What can I do to minimize scarring after an injury or surgery?
Scars are areas of fibrous tissue that form to repair damaged areas of skin and are a natural physiologic response to trauma or injury — they are how the body heals itself. Immediately after an injury there is a phase of reduced blood flow, called vasoconstriction, when bleeding slows while a scar begins to form. Scars are a byproduct of the body forming new collagen fibers, a naturally occurring protein in the body, to mend the damaged skin. It then goes into a phase of vasodilation, or increased blood flow to the wound; this is why scars may initially look red and sometimes appear firm or raised.
Good scar prevention starts well before a wound even occurs. Your genetic makeup, wellness habits and overall health history play the largest part in how you will heal and scar.
Medical professionals do their best to help you from there. The gold standard for stitch technique is a running subcuticular or intradermal suture — continuous stitches below the skin with dissolvable sutures. In a multi-layered closure, the surgeon will stitch each level individually, starting with the deepest dermal layer, moving up to the fatty layer, then the fascial layer and finally the epidermis, or outer layer of skin. Often, occlusive dressings like surgical tape, silicone strips or surgical glue will be placed on top to provide additional pressure and improve the result.
The most important thing you can do to minimize scarring after surgery or receiving stitches is to follow your doctor’s instructions. Protecting the wound from the sun is crucial, especially early on. Wear recommended dressings and use antibiotic ointment to keep the environment moist for faster healing while also preventing infection. You don’t want to get it too wet, though, so avoid showering or immersing the area for at least 48 hours or as advised. To minimize skin tension, avoid working out, stretching or lifting heavy items until you get the OK. Supplementation with vitamin C and zinc can often be helpful; check with your doctor for recommended amounts.
If you notice a wound is not healing well, follow up with your doctor for steps you can take to prevent scars from worsening, including steroid injections or more aggressive pressure treatments. If a scar hasn’t healed well after an appropriate length of time, vascular lasers and fractional CO2 lasers can often be an effective option.
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Dr. Andrew Ordon is a board-certified surgeon in the areas of aesthetic, plastic and reconstructive surgery and co-host of the Emmy®-nominated syndicated series, The Doctors. He is a proud, founding member of the Surgical Friends Foundation that offers complimentary reconstructive surgery around the world to those who cannot afford medical treatment. Many of these patients suffer from birth defects, physical abuse and burns, among other adverse conditions.