Scars are a natural part of the body’s healing process after an injury, accident, or surgery. They form as the body works to repair damaged tissues, creating a visible mark that replaces the original skin. While many scars are often unnoticed and painless, discomfort associated with scar tissue is a common concern. This discomfort can range from mild irritation to significant pain, raising questions about why some scars hurt and what can be done to alleviate this sensation.
What Scar Tissue Is
Scar tissue forms as the body’s response to damage, repairing and closing a wound. It involves cells that lay down fibrous connective tissue, primarily collagen, at the injury site. Unlike original skin, which has a basketweave pattern of collagen fibers, scar tissue typically features collagen aligned in a single direction, making it less elastic and structurally different. This new tissue can form on the skin’s surface or internally, such as after surgery or in response to certain medical conditions. The amount of inflammation during healing influences how much collagen is produced.
Reasons Scar Tissue Can Cause Pain
Scar tissue can cause pain due to its distinct structure compared to healthy tissue. One common cause is nerve entrapment or damage, where nerves within or near the injury site become compressed or irritated by the forming scar. This can lead to sensations such as burning, tingling, numbness, or sharp, shooting pains. The body’s inflammatory response during healing can sometimes persist, leading to ongoing inflammation within the scar tissue, contributing to pain, swelling, and tenderness.
Excessive tension or tightness within the scar also causes discomfort. Scar tissue is less elastic than normal skin, and when it forms over joints or large areas, it can restrict movement and pull on surrounding tissues, causing a pulling or tugging sensation. This tightness can also impede circulation and lymphatic drainage, causing a buildup of pain-inducing chemicals. Specific types of scars, such as hypertrophic scars and keloids, are also prone to pain. These scars result from an overproduction of collagen, causing them to be raised and often itchy, tender, or painful.
When to Be Concerned About Scar Pain
While some discomfort can be part of the healing process, certain signs indicate that scar pain warrants professional medical attention. Increasing pain over time, especially if it worsens rather than improves, is a concern. Sharp, shooting pains, persistent numbness, or tingling sensations around the scar could suggest nerve involvement or damage.
Signs of infection, such as increasing redness, warmth, swelling, pus or discharge from the scar, or a fever, demand immediate medical care. If scar pain restricts range of motion or interferes with daily activities like sleeping, working, or moving freely, seek a healthcare professional’s opinion. These symptoms suggest the scar may be impacting underlying structures or its healing is not progressing as expected.
Approaches to Managing Painful Scars
Managing painful scars often involves a combination of at-home care and medical interventions, tailored to the scar and pain experienced. Regular scar massage can help loosen adhesions, improve tissue flexibility, and reduce tension within the scar, lessening pain and improving circulation. Stretching exercises are also beneficial, particularly for scars that restrict movement, enhancing the scar’s resilience and integrity. Silicone sheets or gels are a common non-invasive approach, hydrating the scar tissue and regulating collagen production to soften the scar and reduce discomfort, itching, and redness.
For more persistent or severe pain, medical interventions may be considered:
Corticosteroid injections directly into the scar can reduce inflammation, break down excess collagen, and alleviate pain and itching, particularly in hypertrophic scars and keloids.
Laser therapy can improve scar appearance and reduce symptoms by targeting blood vessels and promoting collagen remodeling.
Surgical revision may be an option to remove painful scar tissue or release nerve entrapments.
Nerve blocks, injecting an anesthetic near affected nerves, can provide temporary pain relief for nerve-related scar pain.
Consulting with a healthcare professional can help determine the most appropriate treatment plan.