A scar is the body's way of repairing skin damaged down to the dermis: instead of ordinary skin, dense collagen tissue without hair follicles and sweat glands is formed. The scar matures over one to two years: first red, raised and tight, then increasingly pale, flat and soft. A scar cannot be removed completely, but you can influence how it turns out: keeping the wound moist and protected until it has healed, silicone and pressure in the first months, sunscreen for a year, and scar massage from when the wound is fully closed make the scar softer, flatter and less stuck to the tissue underneath. Scar massage and light cupping around the scar have the best evidence for reducing tightness, itching and adhesions after surgery, caesarean sections and injuries. Scars that grow beyond the wound edge, hurt, become infected or sit near a joint and limit mobility should be assessed. Here is how scars heal, when you can start, the techniques step by step and what is reasonable to expect.
Different kinds of scars
| Type | Recognised by | What helps |
|---|---|---|
| Ordinary (mature) scar | Red and raised in the first months, then pale, flat and soft within one to two years | Moisture, sunscreen, massage; heals well on its own |
| Hypertrophic scar | Thick, red, raised and itchy, but stays within the wound edges; common over joints, on the chest and after burns | Silicone sheets or gel, pressure, massage, sometimes cortisone injection; usually regresses in one to two years |
| Keloid | Grows beyond the wound edge as a lumpy, shiny, often itchy or tender thickening; more common on dark skin, on the chest, shoulders, earlobes | Doctor: silicone, cortisone injections, pressure, laser; do not massage hard, it can make it worse |
| Atrophic (sunken) scar | A pit in the skin, after acne, chickenpox or tissue loss | Dermatologist: microneedling, laser, fillers; massage does little |
| Contracture | A scar that has contracted and limits mobility, often after burns or over joints | Stretching, massage, splint, physiotherapist, sometimes surgery |
| Adhesion | The scar is stuck to the tissue underneath: the skin does not move when you pull it, pulls and feels tight with movement; common after caesareans and abdominal surgery | Scar massage and cupping that free the layers, stretching |
How a scar heals, and what to do in each phase
- Weeks 0–2, wound healing. Keep the wound clean, moist and covered as advised by your care team; do not touch stitches or tape. No massage, no cupping, no baths or pools.
- Weeks 2–6, wound closed. When there is no opening, scab or fluid: start with very light touch and stroke around (not on) the scar to get the skin used to it. Start sunscreen. Silicone sheets or gel on the scar for 12–24 hours a day for two to three months have the best evidence against thick scars. After surgery: ask the surgeon when massage may start, often at 3–6 weeks.
- Week 6 to 12 months, remodelling. Daily scar massage, stretching of the area, cupping around the scar as below. This is when the scar is shaped and adhesions can be released.
- Years 1–2, maturation. The scar fades and softens; continue sunscreen until it has stopped being pink. Massage can be reduced once the scar is soft and mobile.
Seek care if
Seek care if the scar or wound becomes red, hot, swollen, weeps or you get a fever (infection), if the wound opens, if the scar grows beyond the wound edge or becomes lumpy and hard (keloid), if it hurts, burns or itches intensely for months, if a scar over a joint limits mobility, if the skin around the scar is numb in a way that does not improve, or if an old scar changes appearance, develops a sore or starts to grow.
Scar massage step by step (from a fully healed wound)
Scar massage does three things: it softens the collagen so the scar becomes flatter, it frees the scar from the tissue underneath so the skin can glide, and it reduces itching and hypersensitivity by getting the nerves used to touch. Five minutes daily for three to six months has the best evidence. Use an unscented oil or emollient cream, see the guide to oils.
- Pressure. Place two fingers on the scar and press lightly, hold 10 seconds, move along the whole scar. Gets the tissue used to it.
- Circles. Small circles with the fingertips along the scar, with enough pressure that the skin moves but it does not hurt, one minute.
- Across. Move the skin back and forth across the direction of the scar, one minute. Frees adhesions.
- Along. Move the skin along the length of the scar, in both directions, one minute.
- Lift and roll. Gently pinch the scar and the skin around it and roll it between the fingers, if possible without pain. Shows how stuck the scar is: the skin should lift as easily as elsewhere once the scar has matured.
- Stretch. Finish by stretching the area the scar sits in (extend the abdomen backwards for a caesarean, bend and straighten the joint for a scar over a joint), 30 seconds.
The scar may become slightly pink and warm; it should not become red, tender or open up. With a keloid: only light touch and silicone, no hard massage.
Cupping around scars: lift instead of pressure
Cupping is a complement to scar massage with a different direction: the suction lifts the skin and the layers stuck beneath it, instead of pressing. It is used by physiotherapists for adherent scars after abdominal surgery, caesareans, breast surgery and orthopaedic procedures. Start at the earliest when the wound has been fully healed for six weeks, and ask the surgeon if the procedure was major. Use the mini cup with the lightest possible suction and oil.
- Oil the area. Place the cup beside the scar, not on it, and glide long light strokes away from the scar in all directions, like rays from a centre, 1–2 minutes. That softens the tissue pulling on the scar.
- Place the cup on the scar with very light suction (squeezing it a quarter is enough), hold still for 10 seconds and release. Move along the scar. The suction lifts the scar from its base.
- Once the scar tolerates it (after a few weeks): very light strokes along the scar and across it with the cup, 1 minute.
- Finish with scar massage and stretching. Two to three times a week, massage on the other days. The skin should become lightly pink, never bruised; with marks the suction was too strong.
The full routine with video guidance is in the cupping program for scar tissue. Do not cup a wound that is not fully healed, keloids, irradiated skin without a doctor's go-ahead, over mesh or implants before the surgeon has approved, with infection, or if the skin is thin and fragile. With caesarean and abdominal surgery: not during pregnancy, and start with massage and light cupping around the scar first.
What is reasonable to expect?
With silicone, sunscreen and daily massage most scars become flatter, paler, softer and less itchy than they otherwise would, and adhesions that pull and feel tight can be released almost completely. A scar never disappears, the colour difference may remain, and scars that have matured for years without massage are harder to influence but not impossible. Deep, sunken scars and keloids need a dermatologist. Patience is the most important ingredient: count in months, not weeks.
Frequently asked questions
When can you start massaging a scar?
When the wound is fully closed without scab or fluid, usually two to six weeks after surgery; ask the surgeon after major procedures. Start with light touch around the scar, progress to scar massage on the scar when it does not hurt, and add cupping at the earliest six weeks after full healing.
Does cupping help scar tissue?
As a complement to scar massage, yes: the suction lifts the scar and the layers beneath so adhesions release and the tissue becomes more mobile. Physiotherapists use it after abdominal, breast and orthopaedic surgery. Start at the earliest six weeks after the wound has fully healed, with the lightest possible suction, and never on keloids.
How do you massage a caesarean scar?
From when the wound has fully healed (usually six weeks, after your midwife's or doctor's go-ahead): pressure, circles, strokes across and along the scar, and lifting and rolling the skin, five minutes daily with oil. Light cupping around the scar after a few more weeks releases adhesions to the abdominal wall. Not during a new pregnancy.
What is the difference between a hypertrophic scar and a keloid?
A hypertrophic scar is thick, red and raised but stays within the wound edges and usually regresses in one to two years with silicone and massage. A keloid grows beyond the wound edge as a lumpy, shiny thickening, does not regress on its own and should be treated by a doctor; hard massage can make it worse.
How do you get rid of a scar?
Completely, you cannot, but silicone and pressure in the first months, sunscreen for a year, daily scar massage and cupping make the scar flatter, paler and softer. Deep or disfiguring scars can be improved with laser, microneedling or surgery at a dermatologist, but even then a scar remains.
Sources
- 1177 Vårdguiden (Swedish national health guide), search for "ärr", "sår" and "keloid" for medical information and when to seek care.
- Curam's FAQ and cupping programs, developed with trained massage therapists.
Related guides
- Fascia – what it is, fascia training and cupping
- Diastasis recti and training after childbirth – exercises
Written by Curam. Last updated 17 October 2026. This is general self-care information and does not replace medical care. For sudden, severe or unusual symptoms, contact your doctor. Talk to your doctor before cupping if you are pregnant, take blood thinners or have a condition affecting skin, blood vessels or blood.
