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Scar Care for Trans People: A guide for new and old surgical scars

Learn how to care for your scars in a way that aligns with your personal comfort and goals.
Close-up photo of post-surgery chest scars

Gender-affirming surgery can be a deeply affirming and transformative experience—one that feels like coming home to ourselves. While surgery brings us closer to our true selves, it also comes with the reality of scarring. Whether scars feel like a mark of pride, a neutral part of healing, or something you’d prefer to minimize, there’s no right or wrong way to feel about them. This guide is here to help you understand what to expect and how to care for your scars in a way that feels right for you.

At last: you’ve had the surgery you’ve been waiting for—whether that’s top surgery, bottom surgery, breast augmentation, facial surgery, or another procedure. The healing process takes time, but you may already be feeling the mental health benefits of this long-awaited step.

Part of recovery includes taking care of your incisions as they heal into scars. For those of us in the trans community, scars can carry many different meanings—some of us embrace them, some feel neutral, and others prefer to reduce their appearance.

No matter how you feel about your scars, you deserve knowledge and resources to care for your body in a way that aligns with your needs.

 

What is a scar?

When a wound or incision occurs, the body initiates a healing process that leads to the formation of fibrous tissue known as a scar. Initially, scar tissue appears raised, and thick, and may be pink, red, or purple. Over time, the scar will change to a shade that is either lighter or darker than the surrounding skin. 

"What can I expect during the healing process?"

Healing begins right after surgery. In the early days, you’ll likely feel sore and will need rest. Your incisions may be closed with stitches, steri-strips, or surgical glue, and you might be instructed to apply antibiotic ointment. Dressings will cover the incision sites, and you may have drains to collect excess fluid. Many surgeons also recommend compression garments to help reduce swelling.

Around the two-week mark, your incisions will start forming scars. By 3 months, they typically begin to soften and lighten. Complete scar healing can take 18 months to 2 years, though the initial incision healing phase is much shorter—about 6 to 8 weeks.

If at any point you experience fever, increasing redness, significant swelling, or pain in your legs, reach out to your care team immediately.

"When can I begin scar care?"

Scar care can start once your incision has fully healed—when it’s completely closed and any scabbing is gone. This typically happens around 4 to 6 weeks after surgery, though it may be as soon as 3 weeks depending on how your body heals. As always, be sure to consult your healthcare team for any questions or concerns you might have with your healing process.

 

Scar care: What you need to know

Taking care of your incisions is key for healing and infection prevention, but ongoing scar care is a personal choice. Some of us choose not to do much, while others prioritize minimizing scarring—and both are completely valid! One exception? Scar massage. Regular scar massage can help reduce adhesions (where scar tissue sticks to underlying structures), which can improve range of motion and comfort over time.

If you’re looking to care for your scars, here are four main steps you can take:

  1. Moisturizing – Helps prevent dryness, itching, and roughness.
  2. Using Silicone Products – Can reduce redness, thickness, and discomfort.
  3. Applying Sunscreen – Prevents scars from darkening.
  4. Scar Massage – Supports flexibility and minimizes adhesions.

Moisturizing

You can use something as simple as a fragrance-free lotion, or opt for what is commonly recommended for scar healing, a silicone product. Moisturizing works well in conjunction with scar massage.

Silicone products

Silicone is widely used to improve scar healing. Options include:

  • Silicone Sheets or Tape: These come in either a sheet form or as a roll of "tape" that can be cut to match the shape of your incision. The sticky side should be placed over your scar. Silicone sheets and tape are available in a variety of skin tones, as well as clear. They can be rinsed or washed with soap and water, then air-dried for reuse. Silicone sheets or tape are usually worn during the day and removed at night. They should also be taken off before swimming or bathing. These products are particularly well-suited for top surgery scars. The main advantage of silicone sheets or tape is that they are reusable. However, a potential drawback is that they may be visible on the skin. 
  • Silicone Gel or Cream: This product comes in either a tube or small container. Apply the cream or gel directly onto the scar twice a day, and also after swimming or bathing. Silicone gel or cream is versatile and can be used anywhere on the body including on both facial and genital scars, and it dries clear. You will need to wash and dry the area before reapplication.
  • Silicone Spray: This option is less common but works similarly to the gel or cream. 

Silicone products are available over the counter, and some insurance plans may cover them. If you’re interested in exploring coverage, check out Point of Pride’s article on insurance and gender expression.

Sunscreen

Sunscreen is essential for reducing the darkening of scars, especially for the first year after surgery on scars that are exposed to the sun. You should start applying sunscreen once your incision has fully healed.

It's best to use a sunscreen with a high SPF; at minimum, choose one that is SPF 30 and broad spectrum. If you're using a silicone gel, cream, or spray and plan to be in the sun, first apply the sunscreen. Allow it to dry completely before applying the silicone product.

Alternatively, you can cover the scar with a non-clear silicone sheet or tape to protect it from sun exposure. Another option is to apply a waterproof dressing over the scar after using the silicone gel, cream, or spray, which can help you avoid the need for sunscreen if you prefer.

Scar massage

Scar massage is essential for preventing scar tissue from adhering to underlying tissues, which can lead to flexibility and mobility issues. It can also help reduce sensitivity and itchiness, promote healing, and break down collagen or scar tissue.

You can start massaging your scars once your incisions are fully healed and this should continue for at least the first year after surgery. Scar massage should be performed two to three times a day for brief periods of 5 minutes or less. If your scars become inflamed or painful, stop and consult with your care provider. Remember to be gentle with yourself!

It is generally recommended to use silicone scar cream or gel during the massage. Alternatively, you can use a fragrance-free lotion or oil. Here are some additional tips:

  • Use light pressure while massaging. A small amount of discomfort is normal, but if you experience pain – stop!
  • With two fingers or your thumb, use the following techniques: make circular motions across the scar, press down and push straight across the scar, press above the scar, and then push down and back up along the entire length of the scar.
  • You should also massage the areas surrounding the scar to help with tissue adhesion. 

Additional scar tips

  • Foods heal: Try and make sure you’re eating enough protein, as it helps with wound healing. Vitamins A and C, along with zinc, are known to be beneficial for this process. 
  • Reduce or quit smoking: Tobacco can slow down healing. Even cutting back can help. Your  surgeon may even require that you stop smoking before surgery. It’s no easy feat to quit, and this may not ultimately even be your goal. If you’re able to reduce or temporarily stop, even this can help! 
  • Bio-oil and retinoids: These may aid in scar fading and are available both over the counter and by prescription. Again, it's wise to consult with your healthcare provider first.


"What if I don't like the appearance of my scars?"

If you’re unhappy with your scars, there are options:

  • Laser therapy, steroid injections, microneedling, and microdermabrasion can help improve scar appearance.
  • Surgical revision is also an option. Corrective surgery can serve multiple purposes, such as reducing the appearance of scars, improving range of motion by addressing restrictive scars, and helping you achieve your desired aesthetic. 
  • Medical tattooing can also be performed to cover scars, alter their appearance, or create art or designs to cover scars or add nipples and other affirming details.

Hypertrophic and keloid scarring

Some of us may develop hypertrophic or keloid scars due to excess scar tissue. Hypertrophic scars stay within the incision line, while keloids extend beyond it.

Keloids are more common in people with darker skin tones. Treatment options include silicone therapy, steroid injections, cryotherapy, and even botulinum toxin injections.

 

The emotional side of scarring

Our scars tell stories—of healing, transition, survival, and resilience. For some of us, they are a source of pride; for others, they bring up complicated feelings.

Scarring can also play a role in safety concerns, especially for those of us navigating visibility and passing in different spaces. All of these feelings are valid.

If you’re struggling with how your scars impact your mental health, you’re not alone. Reach out for support—whether that’s from a trusted friend, therapist, or community resources.

 

Final thoughts

Gender-affirming surgery is a powerful, life-changing experience. It’s a step toward aligning our physical selves with who we truly are. Scarring is a natural part of that journey, and however you feel about it is okay.

Empowering yourself with knowledge about scar care can help you make informed choices about your healing. And no matter what, remember this: you are worthy of care, support, and understanding.

Resources

 

Contributor thanks

We’re grateful to have insights from a dedicated advocate in the field. Thank you to:

Elizabeth Hood, RN, BSN
Seattle, WA & Portland, OR based.
Queer nurse. Social justice advocate. Aspiring freelance health writer.
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Point of Pride

Written by Point of Pride

Point of Pride provides financial aid and direct support to trans folks in need of health and wellness care.