Best Way to Minimize Developing Scar?

My 3-year-old daughter has had her third facial laceration on her left eye, above her eyebrow. The first doctor told us to apply neosporin on the stitches to reduce scarring and this morning, another doctor instructed us not to use anything. What is the best way to minimize the scar that will develop?

Doctor Answers 5

Optimizing a scar on a child - Los Angeles

Optimizing local tissue will help in the long and short term treatment of a scar on the face. I would error towards using the creams, rather than not. Raffy Karamanoukian Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Scar on the face

Unfortunately anytime the skin is cut, there will be a permanent scar if it is a full thickness cut. I find that paper tape or steri-strips that are left on for at least 6 weeks often lead to the best scars. I prefer a good sun screen afte everything has healed to both moisturize the skin and protect it fromt he sun.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Not Neosporin

I can almost guarantee that the first physician was not a dermatologist. We have seen way to many allergic reactions to Neosporin, especially if used on traumatized, or eczematous skin.

I would use either Aquaphor or ScarGuard MD. There are other good silicone products on the market such as Curacare, Neosporin Scar Solution ( which does NOT contain the allergy producing Neomycin) Curad Scar Therapy. There are a number of other products in development to improve scarring. I would not particularly recommend Vitamin E, although that seems to be a favorite of pharmacists. I have seen allergic reactions to that too. Studies have been mixed with Mederma which incidentally is derived from onion...though please do not add it to a casserole.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Scar reduction

I agree that neosporin can have about a 10% chance of an allergic reaction. Aquaphor is much better. In rare cases when Aquaphor causes allergy (especially after peels), I use crisco. I only use this for the first 7 days until sutures come out because it can macerate the wound over the long run. In the short run, the moisture provides better epidermal healing.

Studies from about 2 years ago have shown that vitamin e could actually worsen scar healing so i have stopped using it. Also, I agree silicone is now recommended without a clear reason why in the healing phase to reduce scarring. The thought is possible dermal/epidermal hydration by sealing the wound.
Also if it is far enough away from the eye, sometimes IPL/KTP/PDL laser can reduce thickening that can occur down the road like 6 weeks to 3 months. Unfortunately, the younger you are the more scar response that occurs. if it truly gets thick i also at times use 5-FU (5-fluoruracil), a non-steroid based injection, to manage thickening along with laser.
Obviously, these are general guidelines, and you must follow your own doctor's advice since i have not seen her as a patient.
Just some thoughts.

Sam Lam, MD, FACS
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 57 reviews

Early scar treatment

I agree that aquaphor is a good post injury ointment to promote healing, and as soon as the laceration has sealed (usually 5-7 days in that area) once a day application of 1% hydrocortisone cream once a day for a week or so will likely prevent a thickened scar.  After that a silicone cream may be helpful.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

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