Why Does My Scar Itch Years Later? The Science Behind Old Scars and Persistent Sensitivity

February 17, 2026

Quick Summary: If you've ever wondered, "Why does my scar itch years later?", you're not alone - and there is a clear biological explanation. In most cases, an old scar itches because the nerves and collagen inside it remain biologically active long after the skin surface appears healed. Old scars can itch due to ongoing nerve regeneration, collagen remodelling, and skin barrier changes that persist long after the wound closes. In women approaching or moving through menopause, declining estrogen may amplify scar sensitivity further. This itching is usually normal, but there are evidence-based options that may help, including silicone therapy, consistent hydration, and gentle massage. This article explains what is happening at the biological level and what, if anything, you can do about it.

That Familiar Itch You Weren't Expecting

You noticed it on a warm afternoon - that quiet, persistent prickling along the old C-section scar you'd almost forgotten about. It had been nine years. The scar was flat, pale, and long-healed. And yet, there it was again: an itch you couldn't quite reach, a low-grade buzzing that came and went without explanation.

If this sounds familiar, you're not imagining it. For many women, old surgical scars - from caesareans, breast surgeries, joint procedures, or injuries - can become unexpectedly irritating years, or even decades, after the original wound closed. Understanding why this happens is both reassuring and genuinely interesting from a biological standpoint.

Why Scar Tissue Is Biologically Different from Normal Skin

When skin is injured, the body repairs it with a purpose-built patch rather than restoring the original architecture. Normal skin is a beautifully organised structure: collagen fibres arranged in a basket-weave pattern, interspersed with sweat glands, sebaceous glands, hair follicles, immune cells, and an intricate network of nerve endings.

Scar tissue is none of those things. Collagen in a scar is deposited rapidly by fibroblast cells and laid down in parallel bundles rather than the original basket-weave arrangement. This produces tissue that is denser, less elastic, and structurally distinct from uninjured dermis. Crucially, scar tissue lacks the sweat glands and oil glands of normal skin, which means it struggles to maintain hydration on its own. A dry scar is, by definition, a more irritable scar.

What many people don't realise is that scar remodelling - the gradual reorganisation and strengthening of this collagen scaffold - can continue for two years or more after the wound closes. Some research suggests cellular activity within scar tissue continues for considerably longer, particularly in raised or hypertrophic scars. Scar tissue also develops its own network of small blood vessels as part of the healing process, and this vascular activity can persist well into the mature scar phase, contributing to warmth, redness, and sensitivity that many people notice long after the wound appears closed. If you'd like to understand how this structural difference affects long-term appearance, our guide to scar remodelling explains this process in more depth.

Why Does My Scar Itch Years Later? The Role of Nerves and Collagen

When skin is damaged, the nerves within it are also cut, compressed, or disrupted. These nerve endings don't simply grow back to their original positions. Nerve regeneration is a slow, imprecise process: damaged axons regrow along available pathways and gradually re-establish connections with surrounding tissue. This process can take months to years, and for some individuals the regrowth is incomplete or disorganised.

As nerve fibres regrow toward their target tissues, miswiring can occur, leading to abnormal sensations - including itchiness - at the scar site. This is partly why sensation in and around a scar can feel different from normal skin: hypersensitive in some areas, numb in others, and prone to unexpected flare-ups.

The body also continues producing small amounts of histamine - an inflammatory signalling molecule - as part of the ongoing tissue repair process. Even as inflammation decreases, histamine may still be released in the wound area when cells and blood vessels are actively regenerating, causing intermittent or persistent itchiness. In raised scars especially, where fibroblasts remain more active, this background inflammatory state can persist well beyond the expected healing window.

Mechanical tension is another contributor. Mechanical stress on scar tissue promotes the proliferation of nerve fibres and the directional alignment of collagen, sensitising nociceptive neurons and amplifying scar-associated sensations. This is why scars located over joints, the lower abdomen, or mobile areas of the body tend to be more symptomatic than those on less active regions.

Some researchers also describe a phenomenon known as neurogenic inflammation, where nerve fibres themselves release inflammatory mediators - including substance P and calcitonin gene-related peptide - that contribute to localised itching, redness, and sensitivity in scar tissue. This helps explain why scar itch can feel persistent and difficult to attribute to an obvious cause: the inflammation is coming from within the tissue itself, not from an external irritant.

It is also worth distinguishing between the two most common types of raised scars, as they behave differently. Hypertrophic scars remain within the original wound boundary and often contain more active blood vessels and nerve fibres than flat scars, making them more prone to itch. Keloid scars extend well beyond the original wound site and involve a more aggressive fibroblast response. Both can cause significant discomfort, but keloids in particular warrant specialist assessment rather than self-management alone.

The Menopause Connection: Why Scar Sensitivity May Increase in Midlife

For women in perimenopause or post-menopause, old scars may become more irritable for a reason that has nothing to do with the scar itself.

Estrogen deficiency is associated with reduced barrier function, slower wound healing, and impaired immune and thermoregulatory responses. Research has shown that skin collagen content declines with menopausal age rather than chronological age, at an average rate of 2.1% per postmenopausal year over a 15-year period.

This matters for scar sensitivity because scar tissue - already lacking the support structures of normal skin - becomes even more vulnerable as the surrounding dermis thins and loses hydration. Estrogen deprivation accelerates skin changes including dryness, atrophy, and impaired wound healing, and the resulting changes in skin architecture are rapidly noticeable at menopause.

The skin around an old scar may become drier, thinner, and less well-cushioned as estrogen levels fall. Combine that with the nerve hypersensitivity already present in scar tissue, and a dormant scar can suddenly announce itself.

Additional triggers that may cause old scars to flare include heat and sun exposure, friction from clothing, physical stress or illness, and seasonal changes in humidity. Psychological stress can amplify the perception of itch, as the brain's processing of sensory signals is closely linked to emotional state.

Is It Normal or Does It Need Medical Review?

In most cases, an old scar that itches periodically is a normal - if inconvenient - feature of long-term tissue remodelling. It is generally not a sign of something serious.

However, there are circumstances where a scar that changes warrants a conversation with your doctor or dermatologist. Seek a review if:

The scar is visibly growing beyond its original borders
There is new raised thickening, particularly in a previously flat scar
There is significant colour change - deepening red, purple, or darkening
Pain accompanies the itching, rather than itching alone
The scar feels firmer or more tethered to underlying tissue than before

These changes could indicate a developing hypertrophic scar or keloid, both of which are manageable when assessed early.

What Can You Actually Do About It?

Hydration

Because scar tissue lacks the oil glands that help normal skin self-moisturise, consistent topical hydration is the most basic and effective first step. Well-hydrated scar tissue is less likely to crack, tighten, or generate the irritation signals associated with dryness. A good moisturiser applied gently and regularly - twice daily, at minimum - can make a meaningful difference to how an old scar feels.

Silicone Therapy

Silicone is the most studied topical intervention for scars, and the one most consistently recommended in international clinical guidelines. The way it works is biologically logical rather than mysterious.

Silicone forms a semi-occlusive layer that helps regulate hydration in the upper layers of the skin. This moisture balance appears to send signals to deeper scar cells, helping calm overactive collagen production - a process that research suggests is mediated through keratinocyte and fibroblast communication.

Silicone increases hydration of the stratum corneum, facilitates regulation of fibroblast production, and reduces collagen overproduction, resulting in softer and flatter scar tissue. It also modulates the expression of growth factors that regulate collagen synthesis and breakdown.

Importantly, silicone gel - particularly in topical gel form rather than traditional sheeting - has also been shown to reduce itching and discomfort associated with scars, making it relevant not just for appearance but for symptom management.

For those looking for a clinically grounded option, silicone scar therapy remains the most widely recommended first-line approach in international scar management guidelines. Genova Silicone Scar Gel is formulated specifically for this purpose - designed to dry as a breathable, invisible layer suitable for both newer and mature scars. It can be applied daily over the scar site and used alongside moisturiser and sun protection as part of a consistent routine.

Gentle Massage

Scar massage - applying moderate pressure and moving in slow circular or cross-fibre patterns - may help soften raised scar tissue and improve local circulation. It also serves as a form of desensitisation therapy for hypersensitive nerve endings. Consistency matters more than pressure: Two to three minutes daily is more beneficial than an occasional deep session.

Sun Protection

Scar tissue does not produce melanin the same way normal skin does, making it more vulnerable to UV-induced changes. Sun exposure can darken scar tissue and contribute to inflammation. Applying sunscreen to any exposed scar reduces this risk.

Is It Too Late If Your Scar Is Already Years Old?

This is a question worth answering clearly: no, it is not too late.

The belief that scar treatment is only useful in the first months after injury is not supported by evidence. Scar tissue continues to remodel over time, and the biology that makes itching possible - collagen reorganisation, nerve activity, fibroblast signalling - also makes the tissue responsive to consistent treatment.

Silicone-based products are widely regarded as an effective scar therapy solution and are recommended as a first-line form of scar management - both as prevention for new scars and as treatment for established ones, including hypertrophic and keloid scarring.

Realistic expectations are important here. A mature scar is unlikely to disappear entirely. What consistent treatment may offer is a reduction in itching, softening of raised tissue, improvement in texture, and better integration with surrounding skin. Results vary between individuals and are generally seen over a six to twelve week period of consistent use.

Who May Benefit from Scar Management

Likely candidates for evidence-based scar management:

Surgical scars from procedures including breast surgery, abdominoplasty, or orthopaedic operations
C-section scar care: C-section scars are particularly common candidates, especially those with persistent sensitivity or tethering along the lower abdomen
Managing hypertrophic scars: raised, firm scars that remain within the original wound boundary respond well to consistent silicone therapy
Older scars that have become more irritable during hormonal changes, including perimenopause

Who should consult a specialist first:

Those with keloid scars - scars that have grown well beyond the original wound site
Anyone with active inflammation, broken skin, or infection in the scar area
Those who have undergone radiation therapy near the scar site

Myth vs Reality

Myth: Old scars shouldn't itch. Reality: Scar tissue remains biologically active for years. Itching in a mature scar is usually related to ongoing collagen remodelling and nerve activity - not infection or damage.

Myth: Itching means it's still healing. Reality: Sometimes. But in old scars, itching is more often related to nerve hypersensitivity, dryness, or hormonal changes in the surrounding skin than to active tissue repair.

Myth: Nothing works on a scar that's more than a year old. Reality: Scar tissue continues to respond to treatment beyond the first year. Consistent silicone gel use and good hydration can produce improvements in both comfort and appearance in older scars.

Myth: Silicone gel is only for new scars. Reality: Clinical evidence supports the use of silicone therapy for both prevention and treatment, including in established, mature scars. There is no evidence that age of the scar disqualifies it from responding.

Myth: If a scar isn't raised, it won't itch. Reality: Flat, pale scars can still exhibit nerve hypersensitivity and barrier dysfunction. Appearance and sensation do not always correlate.

The Role of Complementary Factors

Managing scar sensitivity is not just about what you apply topically. Several lifestyle and environmental factors influence how a scar feels day to day.

Hormones play a significant role, as discussed above. Women in perimenopause may notice scar symptoms worsen as estrogen levels fluctuate - for a deeper look at how hormonal change affects skin more broadly, our article on menopausal skin changes covers this in full. Supporting overall skin barrier health - through adequate hydration, nutrition, and sun protection - creates a better environment for scar treatment options to work effectively.

Friction from tight waistbands, bra straps, or activewear that sits directly over a scar can activate mechanical sensitivity in nerve endings. Choosing softer fabrics or using a thin barrier layer over an irritable scar may help. Heat and humidity cause local vasodilation and increased circulation in scar tissue, which can temporarily intensify itch. Stress - through its effects on cortisol, inflammation, and nerve sensitivity - can amplify scar symptoms that would otherwise remain quiet. None of these factors is a cause for alarm, but each is worth considering when trying to understand what is driving a particular flare-up.

FAQ: Old Scars and Itching

Why does my 10-year-old scar itch? Nerve fibres in and around a scar continue to remodel for years, and the nerves that grew back may not have the same threshold as those in normal skin. This means they can fire in response to minor stimuli - temperature changes, friction, dryness - producing itch signals without obvious cause.

Can menopause make scars itch? Yes, research suggests it can contribute. As estrogen declines, the skin becomes drier and thinner, the barrier function weakens, and the dermis around a scar becomes less well-hydrated and supported. This can make previously settled scar tissue more reactive.

Is an itchy scar dangerous? In most cases, no. Periodic itching in an otherwise stable scar is a normal feature of long-term tissue biology. However, if the scar is actively growing, thickening, changing colour, or becoming painful, it warrants a medical review.

Does silicone gel stop itching? Research indicates that silicone therapy can reduce itching and discomfort associated with scars. The mechanism is thought to involve normalising moisture levels in the scar environment and modulating the cellular activity that drives inflammation and nerve sensitivity. Results vary and are typically seen with consistent use over several weeks.

Why does my scar flare up in hot weather? Heat increases blood flow and causes local tissue expansion, which can activate sensitive nerve endings in scar tissue. Sweat can also irritate a scar that lacks functioning sweat glands of its own, as moisture accumulates at the surface without being properly distributed. Applying a light barrier - such as a silicone gel layer or a breathable physical sunscreen - can help.

How long does scar remodelling actually take? Formal scar remodelling is considered complete within one to two years in most cases, but cellular activity within scar tissue can continue beyond this. Many people report changes in how a scar looks and feels for several years after the original injury.

When should I see a dermatologist about an itchy scar? If your scar is growing beyond its original boundary, becoming firmer or more raised, changing colour significantly, or causing pain rather than itching alone, a dermatologist's assessment is worthwhile. Early intervention for keloids or hypertrophic scars produces better outcomes than delayed treatment.

A Final Word

If you're asking "why does my scar itch years later?", the answer lies in biology, not damage. An old scar that suddenly starts itching is rarely cause for alarm. What it usually reflects is the quiet, ongoing activity of tissue that never quite became normal skin - and in women navigating hormonal change, that biology may be influenced by shifts happening across the whole body's skin.

Understanding what is happening takes the anxiety out of an otherwise puzzling symptom. And knowing that scar tissue remains responsive to consistent, evidence-based care - even years after the original injury - means there are practical steps available when the discomfort becomes more than just occasional.

Managing an old scar is not about erasing it. It is about creating the conditions where sensitive tissue can settle, soften, and behave with less urgency. Consistent hydration, thoughtful sun protection, gentle massage, and a clinically grounded product like silicone gel can, over time, make a meaningful difference to how a scar feels - and how much attention it demands.

Related Reading:

Individual results vary. For significant changes in scar appearance, persistent pain, or concerns about keloid development, consult a dermatologist or your GP.

Sources:

Mustoe TA. Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plastic Surgery. 2008;32(1):82-92. doi:10.1007/s00266-007-9030-9
Brincat M, Pollacco J. Menopause and the effects of Hormone Replacement Therapy on skin aging: A Short Review. GREM Gynecological and Reproductive Endocrinology & Metabolism. 2024;5(1):034-037. doi:10.53260/grem.2450106