What is a scar?

It is the result of the tissue healing process and the replacement of damaged tissue with new connective tissue, which differs from the original skin in both appearance and properties.

Phases of tissue healing:

• Inflammatory phase – triggers a cascade of inflammatory processes to initiate healing.

• Proliferation phase – formation of granulation tissue, wound healing, and creation of new tissue.

• Remodeling phase – scar tissue is formed.

Depending on the type of tissue that was damaged, the healing phases occur over different time frames.
In the case of the skin, direct scar therapy can begin during the proliferation phase, around 5–6 weeks, provided that healing is progressing properly.
Scar therapy around the scar (mobilizing surrounding tissues) can begin as early as week 3–4.

Types of scars and their characteristics:

1. Immature – before 6 weeks; collagen synthesis and organization are not yet complete.

2. Physiological – similar to surrounding tissue, without local or distant symptoms.

3. Sclerotic – hard, non-elastic, may provoke additional symptoms; often shows tissue “pulling.”
   Forms when an immature scar is overloaded too early or when activation is insufficient after 6 weeks of healing.

4. Atrophic – results from prolonged healing processes; insufficient collagen, low strength, weak blood supply; common with high stress and frequent NSAID use.

5. Hypertrophic – too much collagen; raised above the skin, but does not spread sideways; appears shortly after injury in highly mobile or overload-prone areas.

6. Keloid – a hypertrophic scar that does spread sideways; even more collagen, fewer myofibroblasts; often accompanied by redness, itching, burning, hypersensitivity, or pain.

7. Contracture scar – significantly restricts mobility; common after burns.

8. Active scar – red, painful, tender on palpation.

What does scar therapy look like?

Like every physiotherapy visit, it begins with a conversation. To conduct effective scar therapy, we need to understand how and under what circumstances the scar developed.
Each type of scar has different therapeutic needs, so the next step is visual assessment and evaluation of scar mobility by the physiotherapist.

The following step is manual therapy of both the surrounding tissues and the scar itself. Techniques are selected individually, depending on the stage of tissue healing.

Important to remember:

• Starting work on a scar too early or too aggressively at a given stage of healing can cause harm rather than help.

• Scar therapy yields the best results when mobilization begins around 6 weeks after formation, but…

• It is never too late for scar therapy. Even if your scar is several years old and still causing discomfort, you can consult a therapist who will choose individualized techniques.

• If you have an upcoming procedure and know you will have a scar, you can take care of it before it forms. Focus on:

  • Healthy nutrition

  • Proper hydration

  • Reducing stimulants (smoking impairs microcirculation and significantly slows wound healing)

  • Supplementing nutrients that support tissue healing

  • Stress reduction

  • Consultations with specialists – dietitian, physiotherapist

Booking link:
futureclinicmokotow.booksy.com/a