Caring for scar tissue after cancer surgery

More than half of cancer patients undergo surgery as a part of their cancer treatment. Just about every patient who has surgery will have a scar.

Scars are actually a sign that the skin is healing. They form as the skin grows new tissue, pulling together the wound by creating collagen, which then forms scar tissue.  

But scars can have uncomfortable or even painful side effects – or serve as unwanted reminders of cancer treatment. Margaret Roubaud, M.D., answers common questions and advice for dealing with scars after cancer surgery.

What are the different types of scars?

A few different types of scars may result following surgery. The most common are:

• Flat scars: Flat scars may become lighter or darker than the surrounding skin, but they’re not raised or sunken.
  
  
• Keloid scars: Keloid scars are thick, dark irregular clusters of tissue that grow beyond the borders of the original incision. They’re formed by collagen after an incision has healed.
  
  
• Hypertrophic scars: These are similar to keloid scars, but they only appear at the original site of the incision. They may be raised or darker in color.

What helps a scar heal after surgery?

There are three things to help reduce the appearance of scars:

• Moisturize. A high-quality moisturizer can lock in natural moisture and oils, keeping your skin hydrated.  
  
  
• Use sunscreen. Sun exposure can cause scars to grow darker, or hyper-pigment. Use a sunscreen with SPF 60 or greater and try your best to keep out of the sun during the first year after surgery.
  
  
• Massage the scar. Once your scar has healed, you can massage it. This provides moisture and flexibility to the scar, which promotes collagen remodeling and helps the scar heal.

What’s the best scar treatment after surgery?

There’s no magic potion. But any high-quality moisturizer, whether that’s lotion – shea butter, or coconut oil– can make a big difference.

There are lotions available at every price point that can help reduce the appearance of scars. In addition to moisturizer, silicone sheets that essentially look like band-aids and help increase hydration, keep out bacteria, and reduce itching and discomfort.

How long does it take a scar to heal?

Scars take at least three months to stabilize. About six to 12 weeks after they first appear, they’ll start to soften, and the color will fade. At about the one-year mark, they’ve finished developing.

It’s important to remember that scars often look worse as they heal before they look better.  

Are there any side effects associated with scars?

Scars aren’t just cosmetic. They can cause pulling or pain, particularly if they’re in a sensitive area. Depending on where they’re located, they can impact movement or function. Scars may require additional surgery if they are affecting a patient’s quality of life, not just because the patient doesn’t like the way it looks.   

Is there any treatment available for scars?

Most scars are fine with massage and some moisturizer and won’t require additional care. But for more severe scars, the following treatments are available:

• Injections: Corticosteroid injections can reduce the size of keloid scars.
  
  
• Laser treatments: Laser and light treatments can make scars less noticeable by causing blood vessels to recede once the scar has fully healed.
  
  
• Scar-revision surgery: If a scar is causing significant functional or aesthetic deformity, surgeons can revise the scar. This may require excision and reclosure, or, if the scar is quite contracted, it may require plastic surgery solutions, such a local tissue rearrangement. This can not only reduce the appearance of the scar; it can also help improve movement and mobility.

What should cancer patients specifically know about scarring?

Everyone, but cancer patients especially, should keep an eye on their scars because of the risk of infection. Redness, swelling, tenderness or drainage are all signs of infection.

Cancer patients should also look for a care team that includes a plastic surgeon who can help them deal with any scarring that occurs during treatment.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.