Hand Therapy – Scars

What is a scar?

All wounds and surgery will cause a scar to develop. Scars form as a result of the body’s normal healing process. Within 2 to 3 days of the skin being injured, a scar tissue will begin to fill the injured area in order to close the wound. Scar tissue can continue to develop over many weeks or months.

How does a scar mature?

Soon after the wound has healed the scar will normally be red, hard and raised. It takes between 3 months and 2 years for the scar to become paler, flatter and softer. The complete process of scar healing can take up to 2 years.

What can I do to help my scar?

The easiest way to help improve both the appearance and feel of your scar is to massage it as soon as it is healed.

Why should I massage my scar?

• Scar tissue may become hard and raised. Massage can help to soften and flatten the scar tissue.
• Scar tissue may stick to underlying tissues such as tendons and nerves. Massage can help to prevent this from happening and keep your scar tissue flexible.
• Scars can feel sensitive, tender or tingly when touched. Regular massage can help reduce this.

How do I massage my scar?

You should start to massage your scar as soon as your wound is fully healed using a non-perfumed cream such as E45 or aqueous cream.

Place your finger or thumb tip on the scar. Use a small, slow circular motion so that the skin moves over the underlying tissue. Your fingertip should change colour from pink to white if you are using the correct pressure.

Scar massage should be done 4 times a day for 5 minutes each time.

What if my scar feels sensitive?

Sometimes after an operation or a wound to the skin, the area can become sensitive, tender or tingly. This is usually the result of over active nerve endings near the injury or surgery site. This is common and there is nothing to worry about.

How can I make my scar less sensitive?

In order to improve the sensitivity of your scar you can use a technique called desensitisation. The desensitisation can be uncomfortable or painful to start with but it is important you persevere with them.

Massage

Continue to massage your scar as previously discussed. You may need to start gently and gradually increase the pressure.

Once you can tolerate massaging your scar, begin to gently tap the area.

Texture

• Use a variety of different textures (for example smooth, fluffy, rough – cotton, wool, silk, flannel etc.) and work out the order of which texture causes the least discomfort and which causes the most.
• Begin with the texture that causes you the LEAST discomfort.
• Gently rub the texture around the area moving towards the most sensitive part. Ensure that the texture is in constant contact with the skin. Try to resist the urge to lift it away from the skin when you get pain. Continue to rub it over the area for 5 minutes or until it no longer feels sensitive.
• Return to using the same texture later in the day, continue with the same texture until it no longer causes abnormal feelings, then move on to the next texture which causes slightly more discomfort and repeat.
• It may take a few sessions until you are able to move onto the next texture.

Immersion

• Fill a number of bowls with particles of varying texture e.g. dry lentils, dry rice, dry pasta, sand etc.
• Create an order as before – most comfortable to least comfortable. Place your hand in the bowl that causes the least discomfort and move it around in various speeds and directions.
• Once the particles become tolerable move onto the next.

Vibration

Vibration is also effective in treating hypersensitivity.

• Use the head of an electric toothbrush or shaver to apply gentle pressure over the scar for 5 minutes or until the pain reduces.

Function

It is important to use your hand in the normal functions for your normal daily activities as soon as you are able. Try to concentrate on including the affected part in your normal activity by not avoiding using it, as this can continue to make your hypersensitivity worse.

Contact Details

Please contact the Hand Therapy Team if you have any concerns or questions or if your splint is uncomfortable, rubbing or is damaged.

North Tees and Hartlepool NHS Foundation Trust:

Hand Therapy Team
Telephone: 01429 522471
Monday – Friday 08:30 a.m. – 04:30 p.m.

North Tees Hospital
1^ST Floor, Hand Therapy, North Wing

Hartlepool Hospital
Ground Floor, Physiotherapy Outpatients Department.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

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Telephone: 01642 383551

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Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]