EP 33: How to Help Your Scars Heal Properly Without Making Them Worse

Let's talk about how to PROPERLY treat scars!

Scar tissue maturation takes 1.5-2 years, with the first 8 months being most critical for proper treatment. Aggressive massaging of scars, especially on hands, can lead to hypersensitivity and complications rather than improved healing.

• Hand scars require special attention due to the high concentration of nerve endings
• Aggressive or frequent scar massage increases sensitivity rather than helping
• Pure vitamin E oil is recommended for topical application to scars
• Apply vitamin E by snipping open capsules and gently rubbing onto the scar
• Proper scar massage should be light to moderate pressure for only 1-2 minutes once or twice daily
• Gel-lined compressive sleeves help shape amputations and decrease sensitivity
• Gel sheeting with light compression can be used overnight for scars on palm or back of hand
• Consistent, gentle approaches work better than aggressive treatments

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Chapters

• 0:00 Introduction to Scar Management
• 1:37 Common Mistakes in Scar Treatment
• 2:40 Proper Scar Care Techniques
• 5:01 Using Compression for Scar Healing
• 6:40 Episode Closing and Resources

Transcript

Speaker 1: 0:00

Thanks for stopping in to visit the Hand-to-Shoulder Solution Giving Pain the Middle Finger. I'm Carl Petito, occupational Therapist and Board Certified Hand Therapist. I'd like to talk today about scars. Everybody asks me questions about scars. You know, some get sensitive, some get lumpy, some are really noticeable. They're dark.

Speaker 1: 0:19

Obviously we want our scar tissue to look good. We want it to be soft and supple, like our normal skin tissue. We want it to not be sensitive and cumbersome. You know, when scar tissue forms, scar tissue shrinks and tends to get tight. But something that I want everybody to know about scars is they mature and they develop over a period of one and a half to two years. The first eight months roughly are most important and there's a lot of techniques that we can do to, you know, really facilitate best maturity of scar tissue so that it looks and feels good. And let's talk about, firstly, a couple of things not to do. I have some patients are told to just rub their scar and make sure they keep rubbing it. But again, scars mature over a period of one and a half to two years. So if we try to rush Mother Nature and make things develop faster than Mother Nature develops things, then we start asking for trouble. Because it's brand new tissue.

Speaker 1: 1:24

It very easily becomes hypersensitive, especially on the hand. So as a hand therapist, I'm dealing with a lot of post-surgical patients, a lot of patients who had trauma. Most recently currently I'm treating a woman who got her hand stuck in a snowblower. She lost some fingertips. In the past they've had just a lot of trauma from knives and screwdrivers, you name it. Then other folks who've fractured a lot of bones and they've had to have plates and screws, reconstruction done internally and of course, in order to get in there you have to go through the skin and that leaves scar In the hand. We have to feel our environment and you should be able to close your eyes and put a nickel in your palm and feel that, yeah, that's a nickel. The way we can do that is to have a lot of nerve endings in our hand and the price we pay for having a lot of nerve endings is that it's a very sensitive area. So if we were to massage that scar frequently and keep rubbing it and be very diligent, that is going to increase hypersensitivity. Too much is just too much. A good analogy is gardening. We have to water our tomato plants, but we can't water them all day long. So let's start from the beginning. So you have an injury, you have a cut, there's a surgery, whatever the case may be, and there's a scar developing.

Speaker 1: 2:44

One thing I like to apply topically to scars is vitamin E oil. If you go to the store and buy a vial of vitamin E oil, when you look at the ingredients there's all kinds of things safflower oil and other seed oils and vitamin E oil is usually pretty far down the list. I like to just buy straight up vitamin E oil pretty far down the list. I like to just buy straight up vitamin E oil. You know just gel tabs that you would swallow, and I have my patients just take a gel tab in their hand and and then snip off the tip with a sharp scissor and put a couple of drops on the scar, smear over the scar and just let it soak in. At least, if a person just did that, oh, before bed, a couple hours before bed, and just let it soak into the scar, you can rub it in very lightly, not not aggressive, nothing should be aggressive.

Speaker 1: 3:43

Rubbing the scar is good for it. The deep pressure is nice to force the fibers to flatten out, because when, if you look at the, the normal skin tissues under the microscope, the fibers are lying flat and parallel and that's why our skin is nice and flat and smooth. When a scar forms, the fibers lay crisscross and the scar can become lumpy. Some deep pressure again light to moderate, nothing aggressive causes the fibers to flatten out and to reorient more parallel, but that's what happens over time. So scar massage can be done with some lubrication, whether it be some nice all natural lotion or ideally the vitamin E oil, just for probably two minutes, one or two minutes, once or twice a day.

Speaker 1: 4:33

All right, now what a lot of us want to do, especially because it's the hand, it's handy, it's right there, and patients come in to their first visit and they're talking to me and they're rubbing it. Oh, I was told to rub my scar. I got to keep rubbing my scar. They're doing it all day long and then the underlying arthritis is exacerbated. We're all excited. The skin is red. So we talk about the timing regarding that and not overdoing it.

Speaker 1: 4:57

Another nice technique we have these gel-lined compressive sleeves. So I deal with a lot of amputations and what we'll do is we'll have the gel-lined compressive sleeve. The gel is nice and smooth and it conforms nicely to the finger and we shape the end of the stump as the scar on the stump starts to form. We want that to form nice and flat, not sensitive. I'll have a patient wear a gel-lined compressive sleeve over the end of their amputation After it's well healed. You know, the skin is nice and solid and that'll put nice light pressure on that during sleeping hours. It'll make the stump form nice and round and also decrease sensitivity. Now if the scar is on, for example, on the back of the hand or on the on the palm or you know, we have special gel sheet and we can lay over the scar, then overlapped that with a nice light compressive wrap. Then all night long when you're sleeping, hopefully for eight hours or so, some nice light pressure will be pushing on that scar, reorienting the fibers, flattening the scar out and again making it less sensitive. So between the use of gel shading, some very occasional light rubbing of the scar for one or two minutes, just once or twice a day, and some application of vitamin E oil at least once a day, again, this is gonna scars mature over a period of one and a half to two years.

Speaker 1: 6:40

Thank you very much for tuning in. I know you know people out there are having pain from their fingertips throughout the shoulder, whether it be the fingers, the hand or the wrist, or the elbow, the shoulder, you know arthritis, you name it. This channel is a good resource for anyone for yourself or anyone you know going through this. Thank you for liking it and subscribing and thank you for sharing it with others who need this. Also, check out my website, carlpetitocom. A lot of great information, thank you.