A surgical scar does not finish healing when the incision closes. It keeps changing for months, and the National Health Service in the UK says most scars fade over time, which can take up to two years or more. What you do in that stretch matters most in three places: when you start, how you protect the skin from sun, and who looks at it if it turns raised or itchy. This guide covers silicone, sun protection and massage with their timing, what the research says about red light, and the point where a scar needs a dermatologist rather than a routine.
One rule sits above all of it: nothing goes on or near a scar until the incision is fully closed and your surgeon says it is time.
What does scar healing after surgery look like over time?
A new scar is usually pink or red and slightly firm, then softens and fades over many months. The NHS says you cannot get rid of a scar, but most fade without treatment, and that this can take up to two years or more. The aim of care is to help it settle flat, soft and pale; it will not erase it.
| Stage | What the sources say |
|---|---|
| Incision still open, scabbed or draining | Nothing is applied except what your surgeon ordered. The AAD says never put a silicone sheet on a scab or open wound. |
| Closed and surgeon-cleared | Silicone can start. The 2014 international recommendations say after the wound has epithelialized (new skin covers it). |
| Weeks to a few months | Daily silicone for at least 1 month, per the same recommendations. Check in around 2 months: if a raised scar is not improving, see a clinician. |
| First year | The NHS advises keeping the scar covered or in sunscreen in the sun for at least 1 year. |
| Up to 2 years or more | Slow fading continues (NHS). |
Does silicone gel or sheeting help a surgical scar?
Silicone is the first thing dermatology guidance reaches for, and its evidence is real but modest. Use it on closed skin, daily, for weeks to months. The research is strongest for people at higher risk of raised scars and weaker for everyone else, and the Cochrane review (2013) calls the quality of many trials poor.
Here is what each source says:
- International recommendations (2014). Gold and colleagues say silicone gel or sheeting is the preferred prevention for high-risk wounds, applied once the wound has epithelialized and kept up for at least 1 month. They suggest sheeting be worn at least 12 hours a day, ideally 24, with washing twice daily, and say gel or ointment may suit the face, large or high-movement areas, and hot, humid climates.
- Cochrane (2013). Twenty trials with 873 people. Silicone sheeting reduced raised scarring in people prone to it (risk ratio 0.46), but the authors call that evidence weak because the studies were highly open to bias.
- Meta-analysis (2020). Wang and colleagues pooled six randomised trials with 375 patients and found topical silicone gel reduced scar pigmentation, height and pliability scores.
- AAD. The AAD says sheets appear to work better than ointment, that you must wear one daily, often for months, and that skin breakdown or a rash can occur. If that happens, stop and tell your dermatologist.
Timing differs between sources. The AAD's scar page says to use sheets after the wound closes. Its keloid prevention advice says as soon as the wound has scabbed, for about six months. Your surgeon's instruction beats both, because the surgeon knows how your incision closed.
Is sunscreen on a scar worth it?
Yes, once the skin has healed. The AAD says sun protection may help reduce red or brown discoloration and help a scar fade faster, using broad-spectrum SPF 30 or higher, reapplied often. The wording is "may": it is guidance and no study promise.
There is a second reason. The AAD notes that skin cancer can sometimes develop in a scar, and advises sunscreen whenever clothing will not cover it. It also says to avoid tanning beds. For brown or black skin, the AAD suggests a tinted sunscreen, which will not leave a white residue, applied 15 minutes before going out.
A quick routine: cover the scar with clothing when you can, use sunscreen on it when you cannot, and keep that going for at least a year, as the NHS advises.
Should you massage a surgical scar?
Maybe, and only after it is fully healed and your surgeon agrees. The NHS suggests massaging a healed scar with a water-based cream a few times a day for up to 10 minutes. The research behind it is thinner than the habit suggests.
A 2020 systematic review and meta-analysis by Deflorin and colleagues found physical scar management in general beat no treatment for pain, itch, pigmentation, pliability, surface area and thickness, with the authors reporting moderate-to-strong effects. Its detail on massage comes mainly from burn scars, where massage looked useful for pain and thickness. Surgical incisions are a different wound, so read that as encouraging and unsettled.
A physical therapist can show you pressure, direction and how long to work. If massage hurts, pulls the incision or brings redness, stop and call the surgeon's office.
What does the research say about red light therapy for scars?
The research is early and small. A 2026 scoping review of red and near-infrared photobiomodulation for scars in Lasers in Medical Science searched PubMed, Embase and MEDLINE through October 2025 and found only seven studies with 297 people across burn, hypertrophic and post-surgical scars. That is the whole evidence base the review could use.
What those studies reported:
- Red LED reduced induration (firmness) and improved POSAS scores (a patient and observer scar rating) in post-surgical scars, with moderate doses working best.
- Near-infrared light improved color and elasticity in hypertrophic scars and reduced thickness, pain and itch after hernia repair, thyroidectomy and blepharoplasty.
- Treatment was well tolerated, with transient redness and warmth most common and rare blistering at higher doses.
The authors also name the limits: small samples, different devices and doses (total light exposure varied from roughly 52 to 384 J/cm2), different ways of scoring scars, and short follow-up. They call light an adjunct and not a substitute for silicone, steroid injections, pressure or laser treatment, and say consensus guidelines on settings are still needed. Evidence in darker skin tones and keloid-prone people is limited.
The review describes LED panels and low-level lasers, so treat a full-body bed as an extension of that evidence rather than a match for it. For the wider picture, see our guide on whether red light therapy works and the research summary.
When does a scar need a dermatologist?
Book a dermatologist when a scar turns raised, spreads, itches, hurts or has not improved after about two months of silicone. The 2014 recommendations suggest adding injected treatment if a 2-month silicone course fails or the scar is severe or itchy. Keloids always belong with a specialist.
The AAD says a keloid grows larger than the wound that caused it, does not fade with time and needs treatment, and that board-certified dermatologists have expertise in treating them. The AAD also names higher risk for people with darker skin tones and a personal or family history of keloids. The 2014 recommendations list silicone plus monthly steroid injections as first-line care for minor keloids. Hypertrophic scars stay inside the wound line and often improve with time. A dermatologist can also confirm that a changing scar is still just a scar.
Tell your surgeon before surgery if you have ever formed a keloid. The 2014 recommendations class a keloid history as higher risk to be treated aggressively, so prevention can start early.
What to ask your surgeon
- When is the incision closed enough for silicone, and which form do you prefer, sheet or gel?
- How long should I wear it each day, and for how many weeks?
- Is any tape, glue or dressing on the wound meant to stay until a set date?
- When can I start massage, and who should show me how?
- Do I have a higher risk of a raised scar or keloid, and who do I see if one starts?
- Is there anything you do not want applied near the incision, including light, heat or lotions?
Where do recovery-studio services fit?
Recovery-studio services sit alongside your surgeon's plan and are not a scar treatment with proven results. OutRecover's red light therapy page lists skin and scar recovery among its uses, and the sessions are brief, with no UV. The evidence above is small and was gathered with other devices, so the honest read is that light was well tolerated in the trials but its scar benefit is unproven.
If you are planning a program around surgery, two packages are built for that. OutHeal covers a wide list of procedures, including tummy tucks, breast procedures and liposuction, and includes red light or PEMF. OutRepair fits lighter procedures and also includes red light or PEMF. Both are timed to your surgeon's clearance. For swelling around a fresh incision, see reducing swelling after surgery, and for cosmetic procedures tummy tuck recovery and liposuction recovery.
Do not start light, heat or any new treatment over an incision until your surgeon clears it.
Your next step
Check the incision with your surgeon at the next visit and ask the questions above. Once cleared, start silicone, add sunscreen daily and put a date about two months out to look at the scar. If it is raised, itchy or spreading by then, book a dermatologist.
Sources
- National Health Service. Scars. NHS, accessed 2026. https://www.nhs.uk/conditions/scars/
- Gold MH, McGuire M, Mustoe TA, et al. Updated international clinical recommendations on scar management: part 2, algorithms for scar prevention and treatment. Dermatologic Surgery, 2014. https://laserplast.org/wp-content/uploads/Updated_International_Clinical_Recommendations_on.2.pdf
- O'Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC7156908
- Wang F, Li X, Wang X, Jiang X. Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. International Wound Journal, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7949016
- American Academy of Dermatology. Scars: diagnosis and treatment. AAD, accessed 2026. https://www.aad.org/public/diseases/a-z/scars-treatment
- American Academy of Dermatology. How to prevent keloid scars. AAD, accessed 2026. https://www.aad.org/news/how-to-prevent-keloid-scars
- American Academy of Dermatology. Minimize a scar: proper wound care tips from dermatologists. AAD, accessed 2026. https://www.aad.org/public/everyday-care/injured-skin/burns/wound-care-minimize-scars
- American Academy of Dermatology. Keloid scars: self-care. AAD, accessed 2026. https://www.aad.org/public/diseases/a-z/keloids-self-care
- American Academy of Dermatology. Keloid scars: overview. AAD, accessed 2026. https://www.aad.org/public/diseases/a-z/keloids-overview
- American Academy of Dermatology. Keloid scars: diagnosis and treatment. AAD, accessed 2026. https://www.aad.org/public/diseases/a-z/keloids-treatment
- Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J. Physical management of scar tissue: a systematic review and meta-analysis. Journal of Alternative and Complementary Medicine, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7578190
- Gaumond SI, Dreifus EM, Mittal A, Eber AE. Red and near-infrared photobiomodulation for burn, hypertrophic, and post-surgical scars: a scoping review of clinical trials (literature searched through October 2025). Lasers in Medical Science, 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC13106236
