How Do I Prevent a Hypertrophic Scar from Forming?

I had a 5mm-long 4mm-deep cut on my chin 4 days ago.Already have a hypertrophic scar on my chin from a similar cut, so now using Mederma and Dermatrix on this new partially-healed wound. The wound has already formed a little scar so I wanted to find out what are other ways I can prevent a hypertrophic scar from forming aside from silicon gels. How early can I start dermabrasion/peels in order to maximize scar prevention, as the earlier you treat the scar - the better. Should I use peels now?

Doctor Answers (3)

Scar Management Following Chin Laceration

+3

Based upon your comments, I am assuming that this wound was not sutured; this might be a primary reason why a hypertrophic scar could form. I realize that the length of the injury is not long, but good tissue re-approximation can make all the difference in terms of satisfactory healing.

I understand your concern about scarring, but would say “slow down just a bit.” I would first let the wound heal before applying any topical scar creams. If any of these cause additional inflammation in the open wound, you are only making things worse. Keep the wound clean while it heals.

Once healed you could consider application of a number of products. I would suggest NeoCutis Biocream or HybriSil. Some research would suggest that NeoCutis Biocream may improve healing and scarring (and there would be some people who say this could be applied to the open healing wound). HybriSil contains a steroid (along with silicone) which may reduce scarring by reducing inflammation and swelling during the maturation process.

Pressure is very beneficial in reducing thickened scars and promoting softening. Scar massage can be performed beginning a week after healing is complete. With a small scar like this you can just use direct moderate finger pressure over the scar, pushing it against the chin bone. Scar massage should be performed for 5-10 minutes at least three times daily.

Microdermabrasion or chemical peels may be of little benefit, and may cause additional inflammation that could promote hypertrophy depending upon how and when they are performed. I prefer fractionated laser resurfacing in many instances to dermabrasion, but often wait until 60-90 days post-op/post-injury before commencing these treatments.

Sun protection remains important during the first several months of the healing process.

If you are really struggling with obtaining a good result, consult a plastic surgeon to help you; steroid injections are sometimes very helpful. Surgical excision and revision is also another option to consider if it doesn’t heal like you want.

Best wishes.

 


Milwaukee Plastic Surgeon
5.0 out of 5 stars 17 reviews

Wait two weeks before using tissue remodeling treatments

+2

You should wait two weeks before embarking on tissue remodeling using dermabrasion and/or chemical peels.  As it takes up to six months for scar tissue to remodel (through the creation of fibrous tissue and collagen), this is your window of opportunity to use these treatments, but in between sessions I would suggest using anti-inflammatory treatements such as hyrdocortisone creams and silicone sheets. Another treatment we have found to be quite effective, and you'll want to consider is micro-needling.

Alexandra Chambers, MD
London Dermatologist
5.0 out of 5 stars 14 reviews

Prevention of hypertrophic scars can be unpredictable and expensive

+2

I understand your anxiety about the scar on your chin.  Mederma may work, but there are plenty of studies that say it won't.  In addition, there are other products like Biocorneum or Neocutis Biocream which may also work.  Really going off the deep end into cutting edge research, there are some studies that demonstrate that Botox can prevent hypertrophic studies (in lab animals), but may result in atrophic scars.  This may be a thought.  It would be relatively safe, but expensive, and unpredictable with results.  Lastly, you ciould also be proactive with some steroid injections that would pre-emptively prevent the hypertrophic scar, but could result in a whiter, depressed scar.

Good luck

Daniel I. Wasserman, MD
Naples Dermatologic Surgeon

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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.