How do you know if you have scarred tissue?

September 26, 2025 •

4 min read

Nearly everyone develops scar tissue after an injury, surgery, or burn, as it is the body's natural repair mechanism. However, identifying internal or subtle scarring can be tricky, which is why it is vital to know the signs. Here is how you know if you have scarred tissue.

Quick Summary

Identifying scar tissue involves recognizing visible skin changes, such as texture, color, and elevation, along with internal symptoms like tightness, persistent pain, and reduced mobility. Unlike healthy tissue, scarred tissue is less elastic and can cause discomfort. A healthcare provider can provide an accurate diagnosis.

Key Points

Visible Signs: Look for skin color changes (pink/red to lighter/darker) and altered texture (raised, bumpy, or sunken) at the site of a past injury.
Internal Symptoms: Feel for persistent tightness, pulling sensations, or aching pain, especially after surgery, which can indicate internal adhesions.
Restricted Movement: Scar tissue over a joint can limit your range of motion, causing stiffness and discomfort during movement.
Keloid vs. Hypertrophic: Keloid scars grow beyond the original wound boundaries, while hypertrophic scars remain contained to the injury site.
Sensory Changes: Scarring can cause nerve compression, leading to localized numbness, tingling, or increased sensitivity to touch.
Palpation Test: Gently compare the density and elasticity of the scarred tissue to the surrounding skin; scar tissue often feels firmer and less flexible.
Seek Medical Advice: Consult a doctor for any persistent pain, restricted movement, cosmetic concerns, or signs of infection around a scar.

Understanding the Healing Process and Scar Tissue

When the body is injured, it initiates a complex healing process to repair the damage. The final stage of this process, known as remodeling, is where new fibrous tissue, primarily made of collagen, is created to close the wound.

While this new tissue is strong, its structure differs significantly from the original skin or internal tissue. In healthy, non-damaged tissue, collagen fibers have a multidirectional, woven-like pattern. Scar tissue, by contrast, aligns these fibers in a single direction, which makes it denser, less flexible, and less elastic. This change in architecture is why scarred tissue can feel and function differently than the surrounding healthy tissue.

Recognizing External (Visible) Scar Tissue

For external injuries, the signs of scarring are often visible and can develop over several months. A maturing scar may appear pink or red initially, eventually fading to a color that is lighter or darker than the surrounding skin. The appearance and characteristics can vary widely, indicating different types of scars.

Common Types of Visible Scars

Flat Scars: These begin as slightly raised but flatten over time. They may eventually become paler or slightly darker than your natural skin tone.
Raised (Hypertrophic) Scars: A hypertrophic scar is a thick, raised scar that remains within the boundaries of the original wound. It can be pink, red, or purple and may feel hard to the touch. These scars can sometimes be itchy or painful.
Keloid Scars: Unlike hypertrophic scars, keloids grow beyond the original wound site, often becoming large, puffy, and raised. They can be painful or itchy and may appear months after the initial injury. Certain genetic and ethnic factors increase the likelihood of developing keloids.
Depressed (Atrophic) Scars: These scars, which often result from severe acne or chickenpox, appear as sunken pits or indentations in the skin.
Contracture Scars: Commonly caused by burns, these scars tighten the skin, which can restrict movement, especially if they are located over a joint.

Identifying Symptoms of Internal Scar Tissue (Adhesions)

Scar tissue can also form internally after surgery, inflammation, or trauma. These internal bands of scar tissue are known as adhesions and can bind together organs, muscles, or other tissues that are not normally connected.

Common signs of internal scarring include:

Persistent Pain: Aching, throbbing, or shooting pains in the area of a past surgery or injury that lasts well beyond the typical healing period.
Tightness or Pulling Sensation: Many people describe a feeling of internal tightness, as if tissues are being tugged or gripped together. This feeling often increases with certain movements.
Restricted Movement: Scar tissue that forms around joints or muscles can limit the normal range of motion, causing stiffness and making certain activities difficult.
Numbness, Tingling, or Burning: If scar tissue forms near or compresses a nerve, it can cause neuropathic symptoms in the affected region or even radiate to other areas.
Gastrointestinal Issues: After abdominal surgery, adhesions can sometimes cause digestive problems such as bloating, cramping, or constipation, in severe cases even leading to bowel obstructions.

Palpating for Surface Scar Tissue

For external scars, a hands-on assessment can provide clues about the underlying tissue. This is not a formal diagnosis but can help you feel the difference between normal and scarred tissue. With gentle pressure, you can compare the texture, density, and elasticity of the scar to the surrounding healthy skin.

Texture: Gently run your fingers over the scarred area. Does it feel bumpy, lumpy, or rope-like? Healthy skin should feel smooth and uniform.
Density & Stiffness: Press down on the scar. Does it feel hard and rigid compared to the softer, more yielding surrounding tissue? Scar tissue is often denser and less pliable.
Elasticity: Gently pinch and lift the skin. Does the scarred tissue stretch or move differently than the adjacent tissue? Scar tissue is less elastic and may feel firmly attached to deeper layers.

Comparison: Healthy Tissue vs. Scar Tissue


Characteristic	Healthy Tissue	Scar Tissue
Collagen Structure	Woven, multi-directional pattern for flexibility	Aligned in a single direction for quick closure
Elasticity	High elasticity; stretches and moves freely	Low elasticity; inflexible and restricted
Color	Matches surrounding skin tone	Initially red/pink, may become paler or darker
Texture	Smooth and soft to the touch	Can be raised, sunken, bumpy, or hard
Circulation	Good blood flow	Poor circulation, impeding oxygen delivery
Nerve Endings	Normal nerve function and sensation	Can be hypersensitive, numb, or tingling if nerves are involved

When to See a Medical Professional

While many scars fade and cause no issues, you should consult a doctor if you experience any concerning symptoms. They can provide an accurate diagnosis, especially for internal scarring. Consider a visit if you experience:

Persistent or Worsening Pain: Aches or throbbing that don't improve over time.
Restricted Movement: Difficulty moving a joint or limb freely.
Changes in Scar Appearance: A scar that is growing, becoming increasingly raised, or changing color long after the initial healing period. This is especially important for keloids.
Unusual Symptoms: New numbness, tingling, or sensations of tightness that interfere with daily life.
Infection: Signs like redness, warmth, pus, or fever at the scar site.

Treatment options, which can include massage, physical therapy, silicone sheets, or injections, depend on the type of scar and its severity. You can read more about scar care on the Cleveland Clinic's website: my.clevelandclinic.org/health/diseases/11030-scars.

Conclusion

Scar tissue is a necessary part of the healing process, but it is not identical to the original tissue. By understanding the signs—from visible changes in texture and color to internal sensations of pain and tightness—you can better assess the health of your healed tissue. While a personal assessment can offer clues, consulting a healthcare professional is the best course of action for persistent symptoms or significant concerns. Early intervention and proper management can help minimize discomfort and improve mobility associated with scarring.

Frequently Asked Questions

Internal scar tissue often feels like a persistent pulling, tightness, or aching sensation. Some people experience a throbbing discomfort or shooting pains, especially with certain movements. If nerves are involved, you might also feel numbness, tingling, or burning sensations.

Yes, it is possible for scar tissue to cause pain months or even years after the initial injury has healed. This is because the body's internal scarring process can continue, and the dense, inelastic tissue can put pressure on nerves or restrict the movement of surrounding tissues.

Normal healing typically results in a scar that flattens and fades over time. Excessive scarring, such as hypertrophic or keloid scars, is characterized by thickened, raised tissue that is more pronounced and may not flatten out on its own. For hypertrophic scars, this is contained within the wound boundary, while keloids grow larger than the original injury.

While palpating external scar tissue for firmness is possible, identifying deep, internal scar tissue requires a medical professional. Doctors use physical examinations and sometimes imaging tests to diagnose adhesions or deeper fibrosis. You should not attempt to forcefully manipulate suspected internal scar tissue on your own.

You should see a doctor if your scar tissue is causing significant pain, restricting your range of motion, or if you notice signs of infection (redness, warmth, pus). Also seek medical advice if a scar is growing or changing in appearance, as this could indicate a keloid formation or, in rare cases, another condition.

For external scars, a dermatologist or plastic surgeon is appropriate. For internal adhesions or pain from a past surgery, an orthopedic specialist, a physical therapist, or a pain management specialist may be the right choice. Your primary care physician can also provide guidance.

No, scar tissue is a permanent repair. While many scars will fade, flatten, and become less noticeable over time (up to two years), they never completely disappear. Treatments can improve their appearance, texture, and function, but the altered tissue structure remains.