Scar Management

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Scars in the hand following injuries or surgery can be very tender. The tenderness can become worse after 1-2 weeks and could form a hard lump underneath. The tenderness sometimes persists and could significantly affect the hand function. Besides the scar matures over a period of 1-2 years, proper scar management could help with the cosmetic appearance and functional outcome.

The following exercises could be uncomfortable while doing them or shortly afterwards. If the exercises are painful, try using less pressure. If it continues to be painful, give yourself a several hour break and try again.

 

Scar Massage

Massaging a scar involves rubbing and moving the skin and underlying tissue.
The wound should be completely healed before massage, otherwise the massage could lead to wound breakdown. The scars should be massaged for five to 10 minutes, two to three times a day.
A. Apply a thick and greasy nonperfumed moisturising cream (E45, Nivea, diprobase etc) over the scar. Place the pad of your thumb or finger on the scar. Massage the entire length of the scar using a slow circular motion so the skin moves on the underlying tissue.
B. The goal of friction massage is to stretch the scar tissue beneath the skin. Do this exercise without cream in order to be able to stretch the skin well.

  • Place the tip/pad of your thumb/finger of your other hand against the central area of the scar.
  • Mentally note four directions that the skin can be pushed sideways: near, far, left and right.
  • With your thumb/finger pressed firmly against the scar and without sliding, gently but steadily push the skin to one side as if you were trying to slide the skin off of the bone. Hold this position for five seconds.
  • Briefly relax and then repeat this manoeuvre in one of the other directions. Make sure you attempt to slide the skin in all four directions.

 

Tapping

  • Tap lightly on the area of your hand that is tender/sensitive with a fingertip of your other hand or with a light object such as a pencil.
  • Start with the most tender spot – tap rapidly (2-3 times a second), lightly and continuously, without a break for 3 minutes or until you notice the feeling in the area change. The area may start to feel numb or it may simply feel a little bit less tender.
  • Take a minute rest and begin again. You may find that a different area is now the tenderest spot.
  • It could be done as many times as possible during the day. It can take many thousands of taps to really change the tenderness in a sore area.

Continue this until your scar has matured and will look paler, flatter and softer.

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