Darkening Scars: Causes and Treatments After Surgery

Scars darken when exposed to heat?

Hello Doctor, I had a car accident in early December last year, resulting in a severe laceration on the dorsum of my foot (with the tendon of my big toe exposed).
The emergency physician performed a suturing procedure, and a week later, I underwent a skin graft surgery.
After the wound healed, the sutured area developed hypertrophic scars.
I would like to ask, up to now, whenever I take a shower or stand for a long time, my scars appear dark red or almost black.
Is this normal? Thank you for addressing these questions!

Wo you wenti, 20~29 year old female. Ask Date: 2016/08/22

Dr. Lu Daokuan reply Plastic Surgery

Scars that appear red or black indicate insufficient healing, and it is recommended to use artificial skin for care for 3 to 6 months.
You may also consider consulting a plastic surgeon for scar reduction injections.

Reply Date: 2016/08/22

More Info

After undergoing surgery, particularly for severe injuries like the one you described, it is common to experience changes in the appearance of scars, including darkening and thickening. Scars can undergo various stages of healing, and their appearance can change over time due to several factors.

Understanding Darkening Scars
1. Normal Healing Process: After a surgical procedure, the body goes through a healing process that involves inflammation, tissue formation, and remodeling. Initially, scars may appear red or dark due to increased blood flow to the area as the body works to repair itself. This is a normal part of the healing process and can last for several weeks to months.

2. Hyperpigmentation: The darkening of scars, particularly if they appear dark red or black, can be attributed to hyperpigmentation. This occurs when the skin produces excess melanin in response to injury or inflammation. Factors such as sun exposure, skin type, and the depth of the injury can influence the degree of pigmentation. It is important to protect healing scars from sun exposure, as UV rays can exacerbate pigmentation issues.

3. Hypertrophic Scarring: The thickening of scars, known as hypertrophic scarring, is also a common occurrence. This type of scar is raised and can be itchy or uncomfortable. It often develops when the body produces too much collagen during the healing process. Hypertrophic scars may improve over time but can take months to flatten and fade.

4. Scar Management: To manage darkening scars and promote healing, consider the following approaches:
- Moisturization: Keeping the scar moisturized can help improve its appearance. Use silicone gel sheets or ointments specifically designed for scar treatment.

- Sun Protection: Apply sunscreen with a high SPF to the scarred area to prevent further darkening from sun exposure.

- Massage Therapy: Gentle massage of the scar tissue can help break down collagen fibers and improve the texture of the scar.

- Consultation with a Dermatologist: If the scar continues to darken or if you experience discomfort, it may be beneficial to consult a dermatologist. They can assess the scar and recommend treatments such as laser therapy, chemical peels, or corticosteroid injections to reduce pigmentation and improve the appearance of the scar.

5. When to Seek Medical Attention: If you notice any signs of infection (increased redness, warmth, swelling, or discharge), or if the scar becomes painful or changes in appearance rapidly, it is important to seek medical attention. These could be signs of complications that require further evaluation.

Conclusion
In summary, the darkening and thickening of scars after surgery are generally normal parts of the healing process. However, it is essential to monitor the scar for any changes and to take proactive steps in scar management. With time and appropriate care, many scars will gradually improve in appearance. If you have any concerns or if the scar does not improve, do not hesitate to reach out to a healthcare professional for further guidance.

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