Scar tissue forms as the body repairs damaged skin, resulting in fibrous tissue that can differ in texture and appearance from surrounding skin. This article explores various at-home and medical methods to soften scar tissue and improve its flexibility.
What is Scar Tissue?
Scar tissue develops when the body repairs a wound, replacing damaged skin with new connective tissue. This process involves fibroblasts that produce collagen, a protein providing strength and structure, to reconstruct the skin. Unlike the organized “basketweave” pattern of collagen in healthy skin, scar tissue collagen often forms haphazardly.
Some scars become firm or raised due to an excessive production of collagen during healing. Hypertrophic scars are thickened, raised scars that remain within the boundaries of the original wound. They can result from factors like infection, increased tension on the healing wound, or burns. Keloid scars, on the other hand, represent an overgrowth of scar tissue that extends beyond the original wound margins and typically do not regress on their own. Both hypertrophic and keloid scars are characterized by excess collagen, making them feel firm or hard.
Methods for Softening Scars at Home
Gentle massage can soften scar tissue once the wound has fully closed. Massaging the scar helps to remodel the collagen fibers, improving flexibility. Specific techniques include circular motions, moving the skin and tissue under the scar, and linear motions along the scar. Apply enough pressure to feel the scar move beneath your fingertips, but avoid causing pain, and aim for 5 to 10 minutes of massage two to three times daily for several months.
Silicone sheets and gels create a moist environment, which hydrates the scar tissue and regulates collagen production. A reduction in scar thickness and improved pliability can result. Silicone products should be applied to healed skin for 12 to 24 hours daily over several months.
Many scar creams contain ingredients that soften and hydrate the skin, reducing scar texture and redness. Common ingredients include allantoin, which supports healing through hydration and anti-inflammatory properties, and vitamin E, known for softening skin. Onion extract is another ingredient found in scar creams, though some studies suggest less impact on scar appearance compared to other methods. Always perform a patch test with new products to check for skin sensitivities.
Keeping scar tissue well-moisturized is important. Moisturizers increase the water content, making the skin smoother and improving scar pliability. Hydration can also help reduce itching and discomfort often associated with healing scars. Simple, fragrance-free moisturizers like petroleum jelly can be effective in preventing dryness and supporting healing.
Protecting scars from the sun is important as UV exposure can worsen their appearance and texture. Fresh scars are vulnerable to UV light because they lack the normal levels of melanin. Sun exposure can lead to hyperpigmentation, causing the scar to become permanently darker and potentially thicker. Applying a broad-spectrum sunscreen with an SPF of at least 30, and reapplying every two hours, helps prevent discoloration and aids in the healing process.
Medical Approaches to Scar Softening
For more stubborn or severe scar tissue, medical interventions can offer additional softening effects.
Corticosteroid Injections
Corticosteroid injections, such as triamcinolone, are used for raised scars like hypertrophic scars and keloids. These injections reduce inflammation, suppress excessive collagen production, and break down collagen fibers, which helps to flatten and soften the scar. Injections are administered directly into the scar every few weeks until the desired flattening is achieved.
Laser Therapy
Laser therapy improves scar texture and flexibility. Different lasers target the skin’s damaged tissue, stimulating the production of new, more organized collagen. Fractional ablative lasers, for instance, create microscopic channels in the scar, prompting the body to replace dense scar tissue with more typical skin. This can lead to a smoother texture and increased elasticity, and some patients report reduced pain and improved movement after treatment.
Cryotherapy
Cryotherapy involves applying extremely cold temperatures, typically using liquid nitrogen, directly to the scar tissue. This process freezes and damages the cells that produce collagen, thereby reducing collagen production and the overall volume of the scar tissue. Cryotherapy is used for raised scars like keloids and hypertrophic scars, leading to their flattening and softening over time.
Dermal Fillers
Dermal fillers are used for atrophic, or indented, scars. While not directly softening the scar tissue itself, fillers raise the depressed area to blend with the surrounding skin. This can indirectly improve the feel and contour of the area, making the scar less noticeable to the touch. The goal is to create a smoother surface that integrates better with the surrounding skin.
Surgical Revision
Surgical revision is an option for severe cases when other methods have not yielded sufficient improvement, particularly for scars that restrict movement or cause significant discomfort. This procedure involves removing the existing scar and carefully rejoining the skin edges to create a less prominent or more flexible scar. The aim is to restructure the tissue, potentially leading to a softer and more functional outcome.
When to Seek Expert Advice
Consult a doctor or dermatologist if a scar causes pain, itching, or restricts movement, as these symptoms can indicate underlying issues that require professional assessment. Seek expert advice if a scar begins to grow, changes color, or shows any signs of infection, such as increased redness, swelling, warmth, or pus. If home treatments do not lead to improvement after consistent application for several weeks or months, a healthcare professional can evaluate the scar and recommend more aggressive or specialized treatment options.