A scar is an area of skin that is permanently changed after a wound. Scars can form after a burn, surgery, an infection, acne, a sore, or a cut. It’s usually thicker than normal skin and can be discolored or shiny.
Scar tissue is the thickened, fibrous connective tissue that develops after healthy skin cells have been destroyed. This can happen just after a surgery or injury or years later. In some cases, scar tissue becomes uncomfortable or even painful.
This article will go over why scar tissue can be painful and how to relieve it, including home remedies and medical treatment options.
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What Is Scar Tissue?
Scar tissue is tissue that develops when healthy skin is destroyed by trauma, such as a surgery, a burn, or an injury. Scars are thicker when they are repairing damage within skin’s deeper layers. The color of scar tissue is often different than that of the surrounding skin.
There are several different kinds of scars, including:
- Flat scars, which usually fade on their own
- Keloid scars, which are firm, raised, and larger than the original area of the wound
- Hypertrophic scars, which are thick and raised due to the presence of additional connective tissue
- Contracture scars, which are tight and often develop due to burns
- Atrophic scars, which are sunken and often related to acne
Can Scar Tissue Cause Pain?
While many scars are painless, some people experience severe scar tissue pain. This is typically due to damage to the nerves surrounding the destroyed tissue.
Scarring-related neuropathy (nerve pain) and nerve sensitivity is especially common after a burn or surgical procedure. Both forms of trauma carry a higher risk of deep tissue damage and involvement of the underlying nerves.
Scar tissue pain is also often related to inflammation. As skin wounds heal, your immune system prompts an inflammatory response to speed up tissue regrowth. Sometimes, this action results in excessive connective tissue growing in the affected area, leading to skin tightness, pain, and itching.
Why Scar Tissue Pain May Appear Years Later
Research suggests that up to 50% of people who undergo certain surgical procedures experience chronic postoperative (postsurgical) pain. Up to 68% of burn patients experience persistent and severe scar tissue pain.
For some people, this pain starts right after the related trauma. For others, it may appear months or even years later or get worse over time. This may be due to the cumulative effects of chronic inflammation, as well as skin tightness due to ongoing restricted mobility. For example, if you can’t fully straighten your leg due to a contracture scar on your knee, your pain in that area may increase gradually.
Other Symptoms With Scar Tissue Pain
Many people with scar tissue experience additional symptoms alongside pain. These can include:
- Anxiety and issues with self-esteem
- Itchiness in the affected area
- Problems with sleep due to discomfort
- Restricted mobility and range of motion, especially in the joints near the affected skin
- Skin tightness
At-Home Therapies
There are many different types of at-home therapies, such as those that follow, to relieve scar tissue pain and help to reduce the appearance of thickened scars.
Massage
There is evidence that gently massaging your scar and the area of skin around it can reduce itchiness, pain, and discomfort. This may be because it helps to break down scar tissue in the area, making the skin more pliable and elastic. Massage therapy has been found to have some of the same benefits.
Moisturizer
Applying moisturizer or petroleum jelly to a recent skin wound or scar can help to reduce pain and slow down scar formation. This keeps the tissue supple and can assist with inflammation and irritation. You may also want to cover the moisturized skin with a bandage to keep it clean and protected.
Silicone Gel
For many decades, silicone gel, either in the form of sheets or topical ointment, has been used to reduce the appearance of scars, especially hypertrophic and keloid scars. Silicone gel has also been shown to relieve related symptoms, from scar tissue pain and skin tightness to stiffness, itching, and swelling.
For best results, you’ll need to use silicone gel sheets consistently for several weeks or months after your skin wound closes.
Taping
Applying a dressing, such as silicone gel or polyurethane dressing, to a raised scar may help it fade. Research suggests that moist scar tape can also soften a firm scar, which can help with pain. Your healthcare provider may suggest that you tape any scars for up to six weeks after a surgical procedure.
Compression Techniques
Compression techniques, also known as pressure therapy, can help to speed up the wound healing process and prevent scars from forming or getting bigger, especially keloid scars. Compression sock or stockings or elastic bandage wraps also work to improve circulation and encourage blood flow to the area. You’ll need to wear them for at least six to eight weeks.
Vibration Devices
Evidence suggests that vibration may help to speed up skin wound healing and soothe neuropathy symptoms. Some people use vibration devices, such as handheld massage tools, on and around their scars. This can break up fibrous scar tissue, encourage blood flow, and improve flexibility in the underlying joints.
Stretches and Exercises
If you have a painful scar, it may be tempting not to move the affected area. However, it’s important to prioritize gentle movement, such as stretches, walking, and other mild to moderate forms of exercise, to boost circulation, improve the wound healing process, and maintain your range of motion and mobility.
OTC Topical Solutions
Some over-the-counter (OTC) topical treatments are available at pharmacies and drugstores to temporarily relieve symptoms like scar tissue pain and itching.
Lidocaine, a topical anesthetic, is one common option for treating scar-related pain. Often used to reduce neuropathy, topical lidocaine is popular, in part, due to its relatively low risk of side effects.
Meanwhile, capsaicin, which is found naturally in chili peppers, also helps to reduce pain, including scar tissue pain, when applied topically. It curbs nerve cell activity, leading to numbness in the targeted area.
Medical Treatment Options
If your scar tissue pain doesn’t go away with at-home remedies, medical treatment may be necessary. Here are some of the available options.
Dermabrasion
Dermabrasion, or dermaplaning, is a skin resurfacing treatment in which a dermatologist removes the top layer of your skin with special tools. It’s sometimes used to reduce the appearance and thickness of certain scars. However, it doesn’t typically work on burn scars or contracture scars.
Grafting
If your scarring and scar tissue pain are extensive and other treatments have failed, your healthcare provider may recommend skin and/or fat grafts. Grafting can prevent further scarring, reduce nerve pain, and repair the area after a sizable scar has been surgically removed.
Laser Treatments
Laser therapy has become a popular treatment option to relieve many scar-related symptoms. It may be combined with injections, medications, and/or physical therapy.
Depending on your type of scar, laser therapy uses light to produce a wide range of potential benefits, including:
- Breaking up scar tissue
- Helping existing scars flatten or fade more quickly
- Increasing range of motion
- Preventing postsurgical scarring
- Preventing or treating scar-related discoloration
- Reducing swelling
- Relieving pain and itchiness
- Softening scars
Scar Revision Surgery
In severe cases, your dermatologist might suggest that you undergo scar revision surgery. This is particularly likely if you have a contracture or burn scar. Surgery may involve cutting out the scar or making flaps in the skin to allow a contracture scar to be released.
The Graston Technique
The Graston technique is a type of instrument-assisted soft tissue mobilization (IASTM). It is a method often used by physical therapists to break up adhesions and scar tissue and improve the mobility of the muscles, tendons, and fascia under the skin.
After a warm-up, your physical therapist or another healthcare provider will use stainless steel tools to manipulate the soft tissue around your scars. This helps to reduce pain and improve range of motion.
Adhesion Barriers
Postoperative adhesions are areas of fibrous scar tissue that develop between the internal organs and other parts of the body after a surgery. After a surgical procedure, your healthcare provider may insert adhesion barriers, such as by embedding antiadhesive drugs, to separate injured body parts and prevent adhesions from forming.
Injections and Injectables
Your dermatologist may recommend that you receive injections directly into a keloid scar. In addition to significantly decreasing the size of your scar, this can soothe pain, inflammation, and itchiness. Common treatment options include corticosteroid, fluorouracil (5-FU), and bleomycin injections.
Physical Therapy
You can work with a physical therapist to develop a multimodal program to improve your range of motion and relieve scar tissue pain. Physical therapy for scar-related pain often involves a combination of guided exercises and stretches, manual (hands-on) therapies such as massage, and passive therapies like electrical stimulation and ultrasound.
When to Contact a Healthcare Provider
Contact your healthcare provider if you have persistent scar tissue pain, a scar that is getting worse, or scarring that bothers you in any way. A dermatologist can determine what kind of scar you have and which treatment options are right for you.
Get medical help right away if your scar shows any signs of infection. These may include pus or other drainage, fever, swelling, severe pain, tenderness, or warmth just under the skin.
Summary
Scar tissue pain often develops due to nerve damage and inflammation, often after a surgery or burn. At-home remedies for scar tissue pain include massage, moisturizer, silicone gel, taping, compression techniques, vibration devices, and stretching.
Medical treatment options include dermabrasion, skin grafting, laser treatments, scar revision surgery, the Graston technique, injections, physical therapy, and adhesion barriers. If you have persistent scarring and/or scar tissue pain, consider reaching out to a board-certified dermatologist for help.
