Compression improves scar outcomes by influencing blood flow, collagen organisation, inflammation, and mechanical tension during healing. It is most often discussed in the context of surgical, burn, and hypertrophic scars, but the principles apply broadly to wound healing.
Here’s how it works, step by step:
1. Reduces excessive blood flow and oxygen delivery
Healing tissue that receives too much blood flow tends to overproduce collagen, which contributes to raised or thickened scars.
Compression:
• Gently reduces capillary blood flow
• Lowers oxygen tension in the scar tissue
• Signals fibroblasts to slow collagen production
This helps prevent hypertrophic and keloid-style scarring.
2. Modulates fibroblast activity and collagen deposition
Fibroblasts lay down collagen during healing. Without regulation, they can:
• Produce collagen too quickly
• Lay fibres in a disorganised pattern
Compression:
• Reduces fibroblast proliferation
• Encourages flatter, more parallel collagen alignment
• Supports smoother, more flexible scar tissue
3. Controls inflammation and oedema
Swelling around a healing wound increases tension and prolongs inflammation, both of which worsen scar quality.
Compression helps by:
• Limiting interstitial fluid buildup
• Reducing inflammatory signalling
• Creating a more stable healing environment
This shortens the inflammatory phase and supports more controlled remodelling.
4. Reduces mechanical tension across the wound
Tension is one of the strongest drivers of raised and widened scars.
Compression:
• Offloads mechanical stress at the wound edges
• Minimises micro-movements that disrupt healing
• Reduces “pull” forces that stimulate excess collagen
This is particularly relevant for areas that move or stretch frequently.
5. Supports long-term scar remodelling
Scar tissue continues to remodel for months to years after injury.
Consistent compression:
• Helps flatten and soften scars over time
• Improves pliability and elasticity
• Reduces thickness, redness, and discomfort
This is why compression therapy is often recommended for extended periods post-injury or surgery.
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Compression in practice
Compression may be delivered via:
• Compression garments (burn or post-surgical care)
• Silicone scar sheets or gel combined with pressure
• Supportive briefs, bandages, or wraps
• Medical-grade tapes that provide both tension offloading and compression
Optimal pressure is gentle and sustained, not tight or restrictive. Excessive compression can impair circulation and delay healing.
Why compression is often paired with silicone
Silicone addresses hydration and barrier function, while compression addresses mechanical and vascular factors. Together, they:
• Reduce transepidermal water loss
• Lower scar tension and inflammation
• Improve scar thickness, colour, and texture more effectively than either alone
Final Thoughts
Compression improves scar outcomes by reducing excess blood flow, calming inflammation, regulating collagen production, and minimising mechanical tension, resulting in flatter, softer, more flexible scars.
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