Whether rubbing or massaging a scar can help it fade is a common question for those hoping to reduce the appearance of scars. While some claim that scar massage can break up internal scar tissue and improve blood flow to promote healing, the evidence on whether rubbing scars makes a significant difference is mixed.
Quick Answers
– Rubbing or massaging a newer scar may help break up scar tissue and improve healing, but should be done gently. Aggressive rubbing of newer scars can cause irritation.
– For older, established scars, the benefits of rubbing are less clear. There’s limited evidence on whether it improves appearance.
– Any scar massage should involve gentle, circular motions. Never rub so hard it causes pain or bleeding.
– Other evidence-based ways to reduce scarring include silicone sheets/gel, compression, moisturizing, and over-the-counter scar treatments.
– See a dermatologist for scar revision options if a scar remains raised or discolored after a year of proper wound care.
How Scars Form
When skin is injured, a wound healing process begins to repair and close the wound. This process results in a scar – fibrous collagen tissue that covers the area of damaged skin.
In the initial inflammatory phase, the body sends increased blood flow to the area to aid healing. Special cells called fibroblasts then travel to the wound and begin depositing collagen fibers in a random pattern to quickly seal the wound.
Over the next year, the scar will remodel and mature. Fibroblasts align the initially disorganized collagen fibers into bundles, increasing the scar’s tensile strength. The scar also gradually becomes flatter and paler during this process, though rarely returns to a completely normal appearance.
Factors That Influence Scarring
How much visible scarring results depends on factors like:
- Size of the wound – Larger wounds require more collagen deposition and are more likely to scar noticeably.
- Location – Scars on the face, neck, chest or shoulders are often more visible. Scars over joints may limit mobility.
- Age – Younger skin produces more collagen and scars worse than older skin.
- Genetics – Some skin types scar more extensively, such as darker skin tones.
- Wound cause – Deep lacerations, burns, and surgical incisions typically cause pronounced scarring.
Proper wound care can help minimize scarring. This includes cleaning the wound, using antibiotic ointment, keeping the area moist with dressings, and avoiding sun exposure as it heals.
Can Rubbing or Massaging a Scar Improve Its Appearance?
Many people massage or rub their scars in hopes it will help flatten, soften and fade them. But does scar massage really make a difference?
Evidence on the efficacy of scar massage is mixed. Some dermatologists and plastic surgeons believe massaging a newer scar can help:
- Break up areas of internal scar tissue adhesion
- Soften the scar by stretching and realigning collagen fibers
- Increase blood circulation to improve wound healing
Gentle scar massage may provide modest improvements in scar appearance during the wound remodeling phase in the first year. However, research reviews have found limited high-quality evidence that scar massage significantly improves long-term scar appearance compared to letting a scar mature naturally.
Potential Benefits of Massaging Newer Scars
Lightly massaging or rubbing a newer scar while it’s still remodeling may provide some benefits, including:
- Keeping the scar tissue soft and pliable
- Preventing cross-linking of collagen that causes rigidity
- Aligning new collagen fibers in the optimal direction
- Enhancing fluid drainage to resolve swelling
- Increasing blood supply to improve wound healing
However, there are some risks to massaging newer scars too aggressively. This can disrupt healing tissue, causing bleeding, irritation or infection. Light massage using gentle circular motions is safest on newer scars.
Limited Benefit for Older Scars
For mature scars that have completed the remodeling process, typically a year after injury, the benefits of massage are less established. One review found that while scar massage improved scar pliability and decreased stiffness, most studies found no significant improvement in scar appearance or vascularity.
Any effects from massaging an older scar are likely temporary. Mature scars contain dense, bundled collagen fibers set in the healed direction. Massage may temporarily soften and realign these fibers, but they tend to revert once rubbing is stopped.
Proper Technique for Scar Massage
While evidence is limited, gentle scar massage is unlikely to cause harm in most cases. If attempting self-massage of a scar, keep these tips in mind:
- Wash hands thoroughly before massaging the scar to prevent infection.
- Apply a lubricant like vitamin E oil or moisturizer to allow smooth gliding motions over the skin.
- Rub the scar using consistent, moderate circular motions with light to medium finger pressure.
- Massage for 5-10 minutes daily, up to 3 times per day, for 8 to 12 weeks.
- Never rub so vigorously it causes pain, bleeding or wound reopening.
- Avoid massaging for at least a month after any revision surgery on the scar.
See your doctor immediately if massage causes increased pain, swelling or other changes in the scar. Advise them you have been massaging the scar so they can properly evaluate any issues.
Other Ways to Reduce Scarring
While scar massage may provide some modest benefits, other evidence-based treatments are more reliably effective for improving scar appearance. Options to discuss with your dermatologist include:
Silicone
Silicone sheets or gels are considered first-line therapy for hypertrophic (raised) and keloid scars. Silicone:
- Softens and flattens scars by hydrating them.
- Reduces collagen deposition to inhibit scar overgrowth.
- May reduce redness and itching.
Apply silicone sheets over scars for 12+ hours per day, or use silicone gel 2-3 times per day. Use for at least 2-3 months to see results.
Compression
Compression garments or bandages apply gentle pressure to:
- Help drain fluid and reduce swelling.
- Flatten and smooth raised scars.
- Improve the alignment of collagen.
Use compression following any surgery to minimize scarring. Continue wearing compression garments for 12+ hours per day for several months on existing hypertrophic scars.
Moisturizers and Occlusives
Scars heal best in a moist environment. Moisturizing the scar prevents dryness and irritation. Occlusive moisturizers like petroleum jelly help seal in moisture. Apply moisturizer to new scars daily during the remodeling phase.
Over-the-Counter Scar Treatments
Topical products are available over-the-counter to improve scar appearance, such as:
- Onion extract: Helps flatten and soften scars.
- Hydroquinone: Lightens discolored scars.
- Topical vitamin C: May aid collagen remodeling to flatten scars.
OTC options have modest effects compared to silicone, but can supplement other treatments.
Corticosteroid Injections
For severely raised or itchy scars, corticosteroid injections may help by:
- Reducing collagen overproduction and inflammation.
- Flattening and softening scar tissue.
- Improving scar appearance when used in early remodeling phase.
However, multiple injections are usually needed for best results.
5-Fluorouracil
5-fluorouracil (5-FU) is a medication that prevents excessive collagen formation by blocking fibroblast activity. When injected into newer hypertrophic scars, it may improve their appearance by:
- Reducing scar size and thickness.
- Making scars softer and more pliable.
- Helping flatten and smooth scar contours.
Multiple treatments are required over several weeks to improve established scars. 5-FU has more effect when used soon after scarring begins.
Laser Skin Resurfacing
Ablative laser resurfacing removes a thin layer of skin around a scar. This promotes new collagen production and skin rejuvenation. Types of ablative lasers include:
- Carbon dioxide (CO2) laser
- Erbium laser
For very deep scars, controlled destruction of scar tissue with laser irradiation may flatten and smooth the skin’s surface.
Dermabrasion
Dermabrasion uses a rotating instrument to remove the top layers of skin around a scar. After healing, the resurfaced skin is often smoother. Dermabrasion may be effective for raised or pitted scars.
Surgical Scar Revision
For severely disfiguring scars or contractures that limit range of motion, surgical scar revision may be performed. Techniques include:
- Excision – Cutting out the scar tissue.
- Z-plasty – Repositioning the scar to minimize contractures.
- Tissue expansion – Using fillers or balloons to stretch healthy skin for scar coverage.
- Skin grafts – Transferring skin from elsewhere on the body to cover a visible scar.
Though invasive, surgery provides the most dramatic improvement for problematic scars.
When to Seek Professional Scar Treatment
Visit a board-certified dermatologist or plastic surgeon if a scar:
- Remains significantly raised, lumpy or discolored after a year of proper self-care.
- Causes ongoing pain, itching or skin tightening.
- Restricts movement in nearby joints.
- Creates significant emotional distress due to its appearance.
A doctor can provide medical treatments and procedures beyond self-massage to improve scar appearance and minimize symptoms. Early intervention provides the best results.
Conclusion
Evidence that vigorously rubbing or massaging a scar improves its long-term appearance is lacking. However, gently massaging a newer scar may provide some modest benefits in pliability and healing. For optimal scar care, also use silicone products, compression, moisturizers and over-the-counter treatments. See a dermatologist for more invasive options if a scar remains problematic after a year of proper self-care.
