Hypertrophic Scars After Circumcision: Is It Normal?

Keloid

The individual has a mild keloid tendency and has undergone circumcision six months ago.
The right side of the scar is beginning to show signs of keloid formation (it feels more swollen, with small nodules appearing at each suture site, and it often itches), while the left side remains smooth.
I would like to inquire whether this is a normal scar that will gradually flatten over time, or if it is indeed developing into a keloid.

Mr. Wang, 20~29 year old female. Ask Date: 2012/08/19

Dr. Li Yilun reply Urology

If you have a keloid-prone constitution, you may be more concerned about the occurrence of hypertrophic scarring.
It is still recommended to have the surgeon perform a visual examination and make a judgment.
The physician often needs to inquire about your medical history, conduct a visual inspection, palpation, and examinations to confirm the diagnosis and determine the treatment plan.

Reply Date: 2012/08/19

More Info

Hypertrophic scars and keloids are common concerns following surgical procedures, including circumcision. Understanding the nature of these scars is essential for managing expectations and determining appropriate treatment options.

Understanding Hypertrophic Scars and Keloids:
Hypertrophic scars are raised scars that occur when the body produces too much collagen during the healing process. They typically remain within the boundaries of the original wound and may improve over time, becoming flatter and less noticeable. Keloids, on the other hand, extend beyond the original wound site and can continue to grow over time. They are often more prominent and can be itchy or painful.

In your case, it seems you are experiencing symptoms that may suggest the development of a hypertrophic scar or possibly a keloid on the right side of your circumcision site. The presence of small, raised nodules at the suture sites, along with itching, is indicative of a scar that is not healing in the typical manner. The fact that the left side appears smooth and without these symptoms suggests that individual healing responses can vary significantly from one side of the body to the other.

Is This Normal?
It is not uncommon for individuals with a predisposition to keloid formation (as you mentioned having a mild keloid tendency) to develop hypertrophic scars or keloids after surgical procedures. The fact that you are noticing changes six months post-surgery is also within the realm of normal healing, as scars can continue to evolve for up to a year or more after the initial injury.

Will It Flatten Over Time?
Hypertrophic scars often improve with time, becoming less raised and more pliable. However, keloids do not typically regress and may require treatment if they become bothersome. Treatments for hypertrophic scars can include silicone gel sheets, pressure therapy, corticosteroid injections, or laser therapy. Keloids may require more invasive treatments, such as surgical excision, though this can sometimes lead to recurrence.

What Should You Do?
1. Monitor the Scar: Keep an eye on the scar for any changes in size, color, or symptoms. If it continues to grow or becomes more painful, it may warrant further evaluation.

2. Consult a Dermatologist: Given your concerns and the potential for keloid formation, it would be beneficial to consult a dermatologist or a plastic surgeon specializing in scar management. They can assess the scar and recommend appropriate treatment options tailored to your specific situation.

3. Consider Treatment Options: If the scar is confirmed to be hypertrophic, treatments such as silicone gel sheets or corticosteroid injections may be recommended. If it is a keloid, more aggressive treatments may be necessary.

4. Avoid Irritation: Ensure that the area is kept clean and avoid any irritants that may exacerbate the itching or inflammation.

In conclusion, while it is not unusual to develop hypertrophic scars or keloids after circumcision, the specific characteristics of your scar should be evaluated by a healthcare professional. Early intervention can often lead to better outcomes, so do not hesitate to seek advice if you have concerns about your healing process.

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