If you’ve recently had an excision procedure, and the stitches have been removed, there are still things you can do to reduce the amount of scarring.
You may not be concerned about the appearance of the scar, but looking after your wound properly can help prevent:
- the wound from pulling open in the next 1-2 weeks
- an overgrown, raised scar (sometimes called a keloid scar) which can be very itchy and difficult to treat once it has formed.
What causes scarring?
All procedures leave scars. They are a normal result of skin growth and repair after an injury. The new skin has a different composition from the surrounding undamaged skin and will usually look different.
In the early stages after a procedure and for about a year after, the scar will be red or pink. This is normal and usually fades.
After that, the scar usually returns to the approximate colour of the surrounding skin, but its surface consistency and pigmentation pattern remain different so the scar can still be seen.
Large or overgrown scars may be raised above the level of the surrounding skin or extend sideways further than the original incision. This type of scarring is called hypertrophic or keloid scarring.
Hypertrophic scars are more likely when:
- The original excision procedure is large
- The spot was removed from an area of the body that stretches, such as the chest, back or shoulders
- The skin needs to be stretched slightly to close the wound
- The patient is a growing child or teenager
- A skin graft is used
- The wound becomes infected or breaks down
Some people are simply more prone to develop hypertrophic scars even when none of these factors apply.
Some scars have crossing lines from were stitches were inserted.
These are more likely if the stitch material was thick (sometimes necessary for stitches on the back) or if the skin was stretched tightly to close the wound. In these cases, the doctor will sometimes use two layers of stitches to make the wound stronger and reduce the risk of scarring
Reducing scarring after stitches are removed: what you can do
You can reduce the risk of an overgrown scar by following these principles:
- Avoid stretching the wound
- Cover the wound tightly to stop it becoming raised
- Promote blood flow to the wound and improve healing by massaging it.
Your skin will take up to twelve months to return to maximum strength (which is still less than the strength of intact skin)
For the first few weeks after the stitches are removed, the wound is relatively weak and is at risk of pulling apart if the skin is stretched. Minimise movements that involve stretching the area for about a month after your stitches are removed. Be especially careful when lifting heavy weights or moving suddenly. If you routinely do gym work, Pilates or yoga, talk to your instructor or trainer about ways of exercising that reduce tension on the affected area.
Wearing tape over the wound can help you be aware of stretching in the area and act as a warning to be careful.
Apply a silicone gel daily. This can help keep the wound soft and flat, and prevent excessive redness or discoloration. For best results, the wound should be treated daily for at least two months. Silicone gels such as Dermatix, Kelocote and Strataderm are available at pharmacies.
To further flatten the wound and reduce stretching, apply a surgical tape such as Micropore. For best results, keep the wound covered with tape for 4-6 weeks after the stitches are removed.
Massage can increase blood flow to the wound and promote wound healing. For best result, massage daily with Bio-Oil for 4-6 weeks for at least 10 minutes at a time.
Sunburn may cause healing scars to become darker. Avoid unnecessary sun exposure to your scar for at least 6 months by applying tape or sunscreen.