Stitches in forehead. How can I avoid or minimize scarring? (Photo)

Question

I received about 25 stitches on my forehead/eyelid a few days ago and will have them out before the weekend. I have an appointment with a plastic surgeon early next week. How soon after an injury would a surgeon usually provide treatments? What should I expect and what are my best options for avoiding or minimizing scarring as much as possible?

Jason Emer, MD · Answer

Thank you for your question, I recommend getting a formal evaluation with a cosmetic dermatologist for after care. I recommend Silagen + Bioshield to promote healing. Scars like these can generally be improved with lasers (ProYellow, Excel V, VBeam) and microneedling with PRP. See an expert. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Hidef protocols can help with keloid and hypertrophic scars on the face and body. Surgery is often not needed if lasers are introduced. 
In our office, we combine treatments starting with topical pre-conditioning of the scars with Plato's Scar Serum for hypertrophy and Melarase PM for pigmentation. Fractional RF, laser, and micro fractional RF can help limit scar growth. Kenalog IIT can also help reduce scar thickness. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Svetlana M. Danovich, MD, PhD, FACS · Answer

Thank You for your question. First you should make sure you apply silicone gel twice daily preferably Stratamed  (blue) gel while sutures are still in place, after sutures are removed you can begin using Strataderm (orange) gel. This will help with healing and scar removal. After 6 weeks you may begin laser procedures such as skin resurfacing There are many laser devices that provide skin resurfacing such as Co2, Erbium and Fractional. Depending on skin type you may want to prep skin 2 weeks prior to treatment using Hydroquinone creams or pads to help keep melanocytes at ease.

Nelson Lee Novick, MD · Answer

As far back as the late 1980s, it was already known that the ideal window for treating a scar of any kind was between a critical window of eight to twelve weeks following any kind of scar forming process, whether from acne, infections (like chicken pox), trauma or surgery, as in the case here.  At eight weeks wounds are generally strong enough to withstand aesthetic treatments and for each month beyond the twelve weeks the chances for achieving the most significant improvements diminishes. So, the old advice of "wait a year till the scar matures" has been considered poor advice for more than three decades. The original work in the 1980s suggested dermabrasion during that critical 8-12 week window, and the procedure was named "scarabrasion."  I have personally found aggressive microneedling, which engenders less downtime, to be extremely useful for this purpose. What is important is that you keep the ideal window in mind and seek treatment treatment appropriately. Best of luck.

Jeff Rapaport, MD · Answer

Split scar studies have been performed on post-surgical scars.  Fractionated laser performed at four to six weeks post suture removal is the standard of care. This is a significant change from the past practice of waiting one year from the date of the suture removal. Find a scar expert.
Jeff Rapaport MD FAAD
Realself Verified All-star

Stitches in forehead. How can I avoid or minimize scarring? (Photo)

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