Some Simple Things to Do to Minimize Scars
The stitches are out. What are some simple things that you can do to minimize the scar?
Even though the stitches are out, the wound is not finished healing. The body does most of the healing of a laceration within two weeks, but will continue to "mold" and "change" the scar for up to two years.
It is important for the stitches need to come out early so that there will not be "stitch marks" or "rail road marks" from the stitches themselves. The "new scar" or "recently healed laceration" needs to still be protected from tension so it won't be pulled back open or the scar widened.
Steristrips can do this, but so can a piece of paper tape applied along (or across) the "healed" scar. Both of these allow the strip or tape to have the tension placed on them rather than actual scar.
Newly healed skin needs to be protect the scar from the sun. Apply sunscreen daily to the scar, if exposed (face, neck, hand), for 6 months or more. This will allow the red color of the newly healed skin/scar to fade.
Applying sunscreen also "massages" the scar as it is rubbed on. Scar massage helps in the "realignment" of the collagen during the maturation phase (up to two years). It is easier to do scar massage if you use something like cocoa butter, vitamin E, Mederma, Aquafor, or just a favorite lotion.
The key to scar massage is to simply do it. Gently massage along the scar. Gently "pinch" the scar up if the scar feels like it is trying to "stick" or adhere to the underlying tissues.
If the scar allows (won't work on areas with great movement), silicone sheeting products can be used. It is hard to use both this and some of the scar massage suggestions at the same time. The Mederma or vitamin E, etc must be cleasned off the skin really well before applying the silicone sheeting.
Remember scars fade, but don't ever go completely away. Scar revisions are not usually done for a minimal of 6 months, as we know that scars change, flatten, and fade. Exceptions to this rule are when the scar is obviously creating a tether across a joint (can not straighten the elbow) or deforming (pulling the lower eyelid away from the eye).
If the scar appears to be getting "puffier" or thicker, it can often be helpful to inject the scar with Kenalog. This must be done carefully, as the injection can thin the scar/skin (atrophy) and decrease pigmentation in the skin. These risks must be weighed against the benefits expected to be gained.
Other things that can help with healing include: not smoking, good nutrition, and keeping other disease processes under control (ie diabetes and hypothroidism).
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