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Minimizing Surgical Scars

I often am asked by patients how to minimize scarring of the skin after a surgical procedure. Actually, this is very straightforward and the following instructions can be applied to both surgical wounds as well as traumatic cuts and burns.

Wound healing can be optimized whether it results from the removal of a small mole, a burn or cut, or a larger surgical procedure such as caesarean section.

My first recommendation is to optimize skin healing by preventing wound infection. Once the wound has been properly cleaned and treated to stop bleeding, it is very important to keep it moist. Covering a healing skin wound with an ointment (Polysporin, Mupirocin or Vaseline) and a clean sterile dressing or Band-Aid is the first step to ensure that it will heal quickly and with minimal scarring. I try to avoid Neosporin ointment since it contains neomycin which may cause skin allergy in many patients.

The clear (serous) fluid that looks like water in the wound is actually a component of plasma that contains all kinds of growth factors to encourage skin cells to grow and multiply, leading to faster healing. Without this serous fluid, the wound becomes dry and takes longer to heal. A scab occurs when this serous fluid mixes with blood, dries up, and forms a hard crust over the wound. Scabs delays healing, literally forming a roadblock to new skin cells trying to grow to cover the wound. Picking off a scab increases the chances of scarring since it may result in a deeper wound.

So contrary to popular belief, it is best to cover your wounds with a clean dressing or Band-Aid (with or without an antibiotic ointment) rather then let wounds heal by leaving them “open to the air.” Using a Band-Aid or dressing with an ointment such Polysporin or Vaseline, keeps the wound moist and prevents scab development which delays skin healing.

After wounds heal, some patients develop itchy, raised scars. This is more common in patients who have a history or keloids. These patients may benefit from using silicone gel dressings such as Cica-care gel sheets to their wounds immediately after healing or on discharge from hospital after removal of sutures or staples. I have found Cica-care brand of silicone gel to be the most effective when used on new scars 24/7 for a couple months, particularly after cesarean section. It is available on Amazon.

If you have concerns about minimizing scarring or would like to treat an existing scar, consult a dermatologist to help you achieve the best results.

Written By: Lillian Soohoo, MD
Board Certified Dermatologist
Golden State Dermatology

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