Scar massage information

What is a scar?

Scarring is part of the body's natural healing process after tissue is damaged through surgical cuts or injuries.

When the skin is injured, our bodies produce a protein called collagen which builds up where the tissue is damaged, helping to heal and strengthen the wound.

New collagen continues forming for several months and the blood supply increases, causing the scar to become raised and lumpy.

In time, some collagen breaks down at the site of the wound and the blood supply reduces. The scar will usually become gradually smoother and softer.

Although scars are permanent, they can fade over a period of up to 2 years. It's unlikely they'll fade any more after this time.

Your age and skin type may also affect how a scar forms and behaves.

Scars develop both on and below the skin. Scarring below the skin can adhere to underlying structures such as muscles and joints which are called adhesions. These effect the flexibility and mobility of the structures in all the layers affected.

How to massage my scar

1. You should start scar massage when your wound is completely healed which is usually around 4 weeks post-injury or surgery.
2. Wash and dry the area with soap to rinse off any previous moisturiser. This is to stop the pores of the skin becoming clogged.
3. Apply a small amount of moisturiser to the area – an oil-based cream is best for example E45 cream.
4. Use the pads of two fingers or your thumb to massage the scar and tissue around the scar. Massage using a slow, circular motion so that the skin moves on the underlying scar tissue.
5. Next, massage side to side across the scar, followed by up and down the length of the scar. Repeat this over the entire scar.
6. You should apply as much pressure as you can tolerate. Begin with light pressure and progress to deeper and firmer pressure.
7. You should massage your scar regularly- at least 2-3 times a day and for 5 minutes at a time. You should continue this for approximately 6 months until the scar has fully matured.

Why should I massage my scar?

Scar tissue may become hard and raised. Massage is a way of softening and flattening scars and reducing the adhesions between the different layers of the tissue, making the scar tissue more flexible. It can also help alleviate any itching and over-sensitivity of the scar.

Your scar may continue to change for up to 2 years, so early and regular scar massage will help reduce the chance of long-term problems.

Precautions

• Do not massage open wounds
• Do not rub skin to cause friction
• If your skin becomes sore or inflamed, blisters or reopens, or your skin develops a rash, stop massaging and seek from your GP practice or the plastic surgery unit (01223 348509)

Sun protection

While your scars are healing, you should avoid sun exposure. Sun exposure may cause your scars to hyper-pigment, or turn darker than the surrounding skin. You should use sunscreen with an SPF of 30 or greater and wear protective clothing at all times. Keep your scars away from the sun for at least one year following your surgery.

Silicone gels or sheets

Some research suggests that silicone creates a protective barrier over the scar which allows it to mature while helping to prevent production of excess scar tissue. This helps to soften and flatten the scar. The silicone layer also assists with hydration of the scar therefore helping to relieve itching and discomfort.

To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day for at least 3 months. They can be washed and reused.

These can be purchased from most pharmacies or on-line.

Where can I find more information?

• British Skin Foundation (opens in a new tab)
• BAHT (British Association of Hand Therapists) (opens in a new tab) • www.hand-therapy.co.uk (opens in a new tab)
• The Scar Free Foundation (opens in a new tab)
• NHS Website (opens in a new tab)
• Katie Piper Foundation (opens in a new tab)
• Kelo-Cote Silicone Scar treatment (opens in a new tab)

Contacts

Please email plastic surgery unit or call 01223 348509 for further help.