How to Restore Indented Scars After Head Injury Sutures?

How can the indentation after suturing a head injury be restored?

Doctor, I recently suffered a skull fracture from falling down the stairs, resulting in a stitched scar.
However, the scar feels like a depression.
The surgeon mentioned that this is due to the gap between the bones.
At that time, I opted for a more expensive method to minimize scarring.
What further treatments can be done to restore it to its original smooth and rounded appearance?

Xiao Lu, 30~39 year old female. Ask Date: 2020/05/12

Dr. Xu Kaixi reply Surgery

If there is a depression in the bone, it will take at least two to three months for the bone to heal and for callus formation to fill in the area, resulting in a smoother surface.

Reply Date: 2020/05/12

More Info

After experiencing a head injury that resulted in a skull fracture and subsequent suturing, it is understandable to be concerned about the appearance of the scar, especially if it has indented. Scarring is a natural part of the healing process, but there are several approaches you can consider to improve the appearance of your scar and promote healing.

Understanding Scarring
When the skin is injured, the body initiates a healing process that involves the formation of scar tissue. This tissue is often different in texture and appearance compared to the surrounding skin. In cases of deeper injuries, such as those involving the skull, the underlying structures can also affect how the skin heals. An indented scar may occur due to a variety of factors, including the depth of the injury, the way the skin was sutured, and the healing process itself.

Treatment Options
1. Silicone Gel Sheets or Silicone Gel: These products are often recommended for scar management. They can help flatten and soften scars over time. Silicone sheets are applied directly to the scar and can be worn for several hours a day. Silicone gel can be applied directly to the scar and allowed to dry.

2. Massage Therapy: Gentle massage of the scar tissue can help break down the dense collagen fibers that form during the healing process. This can be done using a moisturizing lotion or oil. It is important to be gentle and not apply too much pressure, especially if the area is still sensitive.

3. Topical Treatments: Over-the-counter creams containing ingredients like vitamin E, onion extract (found in products like Mederma), or other scar-reducing agents may help improve the appearance of the scar. However, results can vary, and it is advisable to consult with a dermatologist before starting any new treatment.

4. Laser Therapy: For more significant scarring, laser treatments can be effective. These treatments work by resurfacing the skin and promoting new skin growth. A dermatologist or plastic surgeon can provide more information on the types of lasers available and what might be suitable for your scar.

5. Dermal Fillers: In some cases, dermal fillers can be injected into the scar to raise it to the level of the surrounding skin. This is a temporary solution and may require repeat treatments.

6. Surgical Revision: If the scar remains significantly indented and bothersome, surgical options may be available. This could involve excising the scar and re-suturing it in a way that minimizes indentation. This option should be discussed with a qualified plastic surgeon.

7. Sun Protection: Protecting the scar from sun exposure is crucial, as UV rays can darken scars and make them more noticeable. Use a broad-spectrum sunscreen with an SPF of at least 30 on the scar when exposed to sunlight.

When to Seek Professional Help
If you are concerned about the appearance of your scar or if it is causing discomfort, it is advisable to consult with a dermatologist or a plastic surgeon who specializes in scar management. They can assess the scar and recommend the most appropriate treatment options based on your specific situation.

Conclusion
While it may take time for scars to mature and improve in appearance, there are several strategies you can employ to help restore the skin's smoothness and reduce the indentation. Consistency in treatment and patience during the healing process are key. Always consult with healthcare professionals before starting any new treatment to ensure it is safe and appropriate for your specific condition.

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