This is the last post in our three-part series exploring Mohs reconstruction surgery, a common treatment for basal cell and squamous cell carcinomas. In the two previous installments, I outlined what the procedure entails and described what you can expect during the recovery phase. Below, I’ll highlight the most effective scar treatments.
First, I want to repeat something I said in my last post. It’s OK to be concerned about the scar you’ll be left with after the surgery. There’s a pervasive narrative that says you should be grateful for the outcome because you’re cancer-free. But it fails to take into account the uplifting effect on our mental and physical health that taking pride in our appearance can have.
Conversely, there’s nothing wrong with wearing your scar as a badge of honor.
The question most commonly asked by patients in the days leading up to their surgery or immediately afterward: “What’s the best scar cream?” The truth is, there’s no evidence that scar creams make any difference. Even more, most scars will get better on their own. It just requires some patience. Your scar will likely improve dramatically within six months. But even then, it’s still healing. Most scars aren’t considered full healed until 12 months later.
That said, a silicone sheet or gel may be helpful with a raised scar. They create a protective barrier over the scar, which seals in moisture and prevents excessive collagen buildup.
Beyond that, in-office treatments tend to yield the best results. Many of them can be combined and done during the same visit. It’s worth noting that scar treatments are usually covered by insurance only when it’s considered medically necessary. For example, your scar is tender or itchy.
Steroid injections are widely used to flatten the thick edges of a raised scar. It’s only administered to the scar site in a very small quantity, so there’s very little to no systemic absorption. Often, one round is all that’s needed. However, if you have a history of keloids or hypertrophic scarring – which are particularly common in Asian and Black skin – additional rounds may be warranted to prevent those scars from forming.
Dermabrasion basically sands down your skin. The best time to undergo dermabrasion is around six weeks after your surgery. That’s when the fibroblasts (the cells that form collagen) peak. Dermabrasion is often recommended when a skin graft was used for the Mohs surgery because it helps blend it with the surrounding skin. Similar to a steroid injection, a single treatment is usually all that’s needed.
If your scar’s most notable feature is redness, a laser should be able to help with that, more specifically a pulsed dye laser (PDL). A PDL stops blood vessels – the cause of the redness – from continuing to form around the wound, which will reduce the redness. For especially severe discolorations, multiple visits may be necessary.