Scar Management Information leaflet

Swelling and scar tissue formation are the body’s normal response to surgery.

Poor scarring arises for a multitude of reasons. The causes are therefore multifactorial. Addressing each of the components in a small way often leads to a larger positive change. If you have had poor scarring before, occasionally there has been a specific cause for this and it does not mean that your experience will be repeated.

After your operation you will have a dressing over your incision/s. Chris will give you instructions on how to manage the dressings and/or how to take care of the incisions specifically. In general, the scar should stay dry for three days after the surgery following which it can be washed in the shower. Some types of stitches are completely dissolving and do not need to be removed. The timing of stitch removal, if necessary, is important. You will get instructions on when to return to the clinic to have your stitches removed.

Following stitch removal, a period of consolidation is normal. This is where some little scabs form on the surface and is eventually replaced underneath by a pink immature scar. Chloramphenicol ointment is useful during this stage. Reinforcing the scar with steri-strips allows early suture removal to prevent ‘stitch-marks’. There is a small risk that the wound pops apart once sutures are removed. The steri-strips aim to prevent against this.

Once healed and stable, after approximately 10-14 days, massage manipulation using a simple hypo-allergenic moisturiser aids the healing process and ensures the best possible results from your scar. E45, ‘simple’, ‘diprobase’ and aqueous cream are examples of water-based lubricants. Bio-oil and vitamin E oil are oil-based alternatives. No cream is advantageous over its competitors. The more massage you perform with the lubricant, the softer and less noticeable the resultant scar will be, in a faster time scale. This is evidence-based advice.

Application of a silicone preparation after massage helps seal the scar, trapping hydration, which helps scarring. This is evidence-based advice. ‘Dermatix’ is an example.

Your genetics determine ultimate scarring, but these manipulations combine to help the end result. Usually after 9-12 months the result is clear. Only then can scar revision be considered if necessary. Chris can advise you on what is possible.

During this period, it is also important to protect the scar from strong sunlight. It picks up pigment better than normal skin and it is more difficult to camouflage a dark scar, which is more noticeable ultimately. Using an SPF >30 frequently is advised.

Combining the silicone cream with an SPF is common. Kelo-cote UV is an example.

If you have any questions, please don’t hesitate to contact us further.