Smallpox Vaccine Scars: 6 Best Tips To Fade It Away

The sight of long needles and injections all sent a cold shiver through our spine in our childhood days. Yet, we were forced to get them as they will protect us from fatal diseases 1in the future days. Let’s get to know about smallpox vaccine scars.

Between the 1960s and 1980, the World health organization started a worldwide campaign to vaccinate people to eradicate smallpox2. As a result, many people have a permanent smallpox vaccination scar on their upper left arm. The scar and pain were much easy to endure than the severity of smallpox and smallpox scar.

1. History

smallpox vaccine scars
Photo by Ed Us on Unsplash

The story of the smallpox vaccine discovery was itself a very interesting one. Many of us may be familiar with it. In fact, the basis of vaccination was developed around smallpox in the year 1796 by Dr Edward Jenner. The first individual to have the trial was a small boy named James Phipps. The causative virus was the Variola virus.3

As per the statistics given by The Centers for Disease Control and Prevention, in the 20th century, every 3 out of 10 people got infected with smallpox.

Before the typical vaccine, variolation was the most common method. It derived its name from the causative agent variola virus. In this procedure, a small amount of pus from the smallpox sores of infected people was used to rub on the skin of a healthy person which resulted in a mild form of the disease, which the immune system can battle with the infectious disease.

The typical vaccine was developed in the late 1700s to combat the smallpox virus.4

2. Process of Injecting Smallpox Vaccine

Chapter 1: Smallpox Vaccination with ACAM2000: Introduction

Every vaccine has its own way of being injected. Smallpox vaccines are injected through the puncture method. So what is the puncture method of injection?

  • A bifurcated needle is used which has two prongs. The main aim is to make the smallpox vaccines reach a certain fixed depth of the skin.
  • The needle is dipped in the vaccine solution.
  • Then it is pricked on the skin almost 15 times in a shallow way but vigorously. Most of the time the needle is pushed only up to the dermal layer, not to the deeper subcutaneous tissue5.
  • As a result of this pricking, there may be some skin injury at the injection site.

2.1. Why Does The Smallpox Vaccine Leave Scars

Smallpox Scars

Not all vaccines cause skin lesions. Some may only develop it due to various reactions like the BCG vaccine and the smallpox vaccine, The human body reacts differently to the same vaccine in different people.

  • The smallpox vaccine scar is developed mainly due to the process of injecting the attenuated virus particle.
  • As a result of injecting the vaccinia virus6, the immune system reacts to the virus, and a result of which soreness and a skin lesion may get developed.
  • It is due to the interaction of the immune system with the live virus that results in the formation of a sore developing into a blister later and ultimately leads to scar tissue development.

3. Stages of Development of the Scar

The smallpox vaccine scar passes through a number of stages finally it gradually develops.

How do scars form? - Sarthak Sinha

  • Firstly as smallpox vaccinations are taken, one can experience pain in that area as the area needs to be pricked quite a several times.
  • As the vaccine is injected only at the superficial dermal layers of the skin, generally a small pimple or bump appears as an inflammatory response.
  • Then the bump gradually enlarges into a bigger vesicle or fluid-filled blister.
  • The pus may ooze and one may feel itchy and this will ultimately lead to raised scar or scab formation.
  • The scab falls after healing but leaves behind a distinctive mark. It is a natural result of healing the sore and scab tissue formation.
  • Generally, its size is less than that of a pencil eraser, but it can vary from person to person.

Thus, the smallpox vaccine leaves a scar on the skin.

4. Complications

Most people when they get vaccinated generally do not develop any serious complications. In rare cases, it may lead to adverse reactions and cause-

  • Mild fever can develop(due to antibody formation and the reaction of the immune system).
  • Lymph nodes enlargement
  • Soreness in the injected site.

Chapter 4, Part A: Common Reactions and Potential Serious Adverse Events After Smallpox Vaccination

In people with other health issues, it can cause very serious issues-

  • Severe allergic reactions may occur in some.
  • People suffering from eczema may develop eczema vaccinatum7.
  • For those who are immunosuppressive8 in nature, their sore may enlarge and take a larger time to get healed.
  • Scarring of the cornea.
  • Very rarely, it can cause brain inflammation called post-vaccinal encephalitis.

5. How to Treat the Scars

Generally, a smallpox vaccination scar can self-heal itself. But as the live virus is injected, one must be careful with the site.

Preventing Scars - Daily Do's of Dermatology

  1. Keep the injected area covered with a bandage or sterilized cotton.
  2. One should ensure that the pus does not ooze out.
  3. Change the bandage at regular intervals.
  4. One should wash their hands properly after and before dressing the wound.
  5. One should allow others to touch the blister.
  6. One should do separate laundry.
  7. Proper disposal of the dressing is also necessary.

Following all these tips can help one to heal their vaccination scar in a more healthy way. Moreover, it does not even allow the further spreading of the virus from the area to other areas of the body and face.

6. Tips for Fading Smallpox Vaccination Scar

One should consult doctors who can provide medical advice before trying ways to fade the vaccination scar.

  • Protection from Sun Exposure

By using sunscreen or avoiding direct sun, one can avoid exposure of that area to the sun’s rays. It shall prevent the thickening and darkening of the scar.

  • Application of skin-softening ointments

The use of skin-softening ointments can fade away the scar on the upper arm. One can use cocoa butter, and natural oils but these do not have any scientific basis.

  • Dermabrasion

One can consult with health officials and doctors for dermabrasion. In this method, the superficial layers of the skin are removed followed by healing.

  • Scar revision

In this method, the previous scar is surgically removed and the healthy edges are stitched back. Although there remains a scar, that is much insignificant in comparison to the previous one.

  • Skin grafting

In this procedure, the affected area is replaced with new healthy skin. But, there might be some markings around the edges in which the skin grafting is being done.

  • Cryotherapy

In this method, cold treatment is given to the affected area to remove the scar. Generally, the doctor treats this as a keloid-a type of raised scar on the skin.

7. Final Thoughts

Smallpox was one of the scariest diseases ever witnessed by mankind. But, it was also a landmark in the history of medical inventions. The process and understanding of vaccination were developed around smallpox. Thus, the disease also taught mankind something which made him more powerful to combat various infectious diseases.

Although the smallpox vaccine left behind a scar on the skin at the injected site, it protects our lives and also prevents many smallpox scars in our skin that may otherwise develop in the absence of this vaccine. Currently, there are no more smallpox vaccination and hence no more scars related to it.

But if you want to remove a previous scar, you can consult the doctor. However, it does not cause any problems but can make someone uncomfortable. It is also advised to seek medical attention if required.


1. Where is the smallpox vaccine scar usually located on the body?

A: The smallpox vaccine scar is typically found on the upper arm, near the shoulder, or on the upper thigh. The exact location can vary depending on the vaccination method used and the administering healthcare professional’s preference.

2. Can the smallpox vaccine scar be removed or treated?

A: Since the smallpox vaccine scar is a result of the vaccination process, it is generally not possible to remove it without undergoing a surgical procedure, which might not be advisable due to potential risks and scarring. There are no specific treatments or creams that can make the scar disappear completely.

3. Is the smallpox vaccine still given today?

A: As of my last update in September 2021, the smallpox vaccine was not routinely given to the general population since smallpox has been eradicated worldwide. However, some specialized groups, such as certain military personnel and laboratory workers handling the virus, might still receive the vaccine under certain circumstances.

Read more

  1. Moore, Susan M., and Cathleen A. Hanlon. “Rabies-specific antibodies: measuring surrogates of protection against a fatal disease.” PLoS neglected tropical diseases 4.3 (2010): e595. ↩︎
  2. Henderson, Donald A. “The eradication of smallpox–an overview of the past, present, and future.” Vaccine 29 (2011): D7-D9. ↩︎
  3. Babkin, Igor V., and Irina N. Babkina. “The origin of the variola virus.” Viruses 7.3 (2015): 1100-1112. ↩︎
  4. Koplow, David A. Smallpox: the fight to eradicate a global scourge. Univ of California Press, 2003. ↩︎
  5. Raskin, Rose E. “Skin and subcutaneous tissue.” Canine and feline cytology: a color atlas and interpretation guide (2015): 34-90. ↩︎
  6. Broyles, Steven S. “Vaccinia virus transcription.” Journal of General Virology 84.9 (2003): 2293-2303. ↩︎
  7. Copeman, PW Monckton, and H. J. Wallace. “Eczema vaccinatum.” British medical journal 2.5414 (1964): 906. ↩︎
  8. Wiseman, Alexander C. “Immunosuppressive medications.” Clinical journal of the American Society of Nephrology: CJASN 11.2 (2016): 332. ↩︎

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Anuradha Saha

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