CHRISTINE
November 2nd, 2014
You come highly recommended through a mutual friend – Susan Worman.Approx 8 months ago I had a small sunspot removed from the shin bone on my right leg by my, annually visited, dermatologist . From memory, 8/9 internal stitches in all. I did all that I was told re care, it was quite a neat line when the bandages were removed, however of the next few days I noticed that it seemed to be widening and thought perhaps the stitches had broken, although the healing process seemed to be continuing quite normally. I pulled it together with some plasters and all seemed to be much better.It’s been winter so there’s been little exposure, and I’ve been using Bio-oil or pawpaw ointment virtually daily expecting the scar to be minimal all these months later but it’s still quite obvious, quite dark and a bit unsightly.I wonder if you have any suggestions about what I might be able to add to my routine to fade it further? Or as someone has suggested perhaps laser is necessary.I look forward to your guidance.Thanks Christine
Susan
Thankyou for your inquiry !I noticed you didn’t upload a photo which would help with me providing appropriate and accurate treatment options but will try and advise with the information you have provided.I have also had a lesion removed from my shin and experienced exactly what you have described which is a dehiscence (widening of the scar) at the site of excision. Where scars are in a very mobile or high tension areas such as arms, legs and backs, it’s very difficult to maintain stability sometimes resulting in the wound appearing wider than the initial excision.It sounds like you cared for the wound in the correct manner and avoided complications which may contributes to dehiscence. Also trying to keep the wound together with plaster strips was a great idea!Wounds typically take around two years to reach maturity and full tensile strength and this will be the scar you would be left with, however over time there is continual fading.Assuming the scar isn’t Hypertrophic or Keloid, that is that is that it hasn’t grown outside the boundaries of the initial excision then Light Based Therapies would be a treatment option worth considering.As has been suggested there is new studies to suggest early intervention of Light Based Therapies /Lasers for scar revision are very helpful in scar minimisation and so this is a treatment option you should pursue for the fading, however it probably won’t impact on the width of the scar. It will help with the colour of the scar if there is some redness or hyper pigmentation reducing the appearance.The scar may also be surgically revised if in consultation with your Dr he/she feels it may improve the appearance.You should stay out of the sun as much as possible, and always use a sunscreen (SPF > 20). Scars exposed to the sun (especially if sunburn develops) not only stay red longer but also may not fade as much as normally expected and in some cases hyper pigment, making the scar appear more noticeable.Keeping the wound pliable with Bio Oil and Pawpaw is also a good idea however these products sit on the surface of the skin and it sounds like there is Dermal involvement in your case meaning products used will only be of benefit superficially.I hope this helps Christine and please don’t hesitate to contact me again if you have any further enquiries.Kind Regards Susan
CHRISTINE
November 22nd, 2014
Hi Susan,
Thanks for all the information very useful… and much as I expected.
I did think I had uploaded some snaps of my leg – but they must have corrupted somehow.
Just for the sake of it they are attached now – so if you did have any more specific advice, please let me know.
Thanks so much Christine
Susan
Hi Christine,
Thanks again for taking the time to provide those photo’s.Great quality and certainly shows what’s going on.The scar does seem to have widened slightly however the pigmentation and vascularity are quite prominent.After contacting you last time I did wonder whether you might also benefit from some Needling scar revision or some LED’s to promote healing but upon looking at those photos I firmly believe you would greatly benefit from either IPL or Laser based therapies addressing the newly formed angiogenesis (redness) which sometimes occurs in fragile skin and the pigmentation. I highly recommend using a sunscreen containing a zinc base which will promote healing and prevent further pigmentation in the future.I’d really appreciate you keeping me updated on which treatment option you choose ?
Kind Regards Susan