Post-Surgery Wound Issues: Managing Hypertrophic Scarring and Discomfort

Postoperative wound issues?

Hello doctor, a few years ago I had thyroid surgery, and after the operation, I had adhesive tape on the incision.
However, it didn't take long for the redness and swelling to subside, and I stopped using the tape.
Later, I developed a keloid at the incision site, and I'm not sure what to do about it.
Recently, I've been feeling very uncomfortable near the surgical area and have a strong urge to cough, which is very distressing! Are these two issues related?

A Fang, 20~29 year old female. Ask Date: 2014/03/13

Dr. Xu Kaixi reply Surgery

There is no effective treatment for keloids formed at the wound site; it is recommended that you consult a dermatologist for examination.
The discomfort at the surgical site after thyroid surgery may not necessarily be related to the surgery itself, so it is advisable to visit a surgical outpatient clinic for further evaluation.

Reply Date: 2014/03/13

More Info

After thyroid surgery, it is not uncommon for patients to experience issues related to wound healing, including hypertrophic scarring or keloids. Hypertrophic scars are raised scars that can be red, itchy, and uncomfortable, while keloids extend beyond the original wound boundaries and can be more pronounced. Both conditions can be influenced by various factors, including individual skin types, genetics, and the nature of the surgical procedure.

In your case, it seems that you have developed a keloid after your thyroid surgery, which can be distressing. Keloids are known to occur more frequently in individuals with a predisposition to this type of scarring, and they can be particularly challenging to manage. The discomfort you are experiencing near the surgical site may be related to the keloid formation, as these scars can cause sensations of tightness, itching, or even pain due to their structure and the way they interact with surrounding tissues.

To address your concerns, here are some management strategies for hypertrophic scars and keloids:
1. Silicone Gel Sheets or Silicone Gel: These products have been shown to be effective in flattening and softening hypertrophic scars and keloids. They work by hydrating the scar tissue and creating a protective barrier that can help reduce redness and discomfort.

2. Steroid Injections: Corticosteroid injections can help reduce inflammation and flatten keloids. This treatment is typically administered by a dermatologist or plastic surgeon and may require multiple sessions for optimal results.

3. Pressure Therapy: Applying pressure to the scar can help flatten it over time. This is often done using specialized garments or dressings.

4. Laser Therapy: Certain types of laser treatments can help improve the appearance of scars by reducing redness and promoting collagen remodeling in the skin.

5. Surgical Revision: In some cases, surgical removal of the keloid may be considered, although this can sometimes lead to recurrence. If surgery is performed, it is often combined with other treatments, such as steroid injections, to minimize the risk of the keloid returning.

6. Avoiding Irritation: It is essential to avoid any irritation to the scar area, which may exacerbate discomfort. This includes avoiding tight clothing or activities that may put strain on the scar.

As for the discomfort you are feeling, it is essential to consult with your healthcare provider. While it may be related to the keloid, other factors could contribute to your symptoms, such as nerve irritation or inflammation in the surrounding tissues. If you are experiencing a persistent urge to cough or discomfort that seems unusual, it is crucial to have a thorough evaluation to rule out any complications related to the surgery or other underlying issues.

In summary, managing hypertrophic scars and keloids requires a multifaceted approach tailored to your specific situation. Consulting with a dermatologist or a specialist in scar management can provide you with personalized treatment options to improve the appearance of your scar and alleviate discomfort. Remember, healing takes time, and with the right care, you can achieve better outcomes.

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