Queensland Health
Scar management
Looking after your scar.
What is a scar? It can take up to two years for a scar to
mature. Scar management can be helpful
Scar tissue forms after there has been an
during this time. Please watch your scar
injury or cut to you skin. First you will have a
closely for at least three months for any
wound. As your wound heals your body will
signs of a problem scar.1
make new scar tissue that will change to
form mature scar tissue.3
How can I prevent a problem scar?
Signs of a mature scar: Everyday wound and scar care can help to
• pale in colour prevent a problem scar from developing.
• flat and evenly contoured • keep your wound clean to avoid
• soft and mobile infections
• non-itchy • avoid too much skin tension (pulling on
• doesn’t restrict movement your skin) around your wound
• is acceptable in appearance. • maintain a healthy diet
• do not smoke
What is a problem scar? • manage swelling1,3
Approximately 15 per cent of patients have Age, ethnicity and some health issues can
problem scars after surgery.1 increase your risk of developing a problem
scar. You should have your scar assessed
Characteristics of a problem scar can be:
early if you think you are at risk.
• red, pink or purple in colour
• raised and uneven
• thick and/or stuck
• itchy or sensitive
• restricts normal movement.
Scar management
What should I do if I develop Silicone
problem scar tissue? Silicone scar products include gel sheeting,
If you notice signs of a problem scar, it is spray or a liquid gel applied directly to
important to have it checked by a health the problem scar. There is mixed evidence
professional. An occupational therapist will for the use of silicone scar products in
be able to talk to you about the best way to preventing problem scars. However, recent
look after a problem scar. studies show there may be some benefit in
reducing itching, maintaining hydration and
Skin care softening thickened problem scars.1 These
Studies show moisture evaporates more products are recommended for use for at
quickly from scar tissue. Moisturising your least 12–24 hours per day for a minimum
scar regularly can help to reduce itching two month period, and should not be
and maintain hydration of scar tissue. Sun started for at least two weeks after a wound
protection is important to prevent excess is healed.2
pigmentation in a scar.4 Avoid exposing It is important to have your scar assessed
your scar to sunlight and use a sunscreen by your health professional prior to
with a high sun protection factor until the commencing silicone scar products. You
scar has matured.1 must also monitor for any reactions or side
effects (e.g. skin rash, infection).2
Massage
Research studies are inconclusive; Exercise and stretching
however, many people report scar There is no specific evidence that looks
massage helps to reduce itchiness, pain at the impact of stretch and exercise on
and sensitivity of a scar. Massage may problem scars. Current expert opinion
improve skin movement around the scar is that maintaining normal movement is
and may even improve your mood. Ask your important for maximising function and
occupational therapist to check that your reducing the impact of problem scars. It is
wound is ready for scar massage before you important not to stretch a fragile wound.
start. Your therapist can show you how to Make sure you check with your occupational
massage your scar.7 therapist which exercises and stretches are
best for you.
Taping
Too much skin tension may lead to a Compression
problem scar. Taping over your scar may Mechanical compression (compression
be useful to control skin tension. This can garments) are shown to reduce problem
be helpful from two weeks to three months scar formation by controlling the amount of
after your wound is healed. Always have oxygen and nutrients delivered to the scar.2
your wound assessed by your occupational For some types of scars, compression can
therapist before you start using tape.1,2,4 be considered useful to start up to three
An initiative of the Occupational Therapy Cancer Collaborative | Page 2
Scar management
months after wound healing.1 Check with References
your health professional to find out your 1. Monstrey, S., E. Middelkoop, J. J. Vranckx, F.
recommended wear program which can be Bassetto, U. E. Ziegler, S. Meaume and L. Teot
gentle compression (20–40mmHg) for up to (2014). “Updated scar management practical
guidelines: non-invasive and invasive measures.”
23 hours per day for 6–24 months.2 Journal of Plastic, Reconstructive & Aesthetic Surgery
67(8): 1017-25.
Camouflage 2. Arno, A. I., G. G. Gauglitz, J. P. Barret and M. G.
Jeschke (2014). “Up-to-date approach to manage
Some scars may never develop to look like keloids and hypertrophic scars: A useful guide.”
normal tissue. Camouflage techniques can Burns 40(7): 1255-1266.
be useful to disguise scars and make them 3. Kerwin, L. Y., A. K. El Tal, M. A. Stiff and T. M.
less obvious to the eye. Fakhouri (2014). “Scar prevention and remodeling:
A review of the medical, surgical, topical and light
Techniques include: treatment approaches.” International Journal of
Dermatology 53(8): 922-936.
• make up in a shade/colour to hide 4. Gold, M. H., M. McGuire, T. A. Mustoe, A. Pusic, M.
unwanted appearance of scars Sachdev, J. Waibel and C. Murcia (2014). “Updated
international clinical recommendations on scar
• clothing or accessories that cover the management: Part 2 - Algorithms for scar prevention
scar (e.g. scarf, hat or jewellery) and treatment.” Dermatologic Surgery 40(8):
825-831.
• hairstyling
5. Sidle, D. M. and J. R. Decker (2011). “Use of
• facial prosthesis5 Makeup, Hairstyles, Glasses, and Prosthetics as
Adjuncts to Scar Camouflage.” Facial Plastic Surgery
Extra techniques Clinics of North America 19(3): 481-489.
6. O’Brien, L. and D. J. Jones (2013). “Silicone gel
Scar tissue should start to respond to the sheeting for preventing and treating hypertrophic
techniques listed within this brochure and keloid scars.” Cochrane Database Syst Rev 9:
within six months of starting them. If CD003826.
you have a lot of problem scarring that 7. Shin, T. M. and J. S. Bordeaux (2012). “The role of
massage in scar management: a literature review.”
does not respond to the techniques Dermatologic Surgery 38(3): 414-23.
above then other measures may need to
be considered.1 This can include laser,
corticosteroid injections, botulinum toxin
injections, surgical revision, radiotherapy
and other drug therapies. A referral to a
medical professional qualified to use these
techniques is required.2,4
Please note the information contained
in this brochure should be taken in
QH548 6/15
consideration of advice and education from
a qualified occupational therapist. Printed
copies are uncontrolled.
Acknowledgements: Princess
Alexandra, Cairns and QE II
Hospitals.
Issue date: April 2015
Review date: April 2018 An initiative of the Occupational Therapy Cancer Collaborative | Page 3
