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Scar Revision Gone Wrong - Could This Be Contact Dermatitis?

I'm questioning if its contact dermatitis (going onto 7 weeks) but it was assumed I was allergic to adhesive applied to my scar revision or steri-strip (on top of adhesive). Maybe there was a disinfected solution used that could've caused it. I've been using Hydrocortisone 0.2% Cream and Prednisone to no avail. The scar is depressed or tethered down, somewhat indented line. My persistent rash is non-itchy, very red, burning, is beyond the excision line. What is this? What can I do to fix this??

Doctor Answers (2)

Surgical scarring

+1

If the redness blanches white on finger pressure, especially if it takes awhile for the redness to return after the finger is removed, your best bet is a flashlamp pumped pulsed dye laser. Some of the newer models have a simultaenous Nd:YAG component that fires at the same time and improves the results. I would strongly recommend against long term topical or oral steroids for this because of the problems the medications can cause and the little or no chance they will do what you want them to do. It can take some time for redness to resolve after a skin injury. The other very important point is to avoid sun exposure, use sunscreen, for about a year after the injury healed. Sun exposure can permanently darken scars. Remember that scars cannot be erased only possibly made less visible or noticeable.


Los Angeles Plastic Surgeon

Your scar has a mixture of problems that I see

+1

Obviously when scars are immature they never look good.  However, in your situation there are things that potentially could be improved and would merit intervention earlier than later.  I would consider KTP or Pulsed Dye laser to manage the redness and the thickness since there are parts that are raised, which I think also make the depressed areas look more depressed.  Hopefully that will calm things down.  Silicone gel is also a good idea to manage things.  The topical prednisone may help but i tend not to use very much.  I do not think topically it should hurt.  I also tend to manage the raised areas with 5-FU injections that help with anything raised without too much risk of atrophy of the tissues unlike cortisone or steroid injections.  Ultimately, you may need another scar revision but that would be many many months from now when things are calmer.

Samuel Lam, MD
Dallas Facial Plastic Surgeon
4.5 out of 5 stars 38 reviews

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