A surgical scar represents the body’s natural process of healing a deep incision by replacing normal tissue with new fibrous connective tissue. This process of tissue remodeling continues for many months, and the final appearance of the scar depends on proper care during this extended period. Once the stitches or staples have been removed and the incision is fully closed, the focus shifts from wound healing to scar maturation. Topical treatments and physical methods applied at this stage are intended to influence the new tissue structure, helping the scar become flatter, softer, and less noticeable over time.
Basic Care for a Healing Scar
The initial step in managing a newly closed surgical incision is creating an ideal healing environment through simple hydration. A moist surface is foundational for optimal scar development, helping the skin’s outer layer function more effectively. This protective barrier prevents the new, delicate tissue from drying out, which can lead to cracking, itching, and increased visibility.
Applying a thick, occlusive moisturizer, such as plain petroleum jelly or a simple, unscented cream, provides this necessary hydration. Application should begin as soon as the wound is completely sealed and any crusts or scabs have naturally fallen away. Using a moisturizing product twice daily supports the complex cellular activity as the scar begins its remodeling phase.
Silicone Treatments for Scar Improvement
Topical silicone is widely recognized as the non-invasive gold standard for managing and reducing the appearance of scars. Its effectiveness stems from creating a semi-occlusive layer over the scar, which regulates moisture and temperature. By reducing transepidermal water loss, silicone normalizes the hydration levels of the skin’s outer layer, the stratum corneum.
This improved hydration suppresses the overproduction of collagen that can lead to raised, thickened scars. Silicone products are available in two main forms: sheets and gels. Sheets are highly effective due to their continuous pressure and occlusion, and they are typically cut to cover the scar area precisely.
Silicone gels offer a practical alternative for areas like joints, the face, or uneven contours where a sheet may be difficult to secure. The gel dries to form a thin, flexible layer that provides the same occlusive barrier as a sheet. For either product type to be effective, it must be worn for an extended duration, generally between 12 and 24 hours per day, and treatment should be maintained for at least two to three months.
Evaluating Common Scar Remedies
Consumers often look to other popular products, but many lack the robust clinical evidence supporting silicone treatments. Vitamin E oil, for instance, is frequently applied to scars, yet scientific studies show minimal benefit for scar appearance. In some cases, applying pure Vitamin E can cause contact dermatitis or irritation, potentially hindering the healing process.
Creams containing onion extract are another common option, often marketed under well-known brand names. While some research suggests they may offer slight improvements in scar height or symptoms like itching, the results are mixed and inconsistent. These products primarily function as moisturizers, and any benefit is generally thought to be due to the hydration and massage involved in their application, rather than the active ingredient itself. Simple moisturizers like cocoa butter or cosmetic oils may feel pleasant, but they do not possess a proven mechanism to structurally alter collagen deposition within the scar tissue.
Protecting the Scar and Massage Techniques
Two physical actions complement any topical scar treatment: protection from ultraviolet (UV) radiation and direct massage. Exposure to sunlight is detrimental to a maturing scar, causing the new tissue to produce excess pigment, resulting in a darker, more noticeable scar (hyperpigmentation). A scar should be protected from direct sun for at least six to twelve months post-surgery, even on cloudy days.
The most reliable protection comes from applying a broad-spectrum sunscreen with an SPF of 30 or higher, or by physically covering the area. Scar massage uses mechanical force to influence the structure of the developing scar tissue. This should be initiated once the incision is fully healed, dry, and no longer tender to the touch, typically two to four weeks after suture removal.
The technique involves applying firm, direct pressure with a finger, moving the scar tissue in circular and back-and-forth motions. Performing this massage for five to ten minutes, twice daily, helps to break up and reorganize the dense collagen fibers. This practice improves the scar’s flexibility, reduces tenderness, and prevents the scar from adhering to underlying tissues.