Managing Red and Raised Scars After Thoracoscopic Surgery: Solutions and Tips

Six months after thoracoscopic surgery, the surgical scar is red and raised. What are the solutions?

I underwent thoracoscopic surgery at the beginning of the year, and my doctor advised me to use silicone gel for wound fixation long-term after the stitches were removed to avoid tension on the wound.
However, prolonged use of the silicone gel caused a severe allergic reaction around the wound, so I switched to a scar gel after about a month.
As time has passed, I feel that the wound has not faded; instead, it has become raised and reddened (similar to hypertrophic scarring).
I would like to ask: 1.
Is it possible that this wound will always look like this and will not fade? Could it worsen and develop into a keloid? 2.
Should I continue using the scar gel, switch back to the silicone gel, or use silicone sheets instead? Thank you.

Nìmíng, 20~29 year old female. Ask Date: 2022/07/26

Dr. Wu Yuxin reply Dermatology

Regardless of whether it is hypertrophic scars or keloids, early intervention treatment should be considered.

Reply Date: 2022/07/26

More Info

Managing red and raised scars after thoracoscopic surgery can be a challenging experience, especially when the scars do not seem to improve over time. It’s important to understand the nature of scars and the various treatment options available to help manage them effectively.

1. Understanding Scars: After any surgical procedure, including thoracoscopic surgery, it is common for the body to form scars as part of the healing process. Scars can vary in appearance, and some may become hypertrophic (raised and red) or even develop into keloids, which are more severe forms of raised scars that extend beyond the original wound site. The likelihood of a scar becoming a keloid depends on various factors, including genetic predisposition, the location of the scar, and individual healing responses. While some scars may fade and flatten over time, others may remain prominent or worsen, particularly if they are subjected to tension or irritation.

2. Treatment Options: Given your experience with allergic reactions to silicone gel and the lack of improvement with scar gel, it is essential to explore alternative treatments. Here are some options you might consider:
- Silicone Gel Sheets: These are often recommended for managing hypertrophic scars and keloids. They work by hydrating the scar tissue and creating a protective barrier that can help flatten and soften the scar over time. Unlike silicone gel, silicone sheets may be less irritating to the skin and can be worn continuously.

- Steroid Injections: If your scar is particularly raised and red, corticosteroid injections can be an effective treatment. These injections help reduce inflammation and flatten the scar. This treatment is usually administered by a dermatologist or plastic surgeon.

- Laser Therapy: Laser treatments can be beneficial for reducing redness and improving the texture of scars. Different types of lasers can target various aspects of scar tissue, including pigmentation and vascularity.

- Microneedling: This procedure involves using fine needles to create micro-injuries in the scar tissue, which can stimulate collagen production and improve the appearance of the scar.

- Pressure Garments: For some patients, especially those with larger scars, wearing pressure garments can help flatten and soften the scar over time. This is often used in conjunction with other treatments.

3. Consultation with Specialists: It is crucial to consult with a dermatologist or a plastic surgeon who specializes in scar management. They can assess your specific situation, determine the best course of action, and monitor your progress. They can also help you understand whether your scar is likely to improve or if it has the potential to develop into a keloid.

4. Self-Care and Monitoring: In addition to professional treatments, self-care is important. Keep the scar moisturized, avoid sun exposure (which can darken scars), and refrain from picking or irritating the scar. Regularly monitor the scar for any changes in size, color, or texture, and report these to your healthcare provider.

In conclusion, while it is possible for some scars to remain prominent or worsen, there are numerous treatment options available to help manage and improve their appearance. Consulting with a specialist will provide you with tailored advice and a treatment plan that suits your needs. Remember that scar management is often a gradual process, and patience is key as you explore different options.

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