I think the Red Hot Chili Peppers said it best – ‘Scar Tissue That I Wish You Saw’…

If people could SEE how scar tissue forms UNDER the surface, they would probably be a lot more motivated and aware of the follow up treatment that is required for long term healing.

As an Occupational Therapist who specialises in lymphoedema treament and post breast cancer recovery, I see a LOT of women post surgery, mastectomy and radiation. When I ask women how their scars are healing, 9/10 say something like ‘great’, ‘they’re healing really well’, but when I palpate the area, notice cording or in their next breath they tell me of pain or restriction of movement at the shoulder or neck, I know it’s not so ‘great’ and we have a scar that needs addressing.

It’s not surprising that people don’t think to treat scars once the surface looks neat and healed, BUT considering that scar tissue continues to develop under the surface, it’s HUGELY important that it’s addressed. 

Scar tissue formation is a normal part of the body’s healing process, heck, it’s necessary and very important. Wound healing is helped by the formation of new collagen for around three months. The blood supply to the area increases, causing the scar to become raised, lumpy and red. Then, as some of the collagen at the wound site starts to break down and the blood supply reduces, the scar gradually becomes smoother, softer and paler. This process differs in everyone but can take many months or even years.

Then there are some different processes that can arise causing complications with scarring such as:

Hypertrophic Scarring – When the body produces too much collagen causing scars to be more raised than usual. This can take several years to settle.

Keloid Scarring – is similar to a hypertrophic scar but it continues to grow, increasing in height and spreading over normal tissue even after it has healed. The scar may be painful, tender and itchy.

Left untreated, scars can cause sensitivity, pain and reduced range of motion at the shoulder/arm/neck. It is estimated that approximately 50% of women will have ongoing breast and shoulder issues post breast cancer treatment, imagine just how much of this is attributable to scarring! The good news is, there ARE treatment options available.

It is important to ensure the wound site has completely healed (no open skin or scabs) before you start treating your scar!

Then your treatment options may include:

  • Massage (my number 1 tip!): This is something that can be done by your lymphoedema therapist, physio etc OR you can even try some massage yourself with light pressure, performing stroking motions perpendicular to the scar or small circles (with or without lotion/oil).
  • Silicone Gel Sheeting: available from your health care professional, pharmacy or online!
  • Taping: This is a technique that can be performed by a trained health care professional
  • Low Level Laser: While these are available for home use they are expensive, you may prefer to see your health care professional for use with these.
  • Stretches: Depending on your surgery or treatment you may be given specific exercises to help with scar tissue flexibility and remodeling.
  • Steroid injection: used to soften and flatten hypertrophic and keloid scars. They may also reduce any pain and itching caused by the scar.
  • Compression: May be used in some cases to help reduce a scar.
  • Surgery: in extreme cases can remove scar tissue (but keep in mind will also make new scar tissue!).
  • Cosmetic camouflage: can help to conceal a scar (but won’t aid in healing).

So PLEASE, think about showing your scars some love! And if you would like more support or have any questions, reach out! I offer appointments most days or am happy to chat over the phone regarding your personal circumstances.

Please note: This information is intended to help inform and increase your awareness, however, it is not designed to replace an individualised assessment from your chosen health care professional to ensure you get the correct information for you. Please get in touch if you would like support in this area.

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