My 5yo tripped and fell into a corner 8 months ago, splitting her forehead fairly deeply. We took her to the ER and she received 12 stitches. The resulting scar is attached - it is about an inch long and straight. I'm wondering what the best course of action would be - remediate now while she is young or wait until she is older? Would she heal better if we took action now? We have been using Mederma daily and have given her bangs to physically shield the wound from sun. Thank you!
5 Year Old Child and Scar Revision on Forehead - Now or Later? (photo)
Doctor Answers 2
Options to treat your five year old child's forehead scar?
I agree with Dr. Winkler that this scar will likely continue to mature and improve for at least one year after the injury. You're doing the right thing using Mederma and trying to camouflage the scar while it matures. You should also consider daily sunscreen as well.
Given the width and depressed nature of the scar, removing the scar tissue and meticulously closing the wound is the best option if you want to improve this scar. This might also be optimized with laser treatments or dermabrasion (sanding) of the scar beginning at 6 weeks after the scar revision.
Another important thing to consider is that your five year old probably will not undergo these procedures without some type of sedation and the risks and benefits and emotional impact of this should be seriously considered.
Thank you for your question.
Stephen Weber MD, FACS
Scar revision timing
The timing of scar revision can be tricky. After the injury, scars continue to change and mature for about 18 months. Therefore, it is never wrong to wait that amount of time to see the final result. That said, the depressed and wide appearance of your child's scar at 8 months is unlikely to improve significantly. If you wanted the scar revised prior to your daughter entering 1st grade, for example, that would seem reasonable to me.
Regarding the best treatment for this scar, I would start with a procedural scar revision. This involves removing the existing scar and realigning parts of it to lie horizontal with the forehead. This would ideally be followed by three Lux1540 Laser Treatments. Keep it covered with sunblock and use Mederma if you like. Using this treatment regimen and given her age, I would expect an excellent result!