SCAR THERAPY

As we all know, one of the most important aspects of your surgery is the final scar. Therefore, we take scar care very seriously.

It is normal for your scar to become red and raised in the first 6-12 months after surgery. After that time it will fade and become softer but will never disappear altogether. It takes a year or more for a scar to “mature” completely and become supple, flat and faded.

Everyone heals differently, due to genetics and personal health factors. There three general types of healing patterns:

1. Normal- The scar is darker or redder but not elevated (most common).
2. Hypertrophic - The scar is thick and cordlike and raised, and it also may itch.
3. Keloid - The scar extends past the original site of the incision and can be very painful.

Scar massage: Use your favorite type of lotion and apply a small amount to the scar when scabs are all gone (3-4 weeks after surgery). We use Walgreen’s brand or Vitamin E. Massage with fingertips for 5 minutes twice daily. Press hard enough so the tissue blanches. Pinching the scar hard between your two fingers is the best technique.

Adjunctive therapy: The following therapy has been shown to be of some benefit in preventing hypertrophic scarring.

There are 3 different methods: silicone pads, silicone gel, and a paint-on scar treatment. With any of the following three methods, you still need to massage twice daily. After massaging scar, clean off scars completely. Therefore, the treatment can go directly on the scar. We provide the following products in our office.

1. Topical Silicone Pads

Dermatix Ultra: Odorless, easy to use, combine with massage for 5 minutes twice daily. Use this product together with scar massage.

Kelo-cote: Use at night since it is greasy

Scargel: Easy to use but you must wait for it to dry.


2. Scar Strip Pads:

   Scar Therapy Pad (Curad, others): Easy to use, reusable until sticky side wears off.

   Cica-Care Silicone Sheeting: More expensive, top-of-the-line, used for thick and problematic burn scars.
   

3. Paint-on treatment: Scarguard: Easy to use, dries quickly, strong medicinal odor.
   

If this scar therapy together with massage is not effective within 3-6 months, there are additional options:

1. Low dose steroid injections: Performed every 6-8 weeks for a maximum of 3 injections. May cause thinning and white pigmentation of skin. We are not responsible for results if injections are given outside this office.
   
   
2. Ultrasound treatments: Take a few minutes, used with or without scar control gel.
   
   
3. Steroid creams: Used once a day in the short term, may improve itching and redness.
   
   
4. Surgical revision: As a last resort, when conservative management has failed. Scar therapy methods above to be initiated within 3-4 weeks and continued for at least 3-6 months to optimize scar maturation.
   
   

Keep in mind that as a scar is maturing, it is more sensitive to the effects of the sun. You should wear sunblock (SPF 30 or higher) on your scars when outdoors, even beneath clothing, to avoid hyperpigmentation (scars tanning darker), which can take months to years to fade.

Be patient and rest assured that all scars go through this normal period of healing. We will work together with you to ensure your post-surgical scars look as beautiful as your surgical results.

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