Underwent a serial incision surgery of a conginetal nevi on face.3.5 weeks after first stitches removal, the one straight line scar is healing however noticing the lower part of scar gets a little widening while the upper part stays close to each edge. is that normal? can scar gets widening or did i massage the scar too hard (my method is press relatively hard onto the scar with vit e cream?)what should i do?will this scar healing affect how the 'final' scar looks like after the second incision?
Can Scar Gets Wider During Healing Process?
Doctor Answers 2
Surgical scarring and scar widening
Although a repaired laceration or incision heals so that it won't come apart within 14 days it takes months to mature. The cells present along the scar have not fully matured. During the maturation phase which can last up to 8 or 10 months the cells making up the scar are still active. This can be clearly seen as a red scar that blanches white with finger pressure. During this phase the scar is malleable & sensitive to external treatments such as laser as well as local skin surface tensile forces. These forces can be distracting causing the scar to widen or parallel to the length or height of the scar causing scar thickening. There can even be a combination of forces. These forces are greatest in areas where the skin is not lax i.e. it is difficult to pinch a significant amount of skin. Just try this on your chin, knee cap area with the knee bent or scalp vs.back of the hand or neck.
To diminish these forces I place elective incisions along lines of least tension & have patients follow a skin taping or silicone sheet regimen for all incisions/laceration repairs. I have had many good results with this management. Thus, you can see that how an incision line is treated for the months following surgery has greater impact on the final look of a scar than the initial stitching procedure. Simple excision of a scar usually does not work. Removal of skin increases tension around the scar & results in a high recurrence rate of unsightly scars.
Preventing widening of the scar
Scars can be subject to tension and widening for a period of up to two years. Millions of dollars have been spent trying to answer the questions you ask. In my experience, I often recommend the use of paper tape for 2-4 momths after surgery to "splint" or stabilize the wound. In my opinion, this helps to protect the wound from excessive tension with movment and activity.