I am a female, late 40's that had Mohs on scalp 10 mos ago. The stitches opened. It was horrible. I am now left with nickel sized indented round hole on head, where no hair is growing. I was told that hair transplant may not work as there is not enough vascularity in a scar - this was an offhand one person opinion. I am seeking answers as to how to reduce this somehow. I am realistic that some scar may remain but would love to minimize so i dont have this large a bald spot.
Can nickel Size Mohs Round Scalp Scar From Stitches Opening Be Corrected or Reduced?
Doctor Answers (4)
How to Reduce Scar on the Scalp from Skin Cancer Surgery
There is a very good likelihood that a scar revision can be performed to improve the final cosmetic result. This might be a good alternative to a hair restoration procedure (i.e. hair transplant). If there is enough laxity in the scalp, the surgeon should be able to remove the scar, loosen the tissue and reapproximate the wound edges and suture it closed. Of course, if the scalp is too tight, a simple scar revision may be difficult. In that case the surgeon might consider a flap repair or might even consider a hair restoration procedure.
Best option is to be examined by a doctor and discuss your options. I would recommend either a fellowship-trained Mohs surgeon (i.e. member of the ACMS) or a plastic surgeon or another doctor who has a lot of experience performing these types of repairs. Good luck.
Scalp defect after MOHS
The scalp can be a difficult area to close. It is not very compliant and needs extensive scoring. A local flap may work or tissue expanders.
Scar Revision following Mohs surgery
I would go to a board certified plastic surgeon for a scar revision. The usual cause of stitches opening if not related to an infection is because of the tension required to close the wound. Plastic Surgeons use techniques to advance your scalp tissue with minimal tension so that a smaller scar should be achievable.
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Scar Repair on Scalp
I agree with Dr. Kaufman's assessment. A scar repair would be the easiest and most ideal, rather than a hair transplant there. I will also, offbrand, suggest you could try Latisse in this area. Allergan is conducting studies right now for hair growth on the scalp using Latisse. I have several patients with more random spots on their heads applying Latisse there and getting good results. As long as you have active follicles there, the hair can grow. However, if the scar has inhibited the follicles entirely, then you wouldn't get growth in that spot. It might be worth the $120 investment for the Latisse (you can always use it on your eyelashes if it doesn't work on the scalp spot) before trying to undergo another procedure. But I think if you do want to do a procedure, a scar repair would be the best and easiest. See a good dermatologic surgeon or Mohs surgeon for an evaluation so they can assess your scalp tension in that area.