Guest guest Posted September 8, 2002 Report Share Posted September 8, 2002 Hi all. My surgeon gave me something called Spectragel that I have been using twice a day since my surgery in July. It is very expensive but a little goes a long way. For all I know, it might contain the very same ingredients that are contained in the scar healing products in the pharmacy. He also said to use sunscreen religiously. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2002 Report Share Posted September 8, 2002 Hi all. My surgeon gave me something called Spectragel that I have been using twice a day since my surgery in July. It is very expensive but a little goes a long way. For all I know, it might contain the very same ingredients that are contained in the scar healing products in the pharmacy. He also said to use sunscreen religiously. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2002 Report Share Posted September 8, 2002 Hi all. My surgeon gave me something called Spectragel that I have been using twice a day since my surgery in July. It is very expensive but a little goes a long way. For all I know, it might contain the very same ingredients that are contained in the scar healing products in the pharmacy. He also said to use sunscreen religiously. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2002 Report Share Posted September 8, 2002 Dear All, A month or two after my TT, I asked my surgeon about my scar; he basically said, 'come back 7 or 8 months post-op; if you still think the scar looks bad, we can do something'. To my surprise, when the time arrived, I hardly even thought about my scar anymore. I found that for many months I didn't like the feel of anything on my neck, except, occasionally, a soft silk scarf. I made a point of keeping my scar out of the sun, and once it felt comfortable to handle, kept it well moisturized. Assuming you have a good surgeon, and unless you have some extenuating circumstances (such as a tendency to keloid), you probably won’t have much problem with your scar, and within a year it will undoubtedly look just fine (which is to say, you’ll be able to forget about it, and most people won’t notice it). If you know you tend toward keloid problems, speak to the surgeon in advance of your surgery. Below are various suggestions from list members over the years, plus web sites for several products. Except for one, which is an herbal mix, most of the scar treatment products seem to be variations of a theme (silicone gel, either in a tube or embedded in paper or fabric tape). Mederma is the name that seems to come up the most. A couple of people said they've used Kelo-cote, with good results. As with everything else, YMMV - some may heal fast, some may heal slow, but sooner or later, virtually all of us heal just fine. Sometimes I think the biggest purpose served by the ointments and tapes is that they give us something to do while nature takes its course... :-) - NYC NOTE: I have no first hand experience with any of the products mentioned below. With the exception of some attributed quotes, all comments are quoted directly from list members. ============================================== Q: Are there ways to help heal the incision from thyroid surgery? Should there be follow-up cosmetic surgery for the scar? A: Thyroid surgery is usually followed by excellent wound healing. In the vast majority of cases, there is a satisfactory cosmetic result. Because of the extensive blood supply in the neck and the fact that thyroid surgery is " clean " (i.e., No contaminated body cavities are explored), infection should be rare. Avoiding sun exposure is wise to promote smooth wound healing. Beyond that, no special wound care is required following thyroid surgery. There are no controlled trials proving that any topical or injected agents are beneficial. In spite of the excellent results obtained in most patients, a few may not satisfied with the appearance of their scars. For some of these patients, plastic surgery can be helpful, but cosmetic procedures are rarely indicated until at least six months after the initial procedure. .... from s Hopkins web page .... http://www.thyroid-cancer.net/resources/answers.php3?keywords=treatment ----------------------------------------------------------------------------- http://www.blackhealthnetwork.com/articles/article.asp?articleid=30 (scar management info) http://www.aestheticinnovations.com/aihome.htm http://www.curadusa.com (Curad Scar treatment) http://www.dermatique.com/ http://www.kelocote.com http://www.mederma.com/ http://www.phudson.com/SCAR/siliconescar.html http://www.scarfade.com/ http://www.scarguard.com/index.html http://www.scarheal.com/ http://www.scars-keloids.com/ Cordran tape is a prescription item; here's some info on it http://www.buildingbetterhealth.com/topic/topic100588927 ------------------------------------------------------------- TAPES & SILICONE SHEETS We've used Kelocote, with some success, but we think the scarguard is probably a better product. Kelocote gel is a silicone gel, and silicone sheets and gels are being used pretty effectively on keloids. But, Scarguard also has vitamin E and and cortisone in it. Cortisone shots have also been effective on some keloids. Scarguard seems like a good bet, in that it's a combination of good treatments. Only complaint is that it's expensive. -------------------------------------------------------------- Most people probably will heal up fine without any special treatment. But I did come across several studies on PubMed showing a significant improvement of scar texture and appearance from using the silicone tape. But you have to be willing to wear the tape continuously for a few months. ------------------------------------------------------------- I had a lot of problems with my scar. It was tight and pulled when I swallowed. I went to a plastic surgeon (it was covered in my insurance) who gave me cortisone injections into the scar tissue and gave me " Kelocote " to apply 2Xday. Kelocote is a silicone type gel that you rub into the scar to make those cells line-up and stretch! I form keloids even tho I'm anglo and it was quite unsightly. The treatment improved the look and suppleness of the scar dramatically. I'm not sure if Kelocote is over-the-counter or not but it is $40.00 for 1/2 oz.! ------------------------------------------------------------- I was told by the surgeon that for 2 months after the surgery the scar would continue to look worse before it begins to look better. (Disappointing but at least honest info). His analogy was that the collagen cells after surgery look like a bunch of logs just thrown on the ground. During the two months post surgery, they are busy rearranging themselves so that they eventually lie neatly on top of each other. Until they finish their rearranging, the scar will be lumpy and red. Being somewhat of a control freak, I just want to get in there and assign the collagen cells numbers and get them to move to their correct spots. I have visions of them running around, unorganized and bumping into each other. I am alternating using a product called Mederma and cocoa butter on my scar. A month after surgery it is pretty much flat, but still red. Am still wearing high necks, scarves and one particular necklace to cover my permanent " necklace. " ------------------------------------------------------------- Re: Elastoplast elastic adhesive bandage tape, #2594 with silicone .... .... the surgeon told her to just put it on and leave it on, through showers, sweats, all, then when it gets too gunky, take it off and put another strip on, I got her supply from the hospital, it is pricey, but so was the hospital stay. The surgeon swears by it. The scar does look good, one advantage of the elastoplast is that it covers the scar from the sun, giving it better protection than any sun block. The scar does not need light or air to heal. the surgeon explained that they really do not know why it promotes healing without scarring, but it does, but it has a window - three weeks post surgery to four months. does not feel the tape until it gets gunky, then she takes it off and puts another one on. ------------------------------------------------------------- The doctor would have used Cordran tape, which is a tape that has steroids in it and is placed over the incision. We've also used Kelocote, which is a silicone gel, and seems effective, if applied religiously. BUT, our best luck seems to be with a new product called, " Scarguard " which is a gel, like Kelocote, but it uses silicone gel AND steroids AND Vitamin E. Fancy that! Sounds pretty hopeful, to me. Scarguard is expensive stuff, but it'll be well worth it, if it works. It's $65.90 for a 30ml bottle, with shipping ... so don't drop the lil' sucker. You apply this stuff TWICE a day. Probably morning and at bedtime? They say it smells yucky at first ... like nail polish ... but the smell goes away as soon as it dries (about 15 seconds). says it peels, after a while, and looks sorta flaky, but it seems to be making the keloids go down and the redness disappear. --------------------------------------- There are a few products out there, all of which work best if used right away. But you might look into them. First...if there's redness, plain old Neosporin and vitamin E should be tried. Also, look up a product called Kelocote, which is a silicone gel. Cordran tape (or also in a gel) uses steroids. I guess a surgeon can use this tape along with or in place of the steristrips. Would have probably helped a lot, if used right away. Scarguard, which is a gel, like Kelocote, uses silicone gel AND steroids AND Vitamin E. Fancy that! Sounds pretty hopeful, to me. My daughter tried it, hated the smell, but thought it helped a lot. About 90% of her scar looks fine, but there's a good bump on each of the scars, that's really being stubborn. The Scarguard is expensive!!! I ordered a 30ml bottle for $65.90 with shipping! You apply this stuff TWICE a day. Probably morning and at bedtime? They say it smells yucky at first...like nail polish...but it goes away as soon as it dries (about 15 seconds). There are also silicone sheets, that used to cost a fortune (like $300 for an 8X11 sheet), but you can now get them more like bandaid size, from regular drug stores. They are usually washable and reusable. They aren't sure why the silicone sheets work, but they seem to help especially with keloids from burns. They take a long time to see results, though. But, you might look for a box of the self stick ones, and try them just at night, and see if they help. Meanwhile, remember that with keloids, any cutting or irritation to the area will just make them worse. Do NOT let anyone laser them!!! We tried that with my son's acne keloids (bumps the size of a big thumb, all over his back), and they just got bigger when they healed over. Best thing for keloids is PRE-treatment, or immediate treatment after surgery. Convincing the doctor that it's necessary, is another story, though. ------------------------------------------------------------- What has really worked for me is to put a product called DuoDerm down over places that are constantly being taped. The DuoDerm adheres very well but comes off when needed without any pain. While it's on, it heals the skin beneath it. And most types of tape adhere to the DuoDerm fairly well. I used 3M TransPore, a plastic tape and the combination was very solid. I couldn't buy the DuoDerm at the pharmacy, I had to rely on the Doctor's office and the hospital for my supply. But just a few samples have gone a long way. ------------------------------------------------------------- I have a 4 " scar from my surgery 18 mos ago that had adhesions that were uncomfortable. I went to plastic surgeon that gave me a couple of cortisone shots into the scar tissue to soften it over a period of 6 months and a prescription for Kelokote which is a silicone gel that you apply 2x a day. My scar improved dramatically and I decided not to have it repaired surgically ... it was all covered by my insurance, too! ------------------------------------------------------------- I tried various topical ointments including mederma, beeswax and lanolin, cocoa butter and vitamin e. I am also an occupational therapist and I work on scar management with my patients. I find that vitamin E capsule that I open with a pin, massage my scar with that works the best, ONLY after I mobilize my scar with absolutely no cream or ointment. I do that at night. During the day, I wear a " cica-strip " that is a silicone gel that gives uniform pressure to the scar to prevent it from keloiding or becoming hypertrophic. It also hastens the healing process. I wouldn't rush to buy mederma because of the expense. ------------------------------------------------------------- CREAMS & OINTMENTS Vitamin E cream is very good for your scars. I'm not sure how much it actually works on the scar but it does keep the skin soft and probably rubbing in the cream is good for the nerves in the area. I had a long scar on the side of my face and no one can see it now. Actually I was surprised when I saw my thyroid scar. It didn't look nearly as bad as some I had seen. The swelling looks worse than the scar. I am wearing neck scarves not so much to cover scar but to keep my clothes from rubbing. My neck is still swollen. ----------------------------------------------------------- Having a neck FULL of scars, I feel I can safely recommend the following treatments: While your stitches/staples are still in, use Neosporin to prevent infection. Immediately after, begin vigorously (but not too roughly) rubbing in 28,000 IU of Vitamin E cream. I use Colonial Dame, available at Osco Drug and other pharmacies in the skin care section. It must be at least 28,000 IU or it won't work as well. I tried 10,000 IU oil on my first set of scars and it did practically nothing. As soon as I switched to the right dose, I noticed immediate results - less redness, reduced raised areas.... I've now switched to Mederma, a thin lotion designed specifically for surgical scars and burns. It smells nice and dries a lot faster than the Vit. E and I can already see more improvement. It's a little expensive (from $15.99 to 25.00 depending on size of tube) but it is available OTC at Walmart. Ask in the Pharmacy section if you don't see it on the shelf. ------------------------------------------------------------- My scar isn't red anymore. I was told by a friend who had seen a plastic surgeon for her daughter's facial scar due to a dog bite to use Polysporin with Vitamin E (and the antibiotic one) daily and massage it for 5 minutes on the incision line and I have to admit I only did it a couple of times a week but it has healed nicely so maybe it did help. ------------------------------------------------------------- just saw a feature on the local news last night about a new ointment for scar treatment. It's called Mederma, and it is available over-the-counter for about $30-40. A plastic surgeon who was interviewed stated that he certainly noted improvement in scar appearance with Mederma. He did hedge a little, saying that it is unclear if any special ingredients in the ointment actually promote better scar healing, or if the effect was secondary to 1) massage of the area during application, or 2) lubrication of the skin. In any event, the scars did look much better, so it's probably worth a try. ------------------------------------------------------------- I alternated between using Vitamin E oil (pure and natural) and natural cocoa butter stick. The cocoa butter is a little hard, but if you rub on your arm or something first to soften it up it is not bad. I started using these right away, but I did not have staples or stitches, they used internal stitches and steri strips to close which I wore for a couple weeks. I'm not sure about the risks of infections with staples or stitches. ------------------------------------------------------------- I asked the surgeon about this today - he said it is a waste of money and that the scar, tho raised and red, will heal eventually - just use vitamin E CREAM ------------------------------------------------------------- I've had some problems with my scar healing - red, dry, and sore. I'm almost a month post surgery. My surgeon prescribed a topical corticosteroid cream (kinda looks and feels like Vaseline) - called Celestoderm V 0.1%. It really helped! ------------------------------------------------------------- Buy a scar cream and use it every day as per the directions (once the surgeon says you can). I found a good lotion called Scargo at a health food store. It is mostly olive oil so it glides on easily without stickiness. That's important because your scar may be hypersensitive for a while (some folks here say their necks were extremely sensitive for months, me included). ------------------------------------------------------------- My scar is only 7 weeks old... and its already quite nice... Vitamin E, every night... sunscreen every day.... its mostly just a line, with a little blobble where the drain was ... my surgeon was funny about it, i asked him about Vitamin E and he said " There's no clinical proof that it helps " and in the next breath said " but I've seen incredibly results, just don't use vitamin E in the daytime as its so oily it can amplify the sun like baby oil " its been working for me... and actually i have not been covering it, except with sunscreen, I wear polo shirts all summer and have been doing so ever since surgery.... folks at work all compliment me on how good its looking --------------------------------------------------------------------------------\ ----------------- MEDICAL PROCEDURES -LASER, CORTISONE INJECTIONS & PLASTIC SURGERY During the last Washington, DC support group meeting, one member was kind enough to invite his neighbor, a head/neck surgeon from Walter , to the meeting. There was much discussion regarding treatment of scars. For those of you who have pink/reddish raised scars or keloid scars, a new laser technique is showing great success at correcting this problem. I believe a dermatologist would perform this technique. The surgeon described this treatment and it sounded very easy. He also did mention the silicone tape that could be placed over the scar but the laser treatment seemed more favorable. For those of you (like me) who don't have a raised scar but have a scar that it a bit " indented " , this scar requires a surgical correction as it is attached to the neck structures underneath. ------------------------------------------------------------- .....A few years ago, a co-worker of mine did a " face plant " into gravel after a young in-line skater darted out in front of her bicycle. The extremely delicate milky white skin of her face had deep abrasions as a result. Since we were working at a major university at the time, with a med. school, she went to the otolaryngology department and they gave her some kind of lotion to put on her face, but they told her that, when in the shower in the mornings to _very lightly_ and with a _very gentle_ moist sponge, to brush over the scar so as to remove the top layer of dead skin cells (it doesn't take much to do this) and to do it in one direction (I guess following the direction of the hairs on your skin). It may seem like your doing nothing, but you are, and it is important that you be gentle. In few months, and to this day, no one can see any discoloration on her face, and although she can slightly detect it herself, it's not enough to send her flying to a plastic surgeon. I waited for almost a month after my thyroidectomy, I think, before I took a moist gentle sponge to my scar. At first, I didn't do it every day, just every few days, and my touch was so light, it seemed like I wasn't doing anything. After showering, I did my normal routine of a gentle toner, followed by a good moisturizer, but on top of that I applied vitamin E oil and I took at least 400 IUs of vitamin E a day orally, too. Vitamin E taken orally helps build cells, and probably eating protein will help. " Prescription for Nutritional Healing " , by Balch and Balch, says that vit. E is best taken at different time of day than iron supplements, because inorganic iron destroys vit. E. The book has cautions about E and anticoagulant drugs, diabetes, rheumatic heart disease and an overactive thyroid (p. 20). Anyhow, to end a long story, my scar is so thin, most people can't see it, even when I call attention to it! Part of this is probably due to a good surgeon, but I feel sure that I had a hand in it too. It's a good thing that the scar is barely visible, because it's crooked! It doesn't follow the natural lines in my neck. By the way, my scar stuck to my throat for a long time and eventually, it returned to almost normal, although, it still feels lightly " catchy " . I lightly massaged the scar once a day to keep the subdermal scar tissue from contributing to that " sticky " feeling, although I wasn't persistent about it. ------------------------------------------------------------- For those of you about to have surgery and concerned about stitches, staples, tape, etc. I wanted to let you know that the first time I had surgery (TT) I had staples. I was horrified when I saw them, but was assured all would be well. The scar was magnificent. The second time I had surgery I had internal stitches and just tape on the outside. The scar is still magnificent. Don't judge anything by the first few days after surgery. The healing process can take many months before you get to the 'end product'. My last surgery was in January, and I still believe my scar is changing. I went to a dermatologist after my second surgery. (The first was in 1979. The second was in 1996.) She injected collagen into the scar as well as the drain scar: this was using a * very * sharp needle and took several pricks. (* Hurt *.) She told me that I should have come in * before * surgery, and then she could have " pre-treated " the area to lessen the scar. (I keloid: the injections did lessen the main scar and almost eradicated the drain scar -- all this in one visit.) -------------------------------------------------------------------------------- My dr. injected the scar with Kenalog (Triamcinalone). He did it twice and this helped greatly with the tight and thick scar. Mine looks like a " normal " scar now. ------------------------------------------------------------------ She had the same problem with scarring even though she used the vitamin E cream as told. Partly this may have been from a very difficult first surgery because her thyroid was very enlarged from hashimoto's which never showed up on previous tests. Her doctor is a plastic surgeon as well as an ENT and kept after her to come back saying he'd fix the scar. Since our insurance company changed and he is now out of our insurance network, my wife was reluctant to spend the money. Turns out he is going to do it at no charge because he didn't like the result even though it seems to be a result of her very fair skin type. She had her first dermabrasion treatment from him last Monday and has the second of five this coming Monday 4/1/02. He uses an ammonium silicate compound or something like that to gently " sandblast " the scar. She said it is not uncomfortable and we can already notice some improvement. ------------------------------------------------------------- ITCHY & PAINFUL SCARS Q: For the past week or so, the area above my scar and around my ears has been itchy like crazy. Now this itchiness is starting to be all over. After my shower this morning, I was ready to rip all my skin off. Is itchy skin a symptom of hypo or hyper or do I just need to do something like change my laundry detergent? A: This is a clear case of " Incision lice " as you describe it. Having said that, I am now going to tell you that that was a joke but I'll do it slowly so that you have a chance to start laughing without hitting the monitor with your teeth. It is not uncommon that in the process of healing an incision there may be some itching, all the way from a mild itch to a severe " insane asylum " sensation. Try an OTC hydrocortisone ointment, the strongest you can get and apply locally 2 to 3 times a day. If that doesn't work, ask your doctor for a prescription for one of the stronger ointments we use. - ARTURO R. ROLLA, MD Boston, MA --------------------------------------------------------------------------------\ ---- .... from an ENT surgeon ... Q: I have been back on my meds for five weeks now after my first RAI treatment and body scan. I am wondering if anyone can shed some light on why my incision is suddenly feeling really uncomfortable (from the inside). Does this have anything to do with becoming less hypo? I often find that when i wake up in the morning and sit up my incision shoots with pain! It's like it is being stretched out of it's comfortable sleeping position! Is this just something that i have to get used to? Or should i be concerned? I also notice that i have been having that " choking " feeling again, almost like the feeling of having an enlarged thyroid pushing up against your esophagus. A: Sometimes after neck surgery, particularly neck dissections, a cut nerve regenerates in a haphazard pattern " balling up " instead of extending into the other cut end. If you press this " ball " or neuroma, you will experience pain or electric shock down the course of the nerve. Sometimes, the nerve that gives you feeling to an area of your body can be uncovered during a neck dissection. Without the overlying fat, lymph nodes and muscle the nerve is very susceptible to pressure stimulation. Your " funny bone " is actually your ulnar nerve coursing around your elbow. Where it is only covered by skin a small ding will send most of us howling. As for weather-related phenomena, I have no explanation except I had a broken knee in 1983 and can still tell when a noreaster is rolling in. We really don't know how to prevent neuromas except that the more meticulously the nerve is cut, the less likely it will be. When reattaching nerves the suturing takes place under a microscope and it takes time. In general, there are so many nerves in the neck that we just can't examine and protect each one, it is impractical, time consuming and bad cancer technique. ----------------------------------------------------------------------------- .... ARCHIVED LETTERS .... To access these letters, go to .......... http://groups.yahoo.com/group/Thyca/messages and enter the message number into the small box marked " msg # " (or enter “http://groups.yahoo.com/group/Thyca/message/xxxx” in the URL, substituting the message number for the xx’s). To search the archives further, go to http://groups.yahoo.com/group/Thyca Scroll down to the empty box near the words “Search Archives”. Enter the word or subject you are searching for. 2972 .... itchy incisions/ keloids 3010 ..... Nanette's success using vitamin E nightly on her scar 3053 ..... Jill describes the difference between keloids and " regular " scars 13501 ..... acupuncture for scar treatment 13522 ..... Katrina gives some details about her acupuncture treatments 13544 .... Jill's warning about laser treatments 20684 ..... 's letter on Dermablend for scar coverage (NOTE: this is the first mention I've seen on this list of Dermablend, but I've heard other success stories. - K) 11791 ..... Dr. Ain on extent of thyroidectomy Quote Link to comment Share on other sites More sharing options...
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