BACKGROUND Many surgeons recommend postoperative scar massage to improve aesthetic outcome, although scar massage regimens vary greatly. OBJECTIVE To review the regimens and efficacy of scar massage.METHODS PubMed was searched using the following key words: "massage" in combination with "scar," or "linear," "hypertrophic," "keloid," "diasta*," "atrophic." Information on study type, scar type, number of patients, scar location, time to onset of massage therapy, treatment protocol, treatment duration, outcomes measured, and response to treatment was tabulated.RESULTS Ten publications including 144 patients who received scar massage were examined in this review. Time to treatment onset ranged from after suture removal to longer than 2 years. Treatment protocols ranged from 10 minutes twice daily to 30 minutes twice weekly. Treatment duration varied from one treatment to 6 months. Overall, 65 patients (45.7%) experienced clinical improvement based on Patient Observer Scar Assessment Scale score, Vancouver Scar Scale score, range of motion, pruritus, pain, mood, depression, or anxiety. Of 30 surgical scars treated with massage, 27 (90%) had improved appearance or Patient Observer Scar Assessment Scale score.CONCLUSIONS The evidence for the use of scar massage is weak, regimens used are varied, and outcomes measured are neither standardized nor reliably objective, although its efficacy appears to be greater in postsurgical scars than traumatic or postburn scars. Although scar massage is anecdotally effective, there is scarce scientific data in the literature to support it.The authors have indicated no significant interest with commercial supporters.D espite appropriate planning and technique, healing after dermatologic surgery may not be perfect, resulting in redness, pruritus, pain, or scar. Patients may suffer from anxiety or depression due to unaesthetic scar appearance and may be less willing to undergo further recommended surgical procedures.Nonsurgical techniques to help prevent and treat abnormal scars include laser therapy, intralesional agents, cryotherapy, radiation, pressure therapy, occlusive dressings, topical agents, and scar massage. 1-10 Some surgeons recommend scar massage during wound healing to improve aesthetic out-come. There is a lack of consistency regarding when to initiate treatment, technique, frequency, and duration of therapy. The aim of this review article was to summarize the published literature regarding the use of scar massage and to propose ways to integrate this therapy into the practice of dermatologic surgery to improve scar cosmesis.
Methods
We searched PubMed (http://www.ncbi.nlm.nih. gov/pubmed) using the following key words: "massage" in combination with "scar," "linear,"