Because using scarred extracts result in a cost of 400coins for each rune crafted, it is not recommended to use extracts as a means of making money; rather, it is intended for ironman players who plan to use the runes for themselves.
When used in combination with a blood essence, their effects stack additively: both the essence and the extract will act on the base number of blood runes crafted.[1]
Scarred extracts can be used at either the traditional runecrafting altars, or at the Zeah blood or soul altars.
If players happen to make too many extracts, they can be refunded for 90% of their original cost by taking them to Hagus in the Scar.
Concept art for various features of the Scar essence mine.
References
^Jagex. Mod Ash's Twitter account. 1 November 2023. Archived from the original on 1 November 2023. Mod Ash: "Its devs tell me it works "additively", i.e. the scarred extract acts on the *base* number of runes crafted, rather than the number after the blood essence boosted it."