Overview

A scar is part of your body's normal healing process after a hand injury or surgery. It is a mixture of blood vessels, cells and tissues that becomes a permanent mark.

The amount of scar tissue that you have depends on:

• how long ago you had your injury
• how big your injury was
• the size of the injury or cut made for surgery 
• your general health

Your scar may look different with time and can change colour. It may become darker (hyperpigmented) or lighter (hypopigmented) than your usual skin colour. The scar may also become dry, itchy or raised. This should get better, but healing can take up to 18 months.

This information shows you some of the ways to look after your scar, including:

• massaging the scar 
• using silicon 
• wearing pressure garments 

It also explains:

• the arrangements for your follow-up appointments
• how to help yourself if you have a hand injury or condition

Scar massage

Scar massage is a way to look after your scar. You need to massage the scar for 5 minutes, 5 times every day using a non-perfumed cream like E45. This helps to:

• reduce the amount of dry skin
• soften the scar

Your therapist will show you how to do deeper massage, in circle movements across your scar.

By massaging your scar regularly, you can help it to heal. This process:

• stops the scar from sticking to the tissue underneath it, which helps the skin to move better
• helps to reduce colour changes and swelling
• can make the scar flatter

Silicon

Silicon helps the top layers of the scar tissue to keep moist and stay hydrated. This can:

• help the scar to soften
• reduce symptoms like itching, burning, dryness and pain
• improve the colour, texture and height of scar tissue

This section gives details about the different types of silicon.

Cica-Care or Mepiform dressings

We may recommend Cica-Care or Mepiform dressings for scars that are hyperpigmented (darker than your usual skin colour), raised or causing symptoms like itching and pain. They are a flexible dressing made up of a plastic covered with silicon gel.

Your skin needs to get used to wearing the Cica-Care or Mepiform dressing gradually as follows:

• Wear the dressing for 1 hour for the first day.
• Build up by an hour a day until you can wear the dressing for 7 hours.
• When you are wearing the dressing for 7 hours a day, continue this for 1 week.
• At the end of the week, start wearing the dressing for 23 hours a day.

You usually need to wear the dressing for 23 hours a day, where possible. It is only necessary to take off the dressing for bathing and massaging the scar. Your therapist will give you individual advice, depending on your scar and symptoms.

The dressing is reusable and can be washed clean before putting it on again.

You should only put a Cica-Care or Mepiform dressing on completely healed wounds.

Here is some guidance for putting on the dressing:

1. Make sure that your skin is clean and moisturised slightly before putting on the dressing.
2. Open the peel pack and remove the dressing.
3. Cut the dressing to size, allowing enough to overlap by 1cm around your scar.
4. Remove the release film and put the dressing over your scar.
5. Avoid stretching the dressing when putting it over joints.

You need to clean the silicon dressing every day. To do this:

1. Remove the dressing and put it in a bowl of warm water.
2. Gently clean the dressing with soap.
3. Pat the dressing dry with a clean towel.
4. Put the dressing on your skin or back in the packet.

When the dressing starts to fall apart, throw it away and use a new piece.

Silicon gel or spray

We may recommend silicone gel or spray for scars in visible, hard to reach or movable areas, such as on the face or between joints. When you put on the gel or spray, it creates an invisible thin layer of silicon over the scar area.

Here is some guidance for putting on the gel or spray:

1. You need to put on the silicon gel or spray 2 times a day after washing the scar in the morning and evening.
2. Before putting on the gel or spray, moisturise the skin and let it dry.
3. When using the gel, put on enough to cover only the area of the scar. There is no need to massage the gel into the scar. It takes about 4 to 5 minutes for the gel to dry. If this takes longer, you have used too much.
4. When using the spray, hold it 15 to 20cm away from the scar. Spray a thin layer over the scar area. The spray also takes about 4 to 5 minutes to dry. If this takes longer, you have used too much.

Safety measures

Some people may have a sweat rash as a reaction to silicon. If this happens:

• remove the gel or spray by wiping and cleaning the area
• allow the symptoms to go away fully
• put the gel or spray back on for 1 hour only
• check the area for any ongoing symptoms

If your symptoms continue, stop using the silicon product and tell your therapist as soon as possible.

Pressure garments

Pressure therapy involves putting pressure on a scar, usually with a pressure garment. The garment is made to measure using an elastic material called lycra^®.

How pressure garments work

Pressure garments limit the growth of scars and help to flatten raised scars. They do this by giving constant pressure to the scar.

The pressure garments that your therapist gives you are not made to protect your skin from sunlight, reduce swelling or help with pain.

How long to wear your pressure garment

You need to wear the pressure garment for 23 hours a day, 7 days a week.

You can take off the pressure garment to bathe and massage your scar. Apart from that, you need to wear it all the time.

After your first fitting session, we give you a second pressure garment. You then have one to wear when the other is being washed.

You need to wear the pressure garment until the scar has stabilised and matured. This can take up to 18 months but depends on the type of scar that you have.

When measured, your pressure garment is effective for 6 months in total. After this, your therapist either:

• assesses you again for a new garment
• talks to you about reducing how much you wear the garment

Caring for your pressure garment

Here are some tips to care for your pressure garment:

What to look out for if you use a pressure garment

Unless the pressure garment fits properly, do not wear it until you have emailed and received a reply from the therapy team. They need to give you more advice in this situation.

Follow-up appointments

If you have a smart phone, you can download our MyChart patient app. This app lets you cancel or change hospital appointments.

Your therapist will talk to you about your follow-up appointments and explain how often you may need them. Some injuries or conditions involve more follow-up appointments than others.

You need to book your next appointment before you leave the therapy department, unless:

• it is a video appointment
• your therapist has told you something different

Things you can do to help yourself

If you have a hand injury or condition, there are ways to help take care of yourself.

Talking therapies

Any injury to your hand or pain in the hand can be overwhelming, and affect your mental health.

If you are struggling with how you feel and need to talk to someone, you can get help from the NHS talking therapy services.

You can speak to your doctor about talking therapies or contact the service directly.

Stopping smoking

Smoking and vaping can delay your healing and affect your recovery, especially if you have a wound. Free services are available to help you stop smoking.

Living well

If you need to wait for hand surgery, there are things that you can do to get ready. The healthier that you are before surgery, the quicker your recovery is likely to be. Healthy living can also help you after your surgery.

Even if you have had your hand injury or condition for a while, a healthy lifestyle can help with your recovery.

We have information about keeping well before surgery. You can also read about diet, exercise, sleep and other healthy living topics on the NHS live well pages.