Your Scar: What It Is and When to Seek Help

Q: Your Scar: What It Is and When to Seek Help

Hello Monicr： The bruising caused by your toe injury should resolve within a month, unless you continue to experience minor injuries that could lead to vascular tumors. <br>Some fibromas may have vascular components, which can make them appear a deeper red. <br>However, since you

What exactly is this type of scar?

Hello: Last May, I accidentally bumped my foot! The area between my big toe (where the hair and nail meet) bruised for a while and after some time, it remained a dark spot.
It doesn't hurt, so I didn't pay much attention to it.
Later, whenever I lightly rubbed the outer edge of this dark scar, it would turn red, swollen, and develop blisters.
Additionally, I have small areas of old scars on my foot and calf that would react similarly.
All these scars are flat because I have keloids, so most of my wounds are raised.
What could this condition be? Should I see a dermatologist or a surgeon? Thank you for your guidance.

monicr, 30~39 year old female. Ask Date: 2008/09/08

Dr. Zhang Zhibo reply Dermatology

Hello Monicr: The bruising caused by your toe injury should resolve within a month, unless you continue to experience minor injuries that could lead to vascular tumors.
Some fibromas may have vascular components, which can make them appear a deeper red.
However, since you have a keloid tendency, it is quite challenging to determine the exact nature of the lesion.
It is advisable to consult a dermatologist, preferably with photographs of the lesion.
If it is a benign tumor, monitoring may be sufficient, but if you have concerns, a biopsy could be performed for further evaluation!

Reply Date: 2008/09/08

More Info

It sounds like you are experiencing a complex issue with your foot, particularly with the scar tissue and the reactions you are describing. Based on your description, it seems that you have developed a scar that is not only discolored but also reactive to touch, leading to redness, swelling, and blistering in the surrounding areas. This could potentially be related to several factors, including your history of keloid formation, which can complicate how scars heal and react to stimuli.

Understanding Scarring and Keloids
Scars form as part of the body’s natural healing process after an injury. When the skin is damaged, the body produces collagen to repair the tissue. In some individuals, particularly those with a predisposition to keloids, the body may produce an excess of collagen, leading to raised and sometimes painful scars. Keloids can be itchy, tender, and may even become inflamed when irritated.

The black discoloration you mentioned could be a result of the original injury and subsequent healing process. If the area is not painful but reacts with redness and swelling upon contact, it may indicate that the scar tissue is sensitive or that there is some irritation occurring in that area.

When to Seek Help
Given the symptoms you are experiencing, it would be advisable to seek medical attention. Here are some signs that indicate you should see a healthcare professional:
1. Persistent Symptoms: If the discoloration and sensitivity do not improve over time or worsen, it is essential to consult a doctor.

2. Infection Signs: If you notice increased redness, warmth, swelling, or discharge from the area, these could be signs of an infection, which requires immediate medical attention.

3. Pain or Discomfort: While you mentioned that the area is not painful, any new pain or discomfort should be evaluated.

4. Functional Limitations: If the scar is affecting your ability to walk or perform daily activities, it is crucial to seek help.

Which Specialist to See
In your case, it would be appropriate to start with a dermatologist. A dermatologist specializes in skin conditions and can assess the scar, determine if it is a keloid or another type of scar, and recommend appropriate treatments. They may suggest options such as:
- Topical Treatments: Steroid creams or silicone gel sheets can help flatten keloids and reduce irritation.

- Injections: Corticosteroid injections can reduce inflammation and help flatten the scar.

- Surgical Options: In some cases, surgical removal of the keloid may be considered, although this can sometimes lead to the formation of new keloids.

If the dermatologist believes that the issue is more related to the underlying tissue or if there are complications, they may refer you to a plastic surgeon or an orthopedic surgeon who specializes in foot and ankle issues.

Conclusion
In summary, it is essential to take your symptoms seriously and seek medical advice. A dermatologist will be your best first step in understanding the nature of your scar and determining the appropriate course of action. Early intervention can help manage the symptoms and improve the appearance of the scar, leading to better outcomes. Remember, your health and comfort are paramount, so don’t hesitate to reach out for help.

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