• Reference Number: HEY1594/2025
• Departments: Physiotherapy, Therapies
• Last Updated: 30 September 2025

Introduction

Following an injury or an operation you might develop a scar. This leaflet explains how scars are formed and what you can do to help.

What is a Scar?

A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body.

How are scars formed?

Scars form because of the natural healing process of the skin. Sometimes, as a scar forms it becomes hard, red, raised and thick. It may adhere (stick) to underlying tissues and it may itch or be sensitive to touch.

Image source: St George’s University Hospitals NHS Foundation Trust

Scars which run across or close to a joint may limit movement (for example bending your wrist or fingers). Everyone’s skin is different, and some people are more prone to problems with their scars.

Scar Management

Scar massage is a treatment to improve the look of your scar and reduce any pain or soft tissue adherence (sticking). You will be given advice from your Hand Therapist on when to the start scar massage.

The following massage techniques can help to soften the scar tissue and make it flatter, paler and smoother. Use an un-perfumed moisturising cream or lotion (e.g. Aveeno, E45, Vaseline Intensive Care).

Image source: The Leeds Teaching Hospitals NHS Trust

• Start with small circles along the length of the scar either with your thumb or first two fingers.
• Begin with a light pressure, progressing to deeper and firmer pressure, as you can tolerate.
• Next, work vertically (up and down) along the length of the scar.
• Then work horizontally (left to right) across the scar, in small movements.
• Massage the scar and any tight or hard areas lying close to the scar.

You should do this for at least 10 minutes, 2 or 3 times a day.

It may take several months to achieve a flat and moveable scar. A scar can take up to 18 months to mature fully.

Stop massaging and contact your GP or Consultant if you experience any of the following: redness, bleeding, the scar feels warmer than the skin around it, more pain than usual at the site of the scar.

Sun Exposure

• Scars are extremely sensitive to sunlight.
• Exposure to the sun without sufficient protection will mean scars burn easily and could cause long term damage, darkening the scar which could be irreversible

We recommend a high factor sun cream both UVA and UVB protection on scarred areas for two years post injury and covering them with clothing where possible to increase the protection

Silicone Gel Therapy

Silicone can work well combined with treatments such as pressure, scar massage and other therapeutic methods in reducing the appearance of problematic scars.

Silicone gel/sheet may hydrate the scar tissue and reduce the production of collagen fibres. It has also been shown to reduce redness and to make the scar flatter, softer and paler. Your Hand Therapist will explain on how to use these and where to get the silicone products from. This will depend on the scar presentation.

What happens if I do not do anything?

Your scar could become hard and inflexible, or adhesions may form. Scars that cross a joint could stop you being able to bend or straighten the joint (a contracture). This may cause a deformity or may mean you have more limited movement which may affect the way you can use your hand.

Contact details:

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the following:

Hand Therapy Castle Hill Hospital Tel: 01482 622296 (Monday to Friday)

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.