Unexplained Internal Itching After Facial Fracture Surgery: What to Do?

Itchy face with areas that cannot be reached by hand?

A family member sustained a zygomatic bone fracture due to a car accident over 20 years ago.
They underwent surgery to place a steel pin at the site of the injury to facilitate healing.
Recently, they have noticed that the area where the surgery was performed has been itching; however, it is not the surface of the skin that itches, but rather the internal area.
Since they cannot reach the affected area to scratch it, they have been trying to alleviate the discomfort by lightly tapping their face.
They are unsure about the cause of this symptom and which medical specialty to consult, so they are seeking advice from a doctor.
Thank you!

Nìmíng, 20~29 year old female. Ask Date: 2017/12/24

Dr. Hong Yuanbin reply Internal Medicine

Hello, typically we assess whether there is an issue at the surgical site based on the presence of fever or localized redness, swelling, heat, and pain.
According to your description, it seems that the affected area is only itchy and does not exhibit the aforementioned symptoms.
However, further examination is necessary to confirm this.
I recommend visiting a surgical or orthopedic outpatient clinic for evaluation.
Thank you for your inquiry.

Reply Date: 2017/12/24

More Info

Experiencing unexplained internal itching after facial fracture surgery, particularly after having undergone a procedure involving the placement of screws or plates, can be concerning. This sensation may arise from several factors related to the surgical site and the healing process.
First, it’s important to understand that after surgery, the body undergoes a healing process that can involve various sensations, including itching. This itching can be attributed to several reasons:
1. Nerve Regeneration: After surgery, nerves that were cut or manipulated during the procedure may regenerate. As they heal, they can send abnormal signals to the brain, which can manifest as itching or tingling sensations. This is a common occurrence after any surgery, especially in areas where nerves are densely packed, such as the face.

2. Scar Tissue Formation: The body forms scar tissue as part of the healing process. This scar tissue can sometimes adhere to surrounding tissues, leading to sensations of tightness or itching. The internal structures may be healing, and as they do, they can create sensations that feel like itching.

3. Allergic Reactions: In some cases, the materials used in surgery, such as metal screws or plates, can cause a localized allergic reaction. This is less common but can lead to sensations of itching or discomfort in the area.

4. Dryness or Irritation: The skin and tissues around the surgical site may become dry or irritated, especially if there has been any disruption to normal skin barrier functions during surgery. This can lead to sensations that feel like itching.

Given these potential causes, here are some recommendations on what to do next:
- Consult a Specialist: Since the sensation is internal and not superficial, it would be advisable to consult with a plastic surgeon or an oral and maxillofacial surgeon who specializes in facial surgeries. They can assess the surgical site and determine if the sensation is normal or if further investigation is needed.

- Avoid Irritation: Try to avoid any actions that may irritate the area further, such as aggressive touching or massaging. While it may be tempting to try to alleviate the itching by tapping or rubbing, this could exacerbate the issue.

- Moisturize: If the area feels dry, consider using a gentle, hypoallergenic moisturizer around the surgical site (but not directly on any open wounds or incisions). Keeping the area hydrated can sometimes alleviate discomfort.

- Monitor Symptoms: Keep track of any changes in the sensation. If the itching becomes more intense, is accompanied by swelling, redness, or any discharge, it is crucial to seek medical attention promptly.

- Medication: If the itching is bothersome, over-the-counter antihistamines may help alleviate the sensation. However, it’s best to consult with a healthcare provider before starting any medication.

In summary, while internal itching after facial fracture surgery can be a normal part of the healing process, it is essential to monitor the symptoms and consult with a specialist if there are any concerns. They can provide a thorough evaluation and ensure that the healing process is proceeding as expected.

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