There are several treatment options available for managing and treating scars. Treatment recommendations will depend upon the preference of each physician, the origin of the scar, the location of the scar, the length of the scar, the Fitzpatrick skin type (the amount of skin pigmentation), and perhaps any prior history of unsatisfactory scarring.

The goal is obviously to obtain a scar that is flat, smooth, and fairly imperceptible. Raised or thickened scars that are within the margins of injury are called ‘hypertrophic’ scars. Raised or thickened scars that are excessive and extend outside the margins of the initial injury are called ‘keloid’ scars. Thinned or depressed scars are called ‘atrophic’ scars.

A scar begins ‘maturing’ about three weeks after the surgery. This maturation and remodeling process may continue for 9 – 12 months; and in a few situations it may take even longer. During the healing process it is normal for swelling to exist in, under, and around the skin closure. For several weeks, or even months, after surgery you may feel a “healing ridge” beneath the scar. This is swelling which is located within the tissue layers deep to the skin.

But excessive or prolonged swelling in a scar may lead to a hypertrophic scar. A common and simple way to manage swelling in a scar is to perform scar massage. The purpose of scar tissue massage is to reduce swelling within the scar, and to soften the skin adjacent to the scar so the area may heal optimally.  Repeated massage over time will help swelling resolve more quickly and may help prevent or minimize hypertrophic scarring.

Suggestions for scar massage are listed below:

  • Individuals may begin scar massage three weeks after their surgical procedure. This allows time for the initial soreness to subside, some initial swelling to resolve, and for the skin closure to become stronger and gain some integrity.
  • When performing scar massage directly on the skin/scar surface, lotion is used as a moisturizer and lubricant so the massage can be performed without friction. You may use any commonly available skin, hand, or body moisturizer.
  • If your doctor has recommended that you apply tape over your scar for an extended period, then the massage can be performed directly over the tape without the need for any lotion.
  • The silicone-based scar creams (BioCorneum+, Silagen, etc.) are not utilized for scar massage, but are meant to be placed on the surface of the skin. If you chose to use one of these products, perform the scar massage before applying the scar cream.
  • Scar massage is performed by using your index and middle fingers. Begin by firmly and systematically rubbing along the direction (the length) of the scar. It is important that you apply moderate pressure to the scar line to help reduce swelling within the scar.
  • This massage exercise should be performed consistently for five to ten minutes at a time, three times per day.
  • You may notice that the scar softens a bit following the massage. It is normal for it to become firm again, as the swelling returns, once you have completed the massage. Repeated massage, over weeks to months, will gradually help to reduce swelling and improve the appearance of the scar.
  • It is important to remember that the effectiveness of the scar massage probably depends more upon the method by which it is performed (i.e. depends more upon the massage itself), rather than the type of moisturizer used.
  • Scar tissue massage should be continued during the scar maturation process (for about 3 – 9 months depending upon the situation) until the swelling has resolved and the tissues feel soft and normal.
  • It is very important to protect the scar from sun exposure for 9 – 12 months after surgery. This will help reduce the risk of darker pigment (hyperpigmentation) forming within or adjacent to the scar.
  • Daily use of a broad-spectrum sunscreen (SPF 30) that blocks both ultraviolet-A and ultraviolet-B rays is recommended. For scars in sun-exposed areas, the sunscreen should be applied throughout the year for optimal protection. And, remember to reapply sunscreen often (at least every 2 hours) when active outdoors or swimming.
  • If scar massage does not appear to be reducing the thickness of a scar, speak with your plastic surgeon; other treatment alternatives such as topical silicone gel sheeting, pressure, and corticosteroid injections may be available.


If you questions about scarring or scar products give us a call at 414-443-0033 or 262-970-5600.