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Red, Raised and Numb Around the Edges at Week 4. Here’s Which Parts Settle on Their Own.
A trapeziectomy scar is usually 3 to 5 cm long, running over the base of the thumb at the wrist.
It’s red, firm, raised and tender for the first 2 to 3 months. Then it softens, flattens and pales over 12 to 18 months.
Start scar massage once the wound has fully healed, usually around week 2 to 3. A numb or tingly patch on the back of the thumb is common, and usually settles over weeks to months.
The scar does most of its changing in the first 6 months…so that’s when your effort counts the most.
Where are you right now?
- Stitches still in, weeks 0 to 2: keep it dry and leave it alone. Skip to the red flags.
- Wound closed, scar firm and pink: go to “How to massage a trapeziectomy scar.”
- Numb, tingly or zingy near the scar: read “The numb patch.”
- Month 3 or later, scar still thick or tight: read “If it isn’t going to plan.”
What’s normal for the scar, week by week
- Weeks 0 to 2 (OPEN): stitches or glue, a dressing, some bruising. The wound edges should stay together and dry.
- Weeks 2 to 6 (OPEN, the best time to start): pink to red, firm, a bit lumpy, sore to press. Itchy. This is an ACTIVE scar laying down collagen. Massage and silicone start here.
- Months 2 to 6 (CLOSING for softening): the scar is remodeling. Daily massage now decides whether it ends up soft and gliding or thick and stuck to what’s underneath.
- Months 6 to 18 (mostly SHUT for big changes): the color keeps fading on its own. Massage still helps comfort, but the scar changes far less than it did earlier.
A fresh scar is a bit like the Hulk…angry, red and swollen at first. Give it months and it turns back into Bruce Banner.
How to massage a trapeziectomy scar
Only once the wound is fully closed, with no scabs and no gaps. If you’re not sure, ask at your wound check.
- Pressure: firm enough that the scar goes pale under your finger. Stroking the surface does very little.
- Movement: small circles, then up and down, then side to side, moving the skin over what’s underneath.
- Dose: about 5 minutes, 3 to 4 times a day.
- Cream: any plain, unscented moisturizer. The cream reduces friction. Your fingers do the work.
- Silicone: gel or sheets over the closed scar for most of the day can help flatten a thick scar. Give it 8 weeks before you judge it.
- Sun: a red scar darkens in sunlight. Sunscreen or cover it for the first year.
(It’ll feel weird pushing on the spot that hurts. That’s normal. Sharp pain isn’t. Ease off if it is.)
More detail in scar management after hand surgery.
A scar remodels for months. What you do with your thumb in those months decides what it remodels into.
The numb patch
A thin skin nerve, a branch of the radial nerve, runs right across the area of the trapeziectomy scar. It gets stretched or irritated during surgery, and sometimes caught up in the healing scar.
So a numb, tingly or electric patch on the back of the thumb is common after this operation. Most of it settles as the nerve calms down over weeks to months.
- Desensitize it: rub textures over the area, soft to rough, 2 to 3 minutes, several times a day. Cotton wool, then a towel, then something scratchier.
- Tap it lightly around the sensitive area, building up over days.
- Massage around it as above, so the nerve isn’t stuck in a tight scar.
A zing when you tap one spot on the scar usually means a nerve sitting close to the surface. Getting better week on week is the good sign.
Is this normal?
Usually expected:
- A scar that’s red, firm and sore to press at week 6.
- A small hard lump under the scar. Usually scar tissue. See lump in the scar after hand surgery.
- Itch, especially in warm weather.
- A numb or tingly patch on the back of the thumb.
- The skin pulling a little when you move the thumb or wrist.
Check with your surgeon if the scar keeps getting thicker, wider or more raised after month 3, or spreads beyond the line of the cut.
If it isn’t going to plan
It’s month 3. The scar is still thick and ropy. It pulls every time you open your thumb to grab a bottle. And the tingling on the back of the thumb isn’t easing.
A scar that sticks to the tissue underneath stops the skin and tendons sliding. That limits how wide the thumb opens…and a thumb that won’t open is a thumb that can’t hold things. Scars stay changeable for about 6 months, then largely stop. Month 3 is still inside that window. Month 9 mostly isn’t.
So don’t wait for it to soften on its own. Massage 3 to 4 times a day, add silicone, and if the scar is still tethered or the nerve is still hot after 4 to 6 weeks of that, ask for a hand therapy referral. A scar that’s raised and spreading also needs your surgeon’s eyes. See the full trapeziectomy recovery timeline, and trapeziectomy with suspensionplasty if a tendon strip was used.
When can I…?
Typical ranges. Your surgeon’s advice comes first.
| Activity | Typical timing |
|---|---|
| Shower without covering it | Once stitches are out and the wound is closed, usually around 2 weeks |
| Soak it: bath, dishes, swimming | Once the wound is fully healed with no scabs, usually 3 to 4 weeks |
| Start scar massage | When the wound is fully closed, usually week 2 to 3 |
| Silicone gel or sheets | When the wound is fully closed |
| Sun on the scar | Cover it or use sunscreen for the first 12 months |
Call your surgeon today if
- Redness spreading out from the scar, heat, pus, a bad smell or a fever. See wound healing or infection.
- The wound opens up.
- Burning pain out of proportion, with a shiny, swollen, color-changed hand. See CRPS.
Get it checked if
- Numbness that’s spreading or getting worse after week 6.
- One spot on the scar gives a sharp electric shock every time it’s touched, and it isn’t easing by month 3.
- The scar is still thick and stuck down at month 3, despite daily massage.
- The scar is raised beyond the line of the cut and keeps growing.
The surgeon decides where the scar goes. The next 6 months decide how it behaves.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. If anything in the red flags sounds familiar, call your surgeon today.
Part of: Recovery after hand, wrist and elbow surgery: every week-by-week guide
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.