Updated: 2 days ago
We all have them, whether it be from abscesses or surgery, scars are a part of our lives with HS. Aside from appearance, scar tissue can be sensitive and very painful and can also hinder blood flow to the area as well as range of motion, depending on the area. Most of us with HS have deep tunneling that result in very deep pitted type scars, therefore, most of the over-the-counter treatments or home remedies will not be helpful.
Speak to your dermatologist about scar management options. Many times they have products to offer you from their office. You can also ask them about freezing therapy using liquid nitrogen depending on the type of scarring you have. There are also types of injections, such as collagen or other "fillers” that may be useful for some types of pitted scarring, although these are not usually permanent solutions.
There are also other options cosmetically that are much more expensive and most likely not covered under insurance. This would not be recommended unless you're absolutely sure you are never going to get a flare in a particular area again, otherwise it would be a waste of time, effort, and money.
Products/Treatments for Non-Surface or Non-Superficial Scars:
Dermabrasion or Microdermabrasion
Surgery revision. This would most likely be considered cosmetic plastic surgery, which is not covered by most insurance, is invasive and quite expensive. You would have to be sure that you were completely flare free in any particular area and that you would not get a flare there again in order for this to be successful.
Products for Superficial Scarring:
Vitamin K cream
Scar Tissue Massage:
Massaging scar tissue has many benefits, especially in the first two years after surgery/injury which include:
Decreasing further scar tissue build-up. Excess scar tissue can make muscles stiff and weak. In some cases scar tissue removal surgery is required
Improving blood flow, which promotes healing and the flexibility of the scar
Draining excess fluid to reduce swelling and growth
Promoting feeling and decreases numbness, tingling, soreness and pain
Increasing range of motion
Bettering the appearance of your scar
Scar tissue forms during the healing process as the body produces collagen fibers to close and heal wounds. The collagen fibers do not always grow in the same direction; they often grow in different directions, which can cause discolored and uneven texture. Typically a scab forms over the wound to protect the area from germs. Once the wound is healed, the scab will fall off and you are left with a newly formed scar.
Phases of Wound Healing and Scar Formation
Below is typically as a result of a surgery or deep wound puncture.
Inflammation Phase: Blood clotting begins. The incision/wound can look red and inflamed. This may last a few days or a week after surgery or an injury.
Growth Phase: New tissue (collagen) will start to form and heal the wound. The area may feel tender, raised, and possibly scabbed; this typically lasts 5-10 days. The area may be inflamed and have some draining and numbness.
Structure Phase: This is the final phase where your scar forms. As the scar tissue forms and nerves heal the feeling should start to return. The scar should feel less textured, be more sensitive and possibly start to itch. You may also notice discoloration; it may appear purple, then white, and eventually become closer to skin color.
How Long Will it Take for my Scar to Heal?
Everyone is different; scars can continue to heal and fade up to two to three years after an incision or injury. The structure phase in your healing involves the lightening of your scar as it heals. A "mature" scar is smaller, flatter, and lighter and this is the best way to know when your scar is completely healed.
Why Scar Massage Therapy?
For larger scars, especially if the area is where movement is required, it is important that you "work" your scar to prevent tightness and increase range of motion. When scar tissue is broken down through massage you help your body heal faster, reduce pain, bring back feeling, and possibly help with the appearance of your scar.
How Do You Massage Scar Tissue?
Do not massage until your incision has fully healed. You do not want to massage while it is still a wound or scabbed because if you massage your scar prematurely you could cause it to reopen or tear, which could lead to an infection. Massaging scar tissue is most effective in the first 2 years while the scar is still forming and healing.
Use Vitamin E lotion or oil on your scar. Vitamin E is proven to help build collagen and using a lubricant cuts down friction during massage.
Massage your scar for 10-15 minutes a day (2-3 times a day for 5 min intervals)
Use the pad of your thumb or finger and firmly massage in a circular motion. Press hard and firm, but not painful.
Work up the scar in a clockwise motion working your way up and around your scar slowly, maintaining firm pressure. Switch to massaging counter-clockwise. This will also help to drain excess any fluid that may remain in the area.
Stretch the skin apart around your scar and repeat your massaging with a firm circular motion by using your thumb or finger.
Applying firm pressure, slowly slide your finger up the scar and then change direction slowly sliding downward.
Scar tissue therapy is most crucial for the first two years after surgery or injury and most beneficial if it’s done daily.
There are several commercial skin care products such as Mederma, Embrace, NewGel, Puriderma, Scaraway, CELSUS Bio-Intelligence, and BioCorneum Plus that can also help with more superficial scar tissue and healing.
Did you know that scars don’t tan? The structural properties of a scar are different from regular skin and scar tissue does not have melanin (skin pigmentation). Scars are more susceptible to UV damage and can sunburned more easily so always put sunscreen on and cover your scar in the sun.
This is an awareness article for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.
Written by Denise Panter-Fixsen
Edited by Brindley Kons