Managing Hypertrophic Scars After Surgery: Steroid Injections and Treatment Timeline

Subsequent treatment for keloids caused by a cesarean section?

Due to the formation of keloids from a laparotomy, I hope to treat it through steroid injections.
I have already received the first injection.
How can I determine when to administer the second dose, and how long should I wait? Additionally, does applying silicone gel sheets during the injection period help flatten the scar? Under normal circumstances, how long does it typically take for the scar to flatten? Currently, the scar is approximately 0.5 cm raised.
Thank you for your response.

Jiang, 20~29 year old female. Ask Date: 2017/03/01

Dr. Wu Yuxin reply Dermatology

Injections can be administered every 2-3 weeks, and the number of doses required varies as individual responses differ.
Applying silicone patches can be beneficial.

Reply Date: 2017/03/01

More Info

Managing hypertrophic scars, particularly after surgical procedures, can be a challenging process. Hypertrophic scars are raised, thickened areas of skin that can develop after an injury or surgery, and they can be particularly bothersome both aesthetically and physically. The use of steroid injections is a common treatment option, and understanding the timeline and effectiveness of this treatment is crucial for optimal management.

Steroid Injections for Hypertrophic Scars
Steroid injections, typically using triamcinolone acetonide, are often administered to reduce inflammation and flatten hypertrophic scars. After the initial injection, it is common for patients to wonder about the timing of subsequent treatments. Generally, the first follow-up injection can be scheduled approximately 4 to 6 weeks after the initial treatment. This interval allows time for the body to respond to the steroid and for the physician to assess the effectiveness of the first injection.

Assessing Effectiveness
It is important to note that the effects of steroid injections may not be immediately visible. In many cases, patients may not see significant changes for several weeks. The scar may appear unchanged or even slightly more prominent immediately after the injection due to localized swelling. This does not necessarily indicate that the treatment is ineffective. Instead, it is a normal part of the healing process.

Use of Silicone Gel Sheets
In addition to steroid injections, the application of silicone gel sheets can be beneficial in managing hypertrophic scars. These sheets create a moist environment that can help to soften and flatten the scar over time. They are typically recommended to be worn for at least 12 to 24 hours a day for several months. The combination of silicone therapy and steroid injections can enhance the overall effectiveness of scar management.

Timeline for Improvement
The timeline for seeing improvement in hypertrophic scars can vary significantly from person to person. Generally, patients may start to notice changes within 2 to 3 months after initiating treatment, but full flattening and softening of the scar can take 6 months to a year or longer. Regular follow-up appointments with your healthcare provider are essential to monitor progress and make any necessary adjustments to the treatment plan.

Conclusion
In summary, after your first steroid injection for your hypertrophic scar, plan for a follow-up injection in about 4 to 6 weeks. Continue using silicone gel sheets as they can aid in flattening the scar. Remember, patience is key, as significant changes may take time. Regular follow-ups with your healthcare provider will ensure that your treatment is on track and adjusted as needed. If you have any concerns about the treatment or the appearance of your scar, do not hesitate to reach out to your healthcare provider for guidance.

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