Introduction
Many patients judge plastic surgeons by the way their scars appear after a surgery. An excellent plastic surgeon is one whose procedures produce least amount of scarring or scarring which is imperceptible. So, can a surgeon always achieve that? Discoloration of scars is a major problem faced by patients in the postoperative period and a real cause of concern which needs proper counseling.
Why do Scars Form?
Scars are a normal result of any healing process. Whenever any incision is made in any part of the body, it is going to result in a scar. There is nothing called “Scarless” plastic or cosmetic surgery. Scarless surgery can occur only in the womb. Now, the degree of scarring can vary according to patients and surgical techniques.
Factors Affecting Scar Discoloration After Surgery
A multitude of factors can affect scar discoloration after surgery, some of them are –
1. Skin color – Scars tend to be darker in patients whose skin color are darker. Prominent dark scars are a characteristic of patients with higher Fitzpatrick scores. Conversely, fair skinned people tend to have lighter scars. However, this might not be always true.
2. Genetics – People having darker scars in the family tend to develop darker scars themselves as a result of the effect of genetics.
3. Sun exposure – Sun exposure after surgery can lead to hyperpigmentation of scars.
4. Location of scars – Scars in hyperpigmented areas of the body tend to be darker.
5. Infection – Any infection in the surgical site can lead to hyperpigmented scars.
6. Nutrition – Adequate nutrition produces less perceptible scars.
7. Scar treatment after surgery – Silicone gel massaging after surgery can lead to less prominent scarring.
Causes of Hyperpigmented Scars
1. Increased melanin secretion by the body
2. Bruising in the underlying skin and deposition of hemosiderin
3. Skin color mismatch in normally hyperpigmented areas like axilla, groin, knees, elbows and so on
4. Post inflammatory redness
Management of Hyperpigmented Scars
1. Skin lightening creams or exfoliative peels
2. Laser therapy
3. Scar revision in extreme cases
4. Silicone gel therapy
For more information and scar management, you can get in touch with Prof. (Dr.) Souvik Adhikari.
