It is estimated that around 60% of people diagnosed with cancer will have surgery, and 50% will have radiotherapy as part of their treatment plan. Advice about how to take care of your scar should be given after any surgery so that you know what to do to support healing in the early days and until the scar matures. Sadly, scar management support is not always provided and can be difficult to find.
In this article we will talk about scar tissue formation as the bodies response to tissue injury and how you can take care of your scar yourself and also how Scar Tissue Relief as a mode of therapy can help.
Advice provided in this blog post is not intended replace any medical advice you have been given.
Understanding Scar Tissue Formation
After surgery scar tissue is formed as part of the body’s healing process. Extra collagen fibres are laid down during the healing process in an attempt to create stability in the body after injury. The density of collagen fibres in scar tissue is greater than other areas of tissue , these adhere to each other, as well as to near-by bony landmarks. Often we think of scars just as what we see on the skin surface but in fact they can extend through multiple layers of tissue, fascia and internal organs. Scar tissue can interfere with the body’s normal function, causing pain and instability. Seemingly unrelated pain, for example back pain, can be related to past abdominal surgeries e.g. a C-section. Anything from a childhood fall to major cancer surgery can have a lifelong effect on the body, but this can be significantly lessened with massage, stretching and scar tissue relief. Around 93% of abdominal surgery or injury cause the body to create internal adhesions. These adhesions may or may not cause noticeable problems. Complications from abdominal adhesions may take years or decades to cause concern, it is estimated 51% of small bowel obstruction is due to scaring.
What are the Possible Effects of Scar Tissue on the Body?
Post-surgical Scar Healing – how to support the early days of scar healing
Scars usually heal superficially within 4-8 weeks after surgery. Once there are no open areas and scabs, a scar will be considered healed. The full process of scar healing and remodelling can take up to 18-24 months. However, it’s never too late to start healing a scar.
It is very important to start self-massage, once your scar has superficially healed, of course unless advised otherwise by your medical team (for example if you have surgical mesh or within 2 weeks of radiotherapy). This will encourage the best possible healing for the layers of soft tissue affected by your surgery.
Gently touching your scar is also important for stimulating and encouraging the repair of nerve endings that may have been damaged during surgery, this can also help to reduce hyper-sensivity and pain.
As well as the physiological benefits of scar massage, touching your scars can help with the psychological and emotional impacts of cancer surgery. It can help you familiarise yourself with your new appearance and have a positive impact on your relationship with your body image.
It’s never too late to start healing a scar.
How can I look after my scar in the early days post surgery?
There are several aspects of scar management, including: moisturising, scar massage and gentle movement/ stretching.
Once your scar is fully healed over (no open areas or scabs), you can start to apply a plain, un-perfumed moisturiser 2-3 times daily to the scar and surrounding skin. It is also worth looking in to barrier sheets, creams and gels, these can help scars heal with a flatter appearance. Finding the right barrier cream/ gel etc is a whole blog post in itself as there are so many products out there to support scar healing and it’s important to do your research.
Keeping up oral hydration throughout the healing process is really important. Applying an SPF to scars that will be exposed to sun is essential as they are more vulnerable to sun damage. You should continue with this for up to 2 years, after which the scar will be considered ‘mature’.
As mentioned, scar massage can have physiological, psychological and emotional benefits following surgery. The main aims of scar massage are to improve flexibility and mobility of a scar and the surrounding soft tissue and joints. Other potential aims are to reduce pain and hypersensitivity, or to bring sensation back to a numb area.
You could try the following techniques, in order of those applicable to you, gradually building up to 5 minutes 2-3 times a day, for at least 6 months after surgery. The more recent your surgery or radiotherapy the more responsive your scar may be to these techniques so be sure to go gently, everything should be pain-free, if pain arises then go back to the more superficial techniques.
1) Light touch: applying a light pressure from your fingertips (the same pressure as if touching over your eyelid), move in all directions over and around the scar, paying attention to how much the skin moves and areas which are more stuck (more adhesions). Imagine you are trying to lightly get the skin to glide over the soft tissue beneath it.
2) Depress and release: applying a slightly firmer pressure from your fingertips, or a flat hand, gently press into the skin and then release the pressure. Repeat this over your scar (if comfortable), around the edge of your scar and to the skin surrounding your scar – can feel like trying to blend the scar into surrounding skin.
3) Sink and twist: applying one or two hands, gently press into the skin using fingertips or flat hand and rotate towards the scar imagining a ‘twist’ movement. You may do this towards or away from the scar, depending on what is comfortable for you.
4) Sink and roll: using one or two hands, create a ‘rolling’ movement by rocking through flat fingers towards or away from the scar. Start with your index finger and roll through a flat hand to your little finger, or try the reverse. It’s worth experimenting with the directions depending on your areas of tightness.
5) Long fibre: using two fingers or soft knuckles, work along the length of the scar in opposite directions imagining you are ‘stretching’ the scar length ways. If your scar is very tight, focus on the end of the scar and work inwards as able.
6) Cross fibre: using two fingers or soft knuckles, work inwards across the length of the scar. Place your fingertips either side of the scar then push them in opposite directions across the scar, so each fingertip ends up on the opposite side.
7) Brushing: using a softly closed fist, use your knuckles to gently brush along your scar to stimulate blood flow and nerve stimulation. This technique is best for those with numbness and not for those who have pain or hypersensitivity around the scar.
How Scar Tissue Relief or ScarWork Can Help Support Scar Healing
If you feel like your scar is needing more attention then you could look in to getting some hands-on therapy from a Scar Tissue Relief Therapist or ScarWork Therapist. Even if your scar is feeling good it may be worth having some ‘deeper’ work on it by a trained therapist. This therapeutic approach can help promote healing on your scar surface and reduce adhesions in the underlying tissues. The techniques used treat the elastin and collagenous components of scar tissue, supporting them to release, realign and rehydrate.
What can scar relief therapy help with:
Loosening and releasing tight scar tissue to reduce discomfort
🌱Help Restricted Mobility
Reducing tightness and encouraging mobility between the layers of skin, fascia and muscle, can often improve your range of movement.
🌱Reduce Sensitivity and Pain
Trapped nerves and irritated scar tissue can be a factor for prolonged discomfort. Therapeutic touch may reduce pain and help to normalise sensitivity
🌱Stimulate and Boost Healing
Scar massage is often recommended by surgeons as a way to promote optimum scar healing after surgery and may minimise longer term complications. However, even scars that are many years old can benefit.
🌱Support Emotional Wellbeing
Therapeutic touch can be a powerful way to aid emotional recovery and help you to reconnect with your changed or changing body.
Stretching and Moving your Scar
Hopefully you will have been given some post-op exercises to help gently mobilise your scar and to reduce the risk of adhesions developing, do these diligently, these should be pain-free. Be mindful of your posture when moving and resting, it’s quite natural to go in to a posture that protects a scar from further damage or pain and this can lead to a tightening of the scar and surrounding tissues. Once you have been given the OK by your surgeon to exercise maybe think about starting a cancer-specific yoga class to help safely stretch, strengthen and mobilise your scar.
If you have any questions about caring for your scar please do reach out. If you are interested in how scar therapy could help support your recovery I will be offering in-person sessions in Ashburton, Devon very soon, and can offer 1-2-1 online sessions. I also offer cancer yoga sessions online and in-person in South Devon. I am always happy to offer a free discovery call to explore how I may be able to support your recovery.
With warmest wishes,