title: The role of massage in scar management: a literature review.
abstract: 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.
authors.affiliation: Department of Dermatology, University Hospitals Case Medical Center and School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Thuzar M
authors.initials: TM
authors.lastname: Shin
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Bordeaux
mesh_terms: D002921:Cicatrix / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008405:Massage; D011182:Postoperative Care / Q000379:methods*; D014945:Wound Healing