle self-harm scars, the challenges of living with them, what to do if someone you love has self-harm scars, and much more.

What are self-harm scars and what do they look like?

Self-harm is the act of deliberately hurting oneself, and it can be a physical manifestation of an underlying mental health condition. The scars that result from the act of self-harm can look very different depending on the person’s individual history.

You may be familiar with self-harm scars depicted in movies which tend to appear as cuts on the inner wrists. In fact, sufferers may choose to harm their body in a number of different places such as the arms, hands or wrists, and may choose hidden places on their body that cannot be seen by others, such as the thighs or stomach.

The severity of self-harm scars can range from small cuts to deeper gashes, or could look like a burn, pierced skin, scratches, bruises, or something else. Some common features of self-harm scars include:

• A pattern of multiple scars near each other
• Scars being lighter in colour than the rest of the skin
• Scars appearing on the non-dominant arm or side of the body
• Behavioural patterns that make it easier to hide scars and avoid being challenged

Why do people self-harm?

Self-harm can affect anyone of any age, gender, background or in any situation, and the reasons why people self-harm can be very hard to understand for those who do not do this themselves. For some, it is a ‘coping mechanism’ linked to certain stresses or experiences happening now or in the past. For others, self-harm occurs for reasons that are much harder to make sense of.

If you feel confused about why you hurt yourself, know that you are not the only one who feels this way. Many people can’t pinpoint exactly why they self-harm, but find it difficult to stop nonetheless.

"Clients often find that a positive change occurs when they can start seeing themselves through a kinder and more compassionate lens. Having a safe and non-judgemental space, such as in therapy, where they can explore why they self-harm, can bring about self-acceptance and a sense of empowerment. This change was best described by a client who said that she now sees her scars as reminders to love herself more, not less."
- Alexandra Quinn, Psychotherapist

What kind of social stigma might people with self-harm scars experience?

There has been much more acceptance and validation in the mental health space in recent years, and as a result, awareness of self-harm has increased. However, we still have a long way to go in society to better understand the reasons people self-harm, and how to help those that do. Some difficulties people face include:

• Being told you are “doing it for attention” — Sometimes people describe self-harm as ‘attention seeking’, which can be damaging to the person suffering. Most people who self-harm do so in private and try to hide it, which negates the argument that it is anything to do with seeking attention.
• Feeling ostracised by peers — Some people may find it difficult to be accepted by their peers due to their scars or behaviours.
• Infections and long-term harm — With things like cutting or burning, people can develop infections and create other health risks without meaning to.

What are the longer-term challenges of having self-harm scars?

Living with self-harm scars can be difficult at times. Since there is still a stigma attached to the subject of self-harm, many people feel uncomfortable letting their scars be seen by their friends, family or strangers around them, and will avoid particular situations in order to avoid showing them.

People with visible self-harm scars have reported struggles with everyday interactions such as meeting new people, going on dates, and even worries in attending job interviews. It may feel like you need to either hide your scars or explain them every time you interact with someone new.

Hiding self-harm scars can be stressful too depending on the situation you are in, for example if you have scars on your thighs and a friend invites you to go swimming, or you are asked to be a bridesmaid at someone’s wedding and know you will need to wear a sleeveless dress that reveals scars on your arms.

Should I cover my self-harm scars?

If you have old, healed self-harm scars that you would prefer to cover, this is absolutely fine. However, you should not feel the need to cover them if you don’t want to or if you would be more comfortable wearing less clothing in warmer months. In fact, many people choose to let them show. Writer Harriet Williamson contributed an empowering personal essay on Metro.co.uk about showing self-harm scars:

“People who are affected by self-harm deserve to be able to wear what they want in the summer, just like everyone else. It’s not ‘advertising’ self-harm to show your scars. The trappings of mental illness and emotional distress are not desirable, they just exist.”

- Harriet Williamson, for Metro

Another great example is writer and author Beth McColl, who contributed a personal essay on the subject of self-harm scars on GlamourMagazine.co.uk:

“For so many years I was the girl who didn’t want to take off the layer, to reveal more skin, to get into the water. Now I’m able [to] see my self-harm scars and to have them seen by others and it doesn’t faze me in the least… I feel mostly neutral about them now; neither ashamed nor celebratory. I don’t laud them as evidence of my survival, call them battle scars or display them on social media, but nor do I make any effort to cover them or pretend they aren’t exactly what they are.”

- Beth McColl, for Glamour Magazine

Learning to accept old self-harm scars as nothing to be ashamed of can be difficult, but ultimately a rewarding experience if you choose to show them in public.

If you have more recent self-harm scars, it is advised to cover these with a plaster, bandage or another appropriate dressing to avoid infection, and reach out to someone who can help, such as a GP, appropriate therapist, or clinical psychologist with experience supporting people who have self-harmed — at Augmentive, we have several specialists who can offer support in this area.

Can anything be done to minimise the appearance of self harm scars, or remove them?

If you would rather reduce the appearance of your scars, there are a number of ways to manage or minimise them. These include:

• Makeup products — There are many makeup products on the market designed to hide scars. If you’re unsure, speak to a makeup artist who specialises in concealing skin concerns.
• Tattoos (medical) — If you are a fan of tattoos, some people choose to cover scarred areas of their body with them. If you choose to do this, be sure to visit a tattoo artist with experience in covering scars. There’s also medical tattooing, which involves finding a colour match between the scars and surrounding skin so they blend in. Any kind of tattoo can fade over time so remember you may need to repeat the procedure in future.
• Needling — Needling involves making tiny perforations in the skin to remodel collagen and make scars appear to blend in with the surrounding tissue. This is a very specific procedure and must be done by a professional.
• Laser resurfacing — Specific skin treatments with lasers can create excellent results for those looking to reduce the appearance of their scars.
• Surgery — A number of surgical techniques have been introduced over the years to minimise the appearance of scarring, including the closure of wide scars to minimise the pattern, the introduction of a skin graft, or tissue stretching using a balloon (done under anaesthesia) to produce enough new skin that the scars can be removed.

All of the above methods of managing or minimising self-harm scars should be accompanied with the appropriate therapy or mental health treatment recommended by a specialist. Simply removing old self-harm scars will not remove the underlying reasons for self-harm, so if you haven’t already spoken to a professional and undergone treatment, you should do this first before embarking on any scar removal missions.

I want to start exposing my self-harm scars. How do I do this?

Telling people about your self-harm scars and showing them can feel like a big step. Some people may decide it’s best to jump right in and show their scars in public, with less worry over what strangers might think. Others may choose to take it slow by following the steps below.

• You could start by telling those closest to you so they know in advance that they might notice your scars from time to time.
• Wear clothes around your home that show the scars only to family or friends who understand. It’s not about “showing them off”, but being comfortable in your own skin so you can wear the clothes you want to and not feel you need to hide them.
• Visit other friends and family outside your home and discuss it with them, perhaps showing them what the scars look like if you feel comfortable doing so.
• Start to leave the house wearing whatever clothes you would like to. It may help to take an optional piece of clothing to cover up in case you start to feel self-conscious.

You don’t have to go through these steps but they may be helpful. If you haven’t mentioned it to friends and family first, they may ask you questions you aren’t ready to answer, or act differently around you because they don’t know how to react. Open communication is helpful for avoiding this and allowing you to share only what you want to.

What do I do if I notice self-harm scars on someone I love?

If you notice someone close to you has self-harm scars, it’s so important to broach the subject with compassion, understanding, and absolutely no judgement, even if you don’t really understand why they may be doing this. Simply showing general love and support could be enough to let them know you are there for them, without them feeling forced into discussing the subject.

In many cases it can help to ask them how they would like to be supported, and letting them know the door is open without forcing them through it.

If you do engage in a discussion about it, offer them the space to open up about underlying emotions causing their self-harm, rather than solely focusing on the scars. Ultimately the goal of the conversation should be to let them know they have support, and to help them seek guidance from a GP, appropriate therapist, or clinical psychologist with experience supporting people who have self-harmed. At Augmentive, we have several specialists that can offer support in this area, and our free 15 minute consultation can help match the person with the best therapist for their specific needs.

Remember, you may not be able to help them on your own, so point them in the direction of resources and counselling that can get them on track to recovery. This may take a while, so patience is key.

If you think someone may take their own life and is in immediate danger, the quickest way to get help is to call an ambulance (on 999 if you are in the UK). Please note that Augmentive offers non-emergency services.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments to helping you find a therapist near you for support on your journey.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.