Scar care after surgery: What really helps and what you should avoid

Scar care following an operation is not an optional step; it plays a decisive role in determining how inconspicuous a scar will ultimately be. Following a surgical procedure, scar tissue inevitably forms as a result of the tissue injury. Starting scar care early and consistently gives the body the support it needs to keep the scar soft, flat and as inconspicuous as possible.

This guide explains how the wound heals after surgery, which care methods are actually effective, and which warning signs you should take seriously.

The 3 stages of wound healing after surgery

Scarring following surgery is a natural protective response by the body. If a wound, such as a surgical incision, extends into the deeper layers of the skin, the skin cannot regenerate fully. Instead, replacement connective tissue forms: the scar.

The three stages of wound healing following surgery, from inflammation through cell regeneration to scar maturation, a process that can take up to two years.

In the first phase, the cleansing phase, blood flushes bacteria and cellular debris out of the wound. Blood clotting then begins, and a scab forms. During the regeneration phase, starting around week 1, specialised cells known as fibroblasts stimulate collagen production. Collagen is the structural protein that provides strength to the developing scar tissue.

The third phase, remodelling, can take up to two years, depending on the extent of the procedure and the individual’s constitution. It is only during this phase that the scar tissue becomes softer, flatter and visibly fades. This is precisely where targeted scar care comes into play: it supports the remodelling process and improves the aesthetic outcome.

When can you start looking after your scar?

Scar care should only begin once the wound has completely healed, with no open scabs or stitches remaining. For most procedures, this is usually 2–3 weeks after the operation. Following an abdominoplasty or tummy tuck, this may be slightly later depending on the size of the incision. Your treating doctor will give the go-ahead on a case-by-case basis.

Patience during the first few weeks pays off.

Proper scar care after surgery: the most effective methods

The Scar care after surgery is based on a few, well-established principles. It is less about a single ‘miracle’ remedy than about the combination of treatments and their consistent use over a period of months.

• Phase 1: Weeks 1–3 after the operation (wound still closed)
• Keep the wound dry and clean: Do not wash or apply cream whilst the wound has not yet fully healed.
• Change the wound dressing regularly: Follow medical instructions; use sterile dressings and avoid the spread of infection.
• Avoid the sun at all costs: Never expose fresh wounds to UV radiation; cover them with clothing or plasters.
• Be on the lookout for warning signs: If you experience increasing redness, warmth, swelling or pus: seek medical attention immediately.
• Phase 2: Months 1–3 (wound closed, aftercare begins)
• Apply silicone gel twice a day: Apply a thin layer to the fully healed scar and, once dry, leave it on for at least 12 weeks.
• Alternative uses for silicone plasters: Particularly suitable for use at night. 12–24 hours a day for optimum results.
• Perform scar massage daily: 2–5 minutes of gentle circular movements with light pressure helps to promote collagen renewal and softness.
• Apply SPF 50+ sun cream: Prevents permanent hyperpigmentation of the fresh scar whenever it is exposed to the sun.
• Phase 3: Months 3–12 (scar maturation)
• Continue applying the silicone gel: A total duration of up to 6 months is recommended for hypertrophic scars.
• Keep the scar moist: Massaging in nourishing oils (e.g. jojoba or rosehip oil) helps to keep the scar tissue supple.
• Attend a medical check-up: Have the scar assessed and, if there is excessive scar tissue, seek professional treatment.
• Continue to use sun protection every day: For at least 12 months after the operation, even on cloudy days.

Immediately after the stitches are removed, surgeons often recommend simple panthenol-based wound care ointments to keep the skin supple and support the healing process. Once the surface has stabilised, the treatment is switched to silicone-based products, which represent the current gold standard in scar treatment.

Silicone gel, scar cream or plasters: which is most effective?

According to the guidelines of the German Dermatological Society (DDG), silicone-based products are supported by the strongest evidence for conservative scar treatment, particularly in the case of hypertrophic scars. Silicone gel forms a protective film over the scar, regulates moisture balance and curbs excessive collagen production.

Product type	Mode of action	Suitable for	Application
Silicone gel (e.g. Kelo-Cote)	Hydration, collagen inhibition	All types of scars, particularly hypertrophic scars	Twice a day, for 60–90 days
Silicone plasters / scar plasters	Occlusive, pressure effect	Extensive scarring, torso, legs	12–24 hours a day, for at least 8 weeks
Scar cream (e.g. Bepanthen Scars)	Moisture retention, promotion of blood circulation	Fresh, superficial scars	Massage in 2–3 times a day

Silicone plasters are particularly suitable for flat scars, such as those resulting from liposuction on the abdomen. They can be worn for 12–24 hours a day and exert a gentle compressive effect, which helps to soften the scar tissue. The patch does not replace the gel but complements it; depending on the location of the scar and their daily routine, those affected can choose the more practical option.

How to perform scar massage correctly

Scar massage, also known as scar pressure massage, is one of the most effective yet most frequently neglected treatments. To do this, massage the scar with two fingers using small circular movements and moderate pressure. The aim is to break up adhesions in the tissue and make the scar tissue more supple.

In practical terms, this means: 3–5 minutes a day, preferably after a shower, when the warmth has improved blood circulation to the skin. Do not start until the doctor has confirmed that the wound has completely healed.

A diet to promote wound healing

Certain nutrients are essential for the formation of scar tissue; if they are lacking, the healing process slows down measurably.

• Vitamin C: Essential for collagen synthesis. Daily requirement: at least 75–100 mg; increased requirement following surgery.
• Zinc: Promotes cell division and wound healing. Found in pulses, meat and nuts.
• Protein: Building blocks for new tissue. A daily intake of 1.2–1.5 g per kilogram of body weight is recommended following major surgery.

Alcohol suppresses the immune system and can promote inflammatory reactions.

Identifying types of scars: hypertrophic scars, keloids and atrophic scars

Hypertrophic scars These occur when the body produces too much collagen. The scar protrudes above the skin’s surface but remains within the original wound boundaries. Silicone-based products help to regulate collagen production and smooth out the scar. Significant improvements are possible with consistent use over 2–3 months.

The Keloid It differs from a hypertrophic scar in that it grows beyond the edges of the wound. Keloids are more common in people with darker skin tones and a corresponding genetic predisposition. Conservative scar management alone is often insufficient in such cases. Cortisone injections, cryotherapy or laser treatment can reduce the appearance of keloids; such procedures should be regarded as follow-up measures that may be necessary after cosmetic surgery.

Atrophic scars are located below the skin’s surface. They occur when the tissue has not produced enough collagen during the healing process. Professional treatments such as micro-needling or fractional laser are more effective here than surface-level skincare alone.

Frequently asked questions about scar care after surgery