A randomised, intra-individual, comparative study demonstrated that both qualitative improvements and significant changes in skin functional condition can be achieved in the tissue of older, mature scars. Four treatment modalities were studied in an intra-individual comparison involving 12 volunteers with 2.5 to 4-year-old scars. The treatments were: a self-adherent, hydroactive, polyurethane dressing alone; polyurethane plus compression; silicone sheeting plus compression; and compression alone. Evaluation criteria were changes in the microcirculation, roughness and the skin temperature of the scar tissue. All treatment modalities were found to have significant effects both on tissue function and scar tissue surface structure. The most pronounced effects were achieved with the combination of polyurethane dressing plus compression or silicone sheeting plus compression. The positive effect of the polyurethane dressing alone on scar tissue was even slightly superior to that of compression therapy alone.