Managing scars

What is a scar?

Scars are areas of fibrous tissue that replace normal skin or other tissue after injury or surgery. Scarring is a natural part of the healing process of the body. No two scars are the same and each person’s scars heal differently. Your scar may be reddened at first and then settle down to become smoother and paler in colour. It can take up to 12-18 months after your injury or operation for a scar to heal.

A normal scar will become darker initially and after a period of time this will start to fade.  Dark scars can remain for years or indefinitely in people with darker skin.

How should I look after my scar following surgery?

  • Always wash your hands before touching your scar.
  • Pat dry your scar after a bath or shower.
  • Use a non-perfumed moisturising cream, preferably with vitamin E, to moisturise the skin surrounding your scar twice a day.
  • Avoid picking or scratching your scar.
  • Keep clothes loose around your scar to avoid tension or friction which may irritate it.

How can I help my scar to heal?

  • Eat a balanced diet

Eat a balanced diet, especially food rich in vitamins, minerals and protein, such as milk, yoghurt and green leafy vegetables. Also, try to drink at least eight glasses of water a day, unless otherwise advised.

  • Smoking is not advised

Smoking delays the healing process. Scars in people who smoke do not heal as well as those in people who don’t smoke.  

  • Protect your scar from sunlight

Your scar is very susceptible to strong sunlight and can burn easily, so please try to avoid exposing your scar to the sun.  You should use a very strong sun block (SPF 50 or higher) on your scar for 18 months after the injury/surgery that caused the scar.  Afterwards, a normal SPF 30 or higher should be used before going out in strong sunlight.  Apply it one hour before going outside and reapply it frequently and generously.  Wearing long-sleeved shirts and shorts will also give you some protection.  If you have facial scars, wear a hat to shade your face.

  • Exercise

Your doctors will advise you when it will be safe to resume exercise before you leave hospital. This also includes what type of exercises you need to take.

Massage your scar

Massaging may relieve itchiness and help to flatten the scar.  We advise the use of a non-perfumed moisturising cream as this will help reduce friction on your skin when you massage the area. 

What changes might I notice in my scar?

  • Scars can itch or tingle from time to time.
  • Scars go through a phase of becoming pinker or slightly red.
  • You may experience a little numbness in the area of the scar and in some situations this numbness may be permanent.

When should I seek medical advice?

  • If your scar is excessively swollen, red or painful or there is discharge or odour.
  • If your scar becomes quite raised and itchy.
  • If you are concerned about your scar.

     

Concealing your scar?

You can use cosmetic make-up or skin camouflage cream to disguise your scar, provided it is completely healed.  In hospital, you can ask to speak to the scar management clinical nurse specialist for advice.

Scar management and camouflage techniques

Scarring is an inevitable result of the natural healing process that occurs when the skin repairs itself after wounding. As noted above, the scar initially appears red and raised but will usually fade over time. In many patients it will flatten as it matures over a twelve to twenty four month period. 

Healing is a long process and unfortunately for some people, as the scar matures, it can become highly visible, especially if it is not managed appropriately. However timely and appropriate care can minimise its appearance. 

Management of scars is usually a staged process.  Once the wound is closed and healed, good scar management can involve:

    • Ensuring the scar is kept clean and well hydrated using a non-perfumed moisturiser.  This helps the scar from drying which causes increase itchiness and discomfort.
    • Massaging the wounded area. This can help reduce rigidity, desensitise the affected area and improve numbness.
    • Use of scar management products such as silicone sheets or gels. This helps in hydrating the scar.
    • A pressure garment can help at the initial stage of wound healing when the scar is hypertrophic (ie raised).
    • Use of sunscreen SPF 50+ is highly recommended to protect the scar from becoming permanently hyperpigmented (brightly coloured).
    • Use of water resistant camouflage products to help conceal the scar during the maturation period which is within 12 to 14 months. 
    • Scar management clinical nurse specialists advise patients on appropriate care and management, and can help with identifying the most suitable camouflage if this is required. Below are some examples of scars pre and post camouflage:

 

Information on this page has been provided by Flordelyn Selim, Scar Management Clinical Nurse Specialist, Royal London Hospital.