How to Reduce Scar Tissue After Surgery

After any surgery,  most people’s priority is a smooth recovery to total health and functionality.

Scar tissue — what seems like a cosmetic concern — is often a secondary priority during surgery prep and recovery. However, scar tissue can sometimes become more than a cosmetic concern. Taking some basic steps during recovery can help you minimize scar tissue.

Learn about scar tissue reduction from the experts at Alexander Orthopaedics to ensure that scar tissue doesn’t affect your mobility — particularly if you’ve had surgery on a key joint such as your knee or ankle.

What Causes Surgical Scar Tissue?

Surgical scar tissue is a natural part of the body’s healing process after surgery. When a surgical incision is made, the body goes into repair mode. It sends fibroblasts, special cells, to the area to produce collagen, a protein that helps rebuild tissue.

Collagen gives scar tissue its strength, but sometimes, too much collagen is produced or laid down in a disorganized way, leading to more pronounced scar tissue.

Different Types of Scar Tissue

While most scars fade over time, different types vary in appearance and texture. Here’s a breakdown of some of the most common types of scar tissue.

Keloid

Keloid scars are raised, red, and often itchy scars that grow beyond the original wound. They are caused by an overproduction of collagen during the healing process. Keloids are more common in people with darker skin tones.

Hypertrophic Scars

Similar to keloid scars, hypertrophic scars are also raised and red. However, unlike keloids, they stay within the boundaries of the original wound and tend to flatten and fade over time.

Atrophic Scars

Atrophic scars are pitted or sunken scars. They occur when the body doesn’t produce enough collagen during the healing process, resulting in a loss of tissue that leaves an indentation in the skin.

Scar Contractures

Scar contractures occur when elastic tissue is lost due to a deep wound, burn, or surgical incision. As the scar tissue heals, it contracts and tightens the skin, limiting movement in the affected area. This can lead to functional limitations, such as difficulty bending a joint or closing an eye.

Adhesions

Unlike other scars on the skin’s surface, adhesion scars form internally, connecting organs or tissues that aren’t usually attached. They can develop after surgery or inflammation and may cause pain or organ dysfunction.

Common Areas for Post-Surgical Scar Tissue to Develop

Scar tissue can develop anywhere on the body where a surgical incision has been made. However, some areas are more prone to excessive scar tissue.

Joints

The knees, shoulders, hips, and elbows are all common sites for scar tissue formation after surgery. This is because these areas move frequently, and the constant motion can irritate the scar tissue and cause it to grow thicker.

Upper Torso

The upper torso, including the chest and back, is another common area for scar tissue formation. This is because the skin in this area is under a lot of tension, which can pull on the scar and make it more noticeable.

Abdomen

The abdomen is a common site for surgery, and scar tissue can also form there. However, abdominal scars tend to be less noticeable than scars in other areas of the body.

Risk Factors for Developing Scar Tissue After Surgery

A number of factors can influence how much scar tissue forms after surgery, including the size and location of the incision, the type of surgery, the patient’s age and overall health, and genetics. In addition, younger people tend to form more scar tissue than older adults, and people with a family history of keloids are more likely to develop them. Infection, inflammation, and tension on the wound can also contribute to scar tissue formation.

Can Scar Tissue Cause Pain or Other Problems?

While generally people think of scar tissue as cosmetic, it can cause pain and other problems in some cases. Scar tissue can be painful for a few reasons. It might be tight and restrict movement, causing discomfort. Nerves can also get trapped in scar tissue, leading to a burning or aching sensation. Additionally, scar tissue may be hypersensitive, making the area tender to the touch.

Scar tissue can also be stiff and inflexible, limiting your ability to move a joint through its full range of motion. This can be particularly problematic after surgeries around joints like the knees, shoulders, or elbows.

It’s important to note that not everyone experiences these problems with scar tissue. Some injuries or wounds heal smoothly and cause no issues. However, if you’re concerned about scar tissue pain or limitations, talk to your doctor.

How Long Does It Take for Surgical Scars to Fade?

A surgical scar typically takes 6 to 18 months to mature and reach its final appearance fully. The scar will gradually become flatter, softer, and paler during this time.

Initial Stage (First 3 Months)

Right after surgery, the scar will likely be red, raised, and possibly itchy. This is a normal part of healing.

Maturation Stage (3 Months to 18 Months)

Over the following months, the scar tissue will remodel and soften. Generally, the redness will fade, and the scar will become flatter and less noticeable. If your scar tissue is causing pain or limiting mobility during this phase, consider treatment for reducing scar tissue.

Treatment Options for Reducing Scar Tissue After Surgery

While there is no way to prevent scar tissue formation completely, steps can be taken to minimize it. During the initial recovery period, keep the area clean, moist, and protected from the sun. Read on for more options for reducing scar tissue.

At-Home Scar Tissue Treatments

• Silicone gel can be applied to scars to keep them hydrated and reduce scar formation. Look for gels that contain silicone dioxide as an active ingredient.
• Sun exposure can darken scars, so it’s important to protect them from the sun with a broad-spectrum SPF 30 or higher sunscreen every day.
• Keeping your skin hydrated can help improve the overall appearance of scars. Look for a gentle, fragrance-free moisturizer on your skin and apply it consistently.

Medical Treatments for Scar Tissue

• Corticosteroids can be injected into raised scars, such as keloids and hypertrophic scars. These injections help reduce inflammation and scar size.
• Cryotherapy involves freezing the scar tissue with liquid nitrogen to flatten and soften it. Cryotherapy is most effective for more minor scars.
• Different types of laser treatments can also be used to target scar tissue. Fractional lasers create microscopic injuries in the skin, triggering collagen production and potentially improving scar texture. Vascular lasers target redness associated with scars.

Surgical Treatments for Scar Tissue

Surgery offers a more invasive approach to scar tissue treatment, particularly for severe scars that significantly impact appearance or mobility.

• Scar Excision: This surgery directly removes the scar tissue. The doctor then closes the wound with stitches using various techniques, depending on the size and location of the scar.
• Skin Grafting: When not enough healthy skin is left near the scar for closure after excision, a skin graft may be necessary. This involves taking a thin layer of skin from another area of your body (donor site), typically the buttocks, thighs, or behind the ear, and transplanting it to the area where the scar was removed.
• Z-plasty and W-plasty: These techniques involve strategically cutting the scar tissue in a Z or W pattern and then rearranging the skin flaps to create a zig-zag closure. This can improve the scar’s appearance and make it less noticeable, particularly for linear scars that limit movement in areas like joints.
• Contracture Release: Surgery may involve releasing the tight scar tissue for contracture scars that restrict movement. This can improve flexibility and range of motion in the affected area. Skin grafts or tissue expanders might sometimes be used with contracture release surgery.

Surgical scar revision isn’t always the first-line treatment. Doctors typically recommend it when the scar is causing significant functional problems, like limited movement, or if it is very large or raised, causing a major cosmetic concern.

What Are the Risks of Scar Treatment Procedures?

Generally, at-home remedies like silicone gel and moisturizer are well-tolerated with minimal risks. However, if you have sensitive skin, itching or irritation could occur.

Some side effects are possible for medical scar treatments. Corticosteroid injections have the potential side effect of thinning or lightening the skin around the injection site. Cryotherapy can cause blistering and nerve damage. Laser treatments can cause redness and swelling.

Surgical interventions carry the same risks as any surgery, including infection, bleeding, and anesthesia complications. Discuss the risks and benefits with your healthcare professional if you’re curious about scar reduction options but unsure what is right for you.

When To See a Doctor for Scar Tissue

If you experience significant pain or a reduced range of motion around the scar tissue, it’s important to consult a doctor. They can assess the situation and recommend treatment options to manage pain and improve mobility.

If your scar is growing larger or becoming increasingly raised and red, especially beyond the initial healing stages (weeks to months after surgery), consult a doctor. This could indicate a keloid scar, which may require specific treatment.

While not a medical issue, some people find scar tissue to be very bothersome cosmetically. If you’re self-conscious about your scar, a doctor can discuss scar revision options.

Remember, it’s always best to err on the side of caution and consult a doctor if you have any concerns about your scar tissue. Early intervention can help prevent complications and improve your overall healing process.

How to Reduce Scar Tissue After Surgery FAQs

How Can I Minimize the Appearance of a Scar?

First, ensure that your wound or incision site stays clean. Infection and inflammation can exacerbate the development of additional scar tissue. After initial recovery, keep the area moisturized and apply sunscreen daily (sun exposure darkens scars).

In addition to these basic steps, you can consult with your doctor to discuss more robust scar-reduction treatments, such as the medical and surgical options detailed above.

Can Vitamin E Remove Scars?

There’s no strong evidence that vitamin E applied directly to scars helps with removal or fading. While not directly minimizing scars, vitamin E may offer some benefits as part of a general scar management routine since keeping the area moisturized can reduce scar formation.

Should You Massage Scar Tissue?

Massaging scar tissue can be beneficial, but it’s not guaranteed to reduce or minimize all scar tissue, so manage your expectations. However, massage can improve mobility by helping to break down scar tissue adhesions, improving range of motion and flexibility. Massage can also help improve blood flow to the area, promoting healing and reducing pain.

Waiting until the scar has fully healed before starting massage therapy is essential. Typically, this means waiting at least 2-3 weeks after surgery. Massaging a fresh scar can irritate it and potentially worsen scarring.

Keep in mind that not all scars benefit from massage. Massage can stimulate keloid scars (raised, thick scars) to grow larger. It’s always best to consult your doctor or a physical therapist before starting scar massage.

Worried About Your Post-Surgical Scar Tissue? Contact Alexander Orthopaedics!

If you’re having issues with post-surgical scar tissue, consult the experts at Alexander Orthopaedics to learn about your options. Schedule an appointment today.