What can I do about the keloid scar that has formed on my nose bridge after a cut? (Photos)

Question

My nose bridge skin was cut open about a month ago and I got 4 stitches and now it’s scarred up seems I have keloid need advice. Been putting on silicone gel during the day and gel sheet at night didn’t help. Can I get steroid injection or laser now? What else can I do?

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars. 
•	Twice daily application of a scar gel. 
•	Scar modulation with gentle massage.
•	Intralesional injections in case there is overgrowth of scar tissue.
•	Vascular lasers for neovascularization of scars.
•	Stimulatory injections for scar atrophy. 
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best, 
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon

Richard W. Siy, MD · Answer

As plastic surgeons, we classify abnormal scarring based on the growth of the scar relative to its original borders.  Scars that grow thick and/or discolored over time but stay within the boundaries of the original scar are labelled hypertrophic, while those that continue to grow beyond those margins are labelled keloids.  Semantics aside, in your case, you appear to have an immature scar that is continuing to undergo the process of scar maturation.  Unforunately, this process takes weeks and continues for as long as a year and a half, during which the scar flattens and lightens in color as the body sends less blood and supplies to the area.  Luckily, your scar does not appear to be growing outside its original boundaries, so I would recommend optimizing scar care and lots of patience.  You can massage the scar with light pressure (enough to push the blood out of the scar and make it change colors) for a few minutes 3-5 times a day to expedite the softening of the scar and regular sunblock application to avoid hyperpigmentation of the scar.  Self-adhering silicone sheets can also be applied, but they need to stay on the scar for at least 12-16 hours a day to be helpful.  It's a little early to think about scar revision, which usually entails excising the ugly scar and reclosing the healthy edges.  I think you'll get a good result with some observant management.  Luckily it's winter and the sun's not as intense, especially up there in Maine.  Good luck!

What can I do about the keloid scar that has formed on my nose bridge after a cut? (Photos)

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What can I do about the keloid scar that has formed on my nose bridge after a cut? (Photos)

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