Caring for scars after breast cancer surgery

What are scars and how are they formed?

Scars are a natural part of the body's healing process. All breast surgery will leave some scarring but it’ll be different for each person.

After breast cancer surgery, wound healing is helped by the formation of new collagen for around three months. The blood supply to the area increases, causing the scar to become raised, lumpy and red.

Then, as some of the collagen at the wound site starts to break down and the blood supply reduces, the scar gradually becomes smoother, softer and paler. This takes many months.

In some cases the body can  produce too much collagen causing scars that are more raised than usual. Such scars are called hypertrophic and can take several years to settle.

A keloid scar is similar to a hypertrophic scar but it continues to grow, increasing in height and spreading over normal tissue even after it has healed. The scar may be painful, tender and itchy.

Both of these kinds of scars are more common in younger and dark-skinned people.

Are there treatments for scars?

There isn’t a treatment that can remove scars, but there are some things that may help reduce them or improve their feel and appearance. Again, the success of a treatment will depend on your individual case.

Your surgeon will have ideas about the best treatment for you.

Your hospital team or breast care nurse will be able to discuss your concerns and expectations, and suggest what treatments might be used to improve your scars. Some treatments are listed below.

• Silicone gel sheets and silicone gel may help to heal a scar, reducing its size and colour, and making it feel softer. The sheet or gel covers the scar and moisturises it. You can get silicone gel products through your GP (local doctor) or hospital team on prescription, or buy it direct from pharmacies.
• Steroid injections can help to soften and flatten hypertrophic and keloid scars. They may also reduce any pain and itching caused by the scar.
• Pressure treatment with an individually tailored elastic garment may help reduce a scar.
• Surgery can remove scar tissue but will also make new scar tissue.
• Cosmetic camouflage can help to conceal a scar.

Care tips

Callers often ask what type of cream they should use to moisturise the scar area. Any emollient cream or oil is suitable.

The type you use will not have a direct effect on your scar but massaging moisturiser into the scar will keep it from becoming dry and helps to make it supple.

Scars, especially new ones, are  sun sensitive. Use sunscreen for protection.

Tight clothing can irritate or injure scar tissue.

Continuing with your post operative exercises is really beneficial for your arm and shoulder movement but take care during stretching because skin that has already been damaged is extremely sensitive.