Scar Management & Physiotherapy/Scar Management & Physiotherapy

Improving the look AND feel of scars

There are a small number of physiotherapists who specialise in the area of burns, scars and plastic surgery. These physiotherapists apply their knowledge of the body and common therapeutic treatment techniques such as exercise, rehabilitation, stretch and massage to scars.

Whether you have had a recent wound or operation or have a scar that is many years old a physiotherapist can help to prevent excessive scarring and/or improve scarring. Large scars from injuries such as road traffic accidents, burns and other traumas can be treated, as well as very small scars. Scars from surgery can cause scarring deep in the tissues, beyond the skin. Scarring in one area can limit movement in another area of your body; wherever your scar is or however deep it is, scar informed physiotherapy can help.

Scar in the arm

Our physiotherapist will thoroughly assess your scar; the assessment is the cornerstone of understanding your scar, the treatment options and what improvements we can expect over time and with treatment.

Scar management offered by our physiotherapist is non-invasive; it will involve advice, education and mobilisation of the scar/body.

Scar management may be beneficial after having another procedures at 152 e.g. scar revision. Or if you start with physiotherapy, the input of another team member may also be needed; our diverse and expert team works together to offer the latest and best treatments for your scar.

Sometimes all that is needed is one assessment with the physiotherapist which involves giving you advice, education and shows you how to manage your scar. Other times you will need a series of treatments.

We can help you understand the results that you can expect and how long this may take based on the type of scar you have, how the scar looks, what treatments are possible and what you want.

Silicone gels and sheets – silicone can help prevent and treat scars, making them less red and more pliable (flexible).

Scar creams – keeping a scar hydrated helps prevent excessive scarring. Creams can also improve scars and keep them comfortable.

Pressure garments – pressure garments are measured just for you and help to reduce the height and redness of scars; they may also improve the comfort of the scar.

Stretching and exercise – if you scar is ‘stuck’, ‘tight’, painful or stiff whether in the skin or in deeper structures a programme of tailored stretch and exercise could really help. Stretch and exercise is often in combination with scar massage, and possibly other invasive treatments.

Desensitisation – some scars are very sensitive, even when touched by things that normally would not cause any discomfort. Physiotherapy can help reduce this sensitivity.

Scar massage – the composition of scar is different from skin, often the scar is more rigid, less flexible and sometimes stuck to the other layers of tissue; this can cause considerable discomfort and loss of function. The therapist uses scar massage techniques to mobilise your scar to make it freer and more relaxed. This can help you return to more activities and may also improve how the scar looks.

LPG (Endermologie) – this is a technology that has a very powerful effect on scars, essentially it is a mechanical devise that massages the scar but has additional benefits in terms of fibroblast stimulation. LPG can improve the look and feel of your scar, it is especially useful in improving the flexibility (pliability) of your scar.

Yes, physiotherapy can help. Pain and discomfort are two of the main symptoms that physiotherapy can help with. Scars that are tight, itching, sensitive, sore and stuck hurt; physiotherapy techniques can reduce pain by reducing the sensitivity of a scar and improving the movement and flexibility of the scar.

Our physiotherapist will take a full history of how you got the scar, what treatments you have already had and what your concerns and expectations are. Your scar will then be fully assessed, this involves touching and moving the scar and if necessary, the surrounding body parts/areas. If affected by your scar, your movement and posture will also be assessed. The physiotherapist will then discuss her findings with you, outline her recommendations and together with you make a treatment plan along with time scales and expectations.

Often the most effective time to treat a scar with physiotherapy is within the first 2 years after the injury. However, our physiotherapist has great results with older scars too. The only scars that our physiotherapist does not treat are acne scars, keloid scars (although there are some exceptions), scars that can only be improved through invasive methods – these are often mature and non-symptomatic scars. Scar physiotherapy can’t change the colour (pigmentation) of a scar.

Usually physiotherapy treatment is not painful, often it feels good. However, sometimes stretching a scar can be painful and initially tight or sensitive scars may hurt when touched. However, our physiotherapist is very familiar with being sensitive and managing pain that may be encountered in achieving the outcomes. If the treatment is painful, rest assured it is not pain due to any tissue damage, but rather from pushing the scar in ways it may not yet be used to


Procedure Overview

  • A range of treatments are available to effectively treat a wide variety of scars
  • Due to the wide variety of scars and scar types, many different treatment options are available
  • Different treatments are better suited to specific scars
  • The cost of treatment is dependent on the nature of the scar and the treatment chosen
  • You will have an initial consultation with an expert specialist in this area
Woman looking in the mirror and passing a facial cream on her face

It will depend on the age, type, size, location and symptoms of your scar. Often, one session is enough to give the reassurance and guidance needed. If physical rehabilitation is needed this is usually needed regularly over several weeks. Scar massage is also often best received regularly (e.g., weekly) over a period e.g., 6 weeks. Usually on the first assessment the physiotherapist can tell you how many treatment sessions will be needed.

Yes, our aim is to teach you how to manage your own scar, if it’s possible for you to do the treatment yourself we will encourage that. Most of the advice given by our physiotherapist involves your participation during the day and outside of your treatment session.

Yes, swelling is quite common in and around scars, especially soon after the injury. In the case of big trauma, swelling may be a considerable problem and may be present for longer. We will assess the cause of the swelling, then advise and treat accordingly. Scar massage is not the same as the treatment needed for lymphoedema. If your swelling is due to lymphoedema we suggest that you also seek advice and treatment from a lymphoedema specialist.

Scar massage is not the same as the massage you may get for deep tissues or relaxation. It is very important that the person treating your scar has a thorough understanding of scar and treats scars regularly. Some types of massage can make scarring worse. It is especially important to receive scar massage from a scar specialist in the early stages of your injury, when your scar is still red and vascular. In time your scar can be massaged in the same way as any other parts of your body, but initially care and scar expertise is beneficial.

This is common advice! It is hard to know how to do this for yourself without clear guidance that is specific to your scar. Our physiotherapist can provide the guidance and reassurance you need. In many cases after surgery, you may only need one session of advice and explanation; other times scars do need therapeutic input.

At 152 physiotherapy does not involve needles or medications, our physiotherapist works through advice, her hands and encourages you to move and help yourself. Our physiotherapist works very closely with the surgeons, if she thinks needles or medications will be beneficial for your scar, with your consent, she will refer you to a team member.

Although you may not know too many other people with scars or anyone with a scar like yours, our physiotherapist has treated thousands of scars. She is very familiar with treating huge scars that cover nearly the whole body, through to scars that are barely visible.

The focus of physiotherapy is often on improving the feel rather than the look of your scar. However, if scars are tight and stuck this can also affect how they or the surrounding area appears. Often there can be an improvement in how the scar looks with physiotherapy, as well as in how it feels.

If your scar is very recent it may be best to see a physiotherapist first as it may be too early to do invasive treatments. At the early stages of a scar, or after a newly healed wound the focus is often on advice to help you know what to do to get the best outcome. We can advise you on how to clean the area, what silicone or creams to use, whether or how to massage the area, what to expect the scar to look like over time and what treatments may be helpful in the future. If the physiotherapist feels that you would also benefit from advice about invasive procedures or from the specialism of another team member, she will suggest which team member could also help. Invasive treatments, particularly lasers are increasingly also used early on. Often scars need input from more than one speciality.

If you are mainly concerned about the look of your scar, especially if it is more than 2 years after injury, then we are most likely to recommend that you see a plastic surgeon. If you see a surgeon first and your scar would also benefit from a physiotherapy treatment such as scar massage, then you may be referred to physiotherapist by the surgeon. We also offer joint assessments with two or more of our specialists in one consultation.

"You have changed my life!"

"Ruthann is the most dedicated and knowledgeable person I have met! She has helped me understand, because she understands. I feel reassured. And I have not had this kind of [scar] massage in this country before, my face feels amazing! I couldn’t open my mouth much before and now I can."

"I have been a patient under RuthAnn for over a year and am delighted with the progress I have made under her care. She has a lovely manner, is invested and caring, and has so much knowledge and expertise in her field. Since seeing RuthAnn for physiotherapy, I have had vast improvements in my neck mobility which has improved my quality of life immeasurably. She always has time to answer any questions or concerns and clearly knows her field. I would absolutely recommend her!"


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