How to Treat Raised Scars After Chalazion Surgery on Eyelids?

It has been six months since the chalazion surgery, but there is still a raised scar?

After the chalazion surgery, there is a raised scar on my eyelid that sometimes becomes red and itchy.
However, most of the time it appears to be the same color as my skin, but it has been raised for six months.
This raised scar makes one side of my double eyelid look very unnatural.
What can I do to reduce it? Is warm compress helpful? Thank you.

GOVINDA, 20~29 year old female. Ask Date: 2006/08/22

Dr. Wang Ziyang reply Ophthalmology

Warm compresses can help soften scars after chalazion excision, but it is best to consult an ophthalmologist for a prescription ointment that may be more effective in reducing scars.

Reply Date: 2006/08/22

More Info

After chalazion surgery, it is not uncommon for patients to experience raised scars on the eyelids. These scars can sometimes be red, itchy, or simply raised above the skin's surface, which can be particularly concerning if they affect the appearance of the eyelids, especially in the case of double eyelids. Here’s a comprehensive approach to managing raised scars after chalazion surgery:

Understanding Raised Scars
Raised scars, also known as hypertrophic scars or keloids, occur when the body produces excess collagen during the healing process. Factors that can contribute to the formation of raised scars include genetics, the location of the scar, and the individual’s skin type. In the case of eyelid surgery, the delicate nature of the skin in that area can make it more susceptible to scarring.

Treatment Options
1. Topical Treatments:
- Silicone Gel Sheets or Silicone Gel: These are often recommended for managing raised scars. They work by hydrating the scar tissue and creating a protective barrier that can help flatten the scar over time. They should be applied consistently for several weeks to see results.

- Steroid Creams: Topical corticosteroids can help reduce inflammation and flatten the scar. Your doctor may prescribe a specific steroid cream to apply directly to the scar.

2. Injections:
- Steroid Injections: If the scar is particularly raised, your dermatologist or plastic surgeon may recommend steroid injections. These can help reduce the size and redness of the scar by decreasing inflammation and collagen production.

- 5-Fluorouracil (5-FU) Injections: This is another option that can be used to treat hypertrophic scars and keloids, often in conjunction with steroid injections.

3. Laser Therapy:
- Laser treatments can be effective in reducing the appearance of raised scars. Fractional laser therapy can help resurface the skin and improve the texture and color of the scar. This treatment typically requires multiple sessions.

4. Surgical Revision:
- In some cases, if the scar is particularly bothersome or does not respond to other treatments, surgical revision may be an option. This involves removing the raised scar tissue and may be followed by techniques to minimize the risk of new scarring.

5. Cryotherapy:
- This involves freezing the scar tissue, which can help reduce its size. It is often used in conjunction with other treatments.

6. Heat Therapy:
- While heat therapy, such as warm compresses, can help with overall healing and comfort, it may not significantly impact the raised scar itself. However, it can be soothing and may help with any associated itching.

Home Care and Lifestyle Adjustments
- 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 on the scarred area when outdoors.

- Moisturization: Keeping the scar moisturized can help improve its appearance. Use a gentle, fragrance-free moisturizer.

- Avoiding Irritation: Be cautious with makeup and skincare products around the scar to avoid irritation, which can exacerbate the situation.

When to Seek Professional Help
If the raised scar continues to be a concern after six months or shows signs of worsening (such as increased redness, itching, or pain), it is advisable to consult a dermatologist or a plastic surgeon specializing in scar management. They can assess the scar and recommend the most appropriate treatment options based on your specific situation.

Conclusion
Managing raised scars after chalazion surgery involves a combination of topical treatments, potential injections, and possibly laser therapy or surgical revision. While heat therapy may provide some comfort, it is essential to focus on proven methods for scar management. Regular follow-ups with a healthcare professional can help monitor the scar's progress and adjust treatment as necessary.

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