Post-Surgery Scars: Treatment Options and Concerns - Dermatology

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Post-surgery scars can be a significant concern for many patients, especially when they exhibit symptoms such as redness, swelling, and discomfort long after the healing process should have completed. In your case, with scars from surgeries performed in September 2015 and May 2016 still showing signs of irritation and potential hypertrophic or keloid formation, it’s essential to understand the nature of these scars and the treatment options available.


Understanding Scarring
Scars form as part of the natural healing process after an injury or surgery. They can vary in appearance and texture based on several factors, including the type of injury, the depth of the wound, the individual's skin type, and how well the wound was cared for during the healing process.
1. Hypertrophic Scars vs. Keloids:
- Hypertrophic scars are raised scars that remain within the boundaries of the original wound. They can be red, itchy, and sometimes painful. These scars may improve over time but can take a year or more to mature.

- Keloids, on the other hand, extend beyond the original wound site and can continue to grow over time. They are often more challenging to treat and can recur after treatment.


Treatment Options
For both hypertrophic scars and keloids, various treatment options are available:
1. Silicone Gel Sheets or Silicone Gel: These are often recommended as first-line treatments for hypertrophic scars. They help to flatten and soften the scar tissue. Polyxal, which you mentioned, is a silicone-based product that can be effective for both hypertrophic scars and keloids. It works by providing a protective barrier that hydrates the scar and can help reduce redness and itching.

2. Steroid Injections: For more severe cases, especially keloids, corticosteroid injections can be administered directly into the scar tissue to reduce inflammation and flatten the scar.

3. Laser Therapy: Laser treatments can help improve the appearance of scars by targeting the blood vessels in the scar tissue, reducing redness, and promoting collagen remodeling.

4. Surgical Revision: In some cases, if the scar is particularly bothersome or unsightly, surgical revision may be an option. This involves removing the scar tissue and allowing a new, less noticeable scar to form.

5. Pressure Therapy: For certain types of scars, especially keloids, applying pressure garments can help flatten the scar over time.


Future Scarring Concerns
Regarding your concern about the scars from your May surgery (on the inner knee and outer thigh), it is indeed possible for these scars to develop similarly to your previous ones, especially if you have a predisposition to hypertrophic scars or keloids. Factors such as the surgical technique used, the location of the incision, and your skin type can all influence the healing process.


Recommendations
1. Consultation with Specialists: Since you have already seen a dermatologist and your orthopedic surgeon, consider consulting a plastic surgeon or a dermatologist specializing in scar management. They can provide tailored advice and treatment options based on the specific characteristics of your scars.

2. Early Intervention: If you notice any signs of abnormal scarring (increased redness, swelling, or itching), it’s crucial to address these concerns early. Early intervention can often prevent the development of more severe scarring.

3. Scar Care Routine: Maintain a regular scar care routine that includes moisturizing the area and protecting it from sun exposure, as UV rays can darken scars.

4. Monitoring Changes: Keep an eye on your scars for any changes in size, color, or texture, and report these to your healthcare provider.

In conclusion, while the presence of hypertrophic scars or keloids can be frustrating, various treatment options are available to help manage and improve their appearance. Early intervention and a proactive approach to scar care can significantly influence the outcome of your healing process.