I'm 1 year post-heart surgery, and my incision is very thickened, raised and is often itchy and tight-feeling. The areas which have thickened are areas that were scabs immediately following surgery (I was surprised to see scabbing in a surgical scar). My GP said it is a keloid and told me the only treatment is corticosteroid injections, but I've done a lot of research and found there are other treatment options. Does this look like a scar which could respond to scar revision or other treatment?
Keloid/hypertrophic Scarring? (photo)
Doctor Answers (5)
Scar after chest surgery
Your scar is more in the category of hypertrophic scar and has all the characteristics that indicate this will improve over time. My Mom had open heart surgery and complained bitterly about a similar scar but within the year it was thin and not that visible. There are techniques to speed up the healing of a red, fresh, raised scar: treatment of the vascular component with pulse dye laser or BBl, injection of the scar with high strength steroid solutions, possible use of 5FU is necessary, and your willingness to use silicone sheeting over the top of the scar as much as you can for the next 6 months or so. But remember that 'the tincture of time' will also do its magic.
Treating your chest keloid scar
In my experience, using liquid nitrogen (in Caucasian skin) along with intralesional cortisone is the simplest, safest, and most cost effective treatment. Occasionally we add 5-FU to our injection of cortisone. Surgical excision is not an option. Pulse dye laser may be of some benefit to reduce redness, but not as effective as cortisone shots to flatten the scar.
Chest keloids and heart surgery scars
I perform many chest keloid treatments and would advise you to undergo pulsed dye laser, IIT, and pressure treatment for these scars.
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Kenalog and Pulsed Dye Laser for Red Scars
Hi Jesse. Your scar is perfect for Kenalog injections and a pulsed dye laser. If it is itchy and/or painful it usually indicates it is still growing and to arrest and reverse that growth we have found the best option to be Kenalog. Surgical revision has the risk of creating the same or a larger problem.
After kenalog injections, we use Pulsed Dye lasers to take the redness out. This 2 stage approach has been very successful for us in removing this kind of scar.
Treatment of keloid/hypertrophic scars
While it sometimes is possible to perform scar revision on a hypertrophic or keloid scar, I would recommend trying the steroid injection first, as this option is less risky and quite possibly could help tremendously. If the steroid injection does not help, you can always consider the surgical option later.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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