In short. Sun, friction, picking and hard massage, set against the short list of measures that have real support behind them for a maturing scar.
Key points
- Silicone in gel or sheet form, pressure where the site suits it, protection from the sun, keeping the skin supple, and keeping a joint moving when a scar crosses it.
- These are the measures started during maturation, and they are started early because they work with the healing rather than against it.
- None of them produces a change that is visible in a week.
A maturing scar is being rebuilt continuously, and what happens to it from the outside is part of what it becomes. Some of that influence is well understood and some of it is asserted far more confidently than the evidence allows. This page separates the measures with support behind them from the things that keep an irritable scar irritated.
What makes a raised scar worse
Sun exposure is the clearest. Ultraviolet light on healing or newly formed skin provokes pigment and can deepen a redness that was already fading, and it is the one factor a patient controls entirely. Friction and repeated rubbing come next: a waistband, a strap, a belt, a bag strap, or a seam sitting directly over the scar. Picking, scratching and firm massage all irritate or reopen the surface and add inflammation to tissue that is already inflamed. An area that is allowed to become dry cracks and itches, which starts the scratching.
The list of things that help is short and unglamorous
Silicone in gel or sheet form, pressure where the site suits it, protection from the sun, keeping the skin supple, and keeping a joint moving when a scar crosses it. These are the measures started during maturation, and they are started early because they work with the healing rather than against it. None of them produces a change that is visible in a week.
What has support behind it
Silicone, as a gel or a sheet, is the most widely used measure for a maturing scar and has the longest record behind it. Pressure, applied through a garment or a dressing, is used where the site allows it and where the scar is raised and firm. Sun protection is not optional, whichever of the others are used. Gentle massage, if the treating team advises it, is massage rather than rubbing, and it is used to keep the scar mobile over the tissue beneath it. Where a scar is keloid in behaviour or is still growing, an injection into the scar may be used, and that is a decision made at an assessment rather than at home.
What is sold but not supported
A large market exists for creams, oils and preparations that claim to make scars disappear. Most have very little behind them; some irritate the skin and make itching worse; and none removes a scar, because a scar is permanent. Vitamin preparations applied to the skin, botanical extracts and pleasant-smelling oils are not harmful in themselves if the skin tolerates them, but they are not a substitute for the measures above, and they are not a substitute for having a scar that is growing or tightening looked at.
Stop, and get the scar seen, if
- Redness is spreading, or the scar is hot, swollen or discharging — seek care the same day.
- It is growing beyond the original wound, or a lump within it is enlarging.
- It is bleeding, ulcerating, or becoming more painful rather than less over time.
Frequently asked questions
Does silicone actually help a raised scar?
It is the most widely used measure for a maturing scar and the one with the longest record behind it, in gel and in sheet form. It is used over weeks and months rather than days, and alongside sun protection rather than instead of it. Whether it suits a particular scar is a decision for the treating team.
Is massage good for a scar?
Gentle massage is sometimes advised, to keep a scar mobile over the tissue beneath it. Firm rubbing is a different thing and is not: it irritates a scar that is still building, and irritation is what a raised scar is made of. If your team has not advised massage, this is not the moment to add it.
Why does my scar itch more when it is dry?
Dry skin itches, and a maturing scar is often dry because its surface and its oil glands have not fully recovered. Moisturising the scar and the skin around it reduces the itch, and reducing the itch reduces scratching, which is one of the more common ways a patient makes a scar worse.
Risks & Limitations
- A scar is permanent. Maturation changes its colour, height and firmness over twelve to eighteen months, not its existence.
- A raised scar is usually uncomfortable rather than dangerous, which is why the small number of findings that are dangerous are named individually.
- Maturation is slow, and a scar often looks worse at six weeks than it will at six months; judging it early means judging a moving target.
- Treatment can improve a scar but cannot remove it, and a further operation trades one scar for another arrangement rather than undoing the first.
- A keloid grows beyond the original wound, does not settle on its own, and tends to recur after it is removed.
When to Seek Care
- A scar growing beyond the edges of the original wound, or a lump within it that is enlarging — have it assessed within days.
- Redness with heat, swelling or discharge in the scar, or a fever — seek care the same day.
- A wound that has opened, or a gap appearing along the scar — seek care the same day.
- A scar tightening across a joint, or pulling on an eyelid or a lip — prompt assessment.
- A scar that has started to bleed or ulcerate — urgent assessment.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — guidance on scar revision and surgical wound care
- National Institute for Health and Care Excellence (NICE, UK) — guidance on surgical scars and wound management
- Cochrane Library — systematic reviews of scar management
- American Academy of Dermatology (AAD) — guidance on keloids and hypertrophic scars
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.