Thick scar tissue under the skin of the back of my head. What can I do to minimize this?

Question

I had a surgery on my skull 2 years ago. The surgery left a 1.5 inch liners scar, that has healed really nicely. However, under the scar is a thick bump of scar tissue that is raised. We did 3 shots of intralesional kenalog spaced 1 month apart but didn’t see any significant results. Is there anything else that can be done to reduce the scar tissue? The location is on the back of my head and not easily massaged, so that is likely not an option.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Randal Haworth, MD, FACS · Answer

Hello !

A scar revision procedure is possible.

Scar revision refers to a surgical procedure aimed at reducing the visibility of scars and correcting any skin changes or disfigurement resulting from an injury, wound, poor healing, or previous surgery. The formation of scar tissue is a natural process during the healing of the skin after an injury or surgery, and the extent of scarring depends on several factors such as the size, depth, and location of the wound, age, and skin color. Scar revision can be performed under local, sedation, or general anesthesia depending on the extent of the procedure.

There are various techniques available to improve the appearance of scars, including scar removal, scar massage, pressure therapy with silicone strips, dermabrasion, laser treatment, and surgery. In cases of large injuries such as burns, hypertrophic scars may form, which can limit movement of muscles and joints. Surgery to remove excess scar tissue and re-orient the scar may be required, along with skin grafting or flap surgery to replace lost skin and improve function. Tissue expansion may also be used for breast reconstruction and to repair damaged skin due to birth defects or injuries, involving the gradual stretching of skin with a silicone balloon.

I hope this helps,
best of luck !

Connie Hiers, MD, FACS · Answer

The scar could be revised, and yes, it can be massaged once healed. You many need to follow the revision with steroid injections to avoid another raised scar.

Thick scar tissue under the skin of the back of my head. What can I do to minimize this?

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Thick scar tissue under the skin of the back of my head. What can I do to minimize this?

Answers (3)

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.