Can you do the kind of surgery that doesn’t leave a scar?

As a plastic surgeon, at least once a week I’m asked:

Will it leave a scar?

 

As I explain to my patients, any time a cut is made all the way through the skin, it heals with a scar.  Today I’ll tell you how to make that scar better.

Courtesy of Office.com

Three things control how good a scar is:

1. How the wound was made.  Sharp, clean cuts leave better ones than say, a dog bite, or road rash.

2. How the wound is closed.  Certainly having a doctor who is expert at repairing cuts and lacerations will help.  But I’m also a plastic surgeon, not a magic surgeon – no matter how perfectly I repair a laceration, it will still leave a scar.

3. How the wound heals. Wounds that heal quickly tend to form less noticeable scars.  Some part of this is genetics, and some part is environment.  If you tend to form big, raised scars, then that’s how your body responds to injury.

So what can you do as a patient to get the best scar possible?  Let’s ignore number two- as long as you see a well-trained doctor, that part is pretty much out of your hands.  And many cuts and scrapes don’t even require the care of a doctor, but still leave scars.  Here are the top 4 things you can do to improve the appearance of a scar:

1. Clean the wound or cut.  Once.  Immediately after the injury, using mild soap and warm water.  That’s all you need.  Avoid peroxide, alcohol, and betadine.  Although these solutions do kill germs, they kill healthy cells as well, and repeatedly dousing a cut in peroxide or betadine will make it heal more slowly.  What do you get when a wound heals slowly?  A worse scar.

2. Keep it moist.  When I was a kid, my mom used to take my band-aids off every day to “let things air out.”  You don’t need to do this, and wounds that are uncovered are exposed to germs.  Keep things covered, and keep them moist using antibiotic ointment or even plain Vaseline.  Granted, you don’t want the surrounding skin looking like a prune, but the cut itself should be covered with Vaseline or antibiotic ointment at all times.

3. Use a scar product.  There are some great scar products out there.  I’ll fully admit that we don’t know exactly why they work, but the fact is, they do work.  Mederma will fade the redness of a scar more quickly.  The product I personally recommend to all my patients is Kelo-cote.  It’s a silicone-based produce, and silicone has been shown multiple times to fade redness and help scars flatten out.  It’s available online, and you don’t need a prescription.

4. Be patient!  Scars take 6-12 months to mature.  Yep- a full year before you know how that scar will really look.  Now if that scar is getting raised, red, or keeps getting bigger go see your doctor.  We have some other tricks up our sleeves such as steroid injections.  But if it’s just not fading as quickly as you want, remember that it takes several months to flatten out and for the redness to fade.

 

Thanks to Dr. Bernstein and Dr. Lin for letting me steal some of your favorite lines!

Do you have any questions about scarring or scar products?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Questions? I'll do my best to answer any questions left in the comments!