Hand therapy
A scar is any mark left on the skin after a wound has healed, this can include a mild texture change, altered pigmentation, hypertrophic scarring or keloid scarring.
Scars occur from “over healing” caused by increased collagen in the underlying skin layers. This collagen is arranged in whirls and bundles and can lead to a bumpy scar. This scar will continue to increase in size and strength and actively contract until mature at 18 to 24 months following injury.
Hypertrophic scars are red, raised, thickened, hard, lumpy and itchy and are found within the boundaries of the scar.
Scar management is used to minimise the effects of scarring, prevent or minimise contractures, improve posture and position of joints, and support patients coping with an altered appearance.
Scar massage
Scar massage helps to increase blood circulation and promotes collagen remodelling by applying pressure to the scar. It can reduce itching, reduce hypersensitivity, soften scars and can prevent or breakdown adhesions to underlying soft tissue.
Technique:
- Can be completed once the scar is completely healed
- Use almond oil or aqueous cream (Mineral oil – baby oil or lanolin based products do not penetrate the skin)
- For the best results the oil or cream used should be absorbed into the skin and leave it feeling supple
- Massage in circles along the scar and horizontally across the scar
- Massage three to four times daily for at least five minutes for each area of scarring.
Silicone therapy
Silicone gels are used in the management of scars as they help promote hydration (moisturisation) of the scar area which improves the appearance of scars through softening, flattening and reducing discolouration.
These gels can also reduce the itchiness often associated with scars. These gels are only used once the wound is fully healed, and it is recommended that they are used for a minimum of two months to see any improvement.
The benefits of silicone gel are that it is transparent, odourless and cosmetics and sunblocks can be used over the top.
Re-usable adhesive silicone sheeting
Application:
- Ensure skin is clean and dry
- Peel away protective liner and save it for later use
- Place the sheet or patch sticky side down, directly over the scarred area
- Keep in place for 12 to 23 hours per day with removal for showering
- At least once daily remove the patch and rinse under water and dry thoroughly
- If you are not wearing the silicone sheet re-apply the protective liner to prevent it from drying out
Topical silicone scar gel
Application:
- Ensure skin clean and dry
- Apply small amount by smearing over scar
- Allow 5 minutes to dry and then you can put clothes over as normal
- Re-apply at least 2 times daily after massaging or getting wet
Who should I contact if I have any problems?
If you have any problems or any questions regarding your hand therapy please contact the hand therapy team on:
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]