How to best heal a facial scar?

May 1, 2008 6:42 AM

ScarFilter: Asking for my sister. My sister fell today while running to the car and smashed her face into the pavement. Nothing broken, but she now has a wide chunk of flesh missing from the area on her nose right between her eyes.

It can’t be stitched because it is not a deep cut, it is really just a chunk of missing skin, and the “dent” is very noticeable – it looks like someone scooped out a portion of her skin with a small spoon. (I apologize if that was too descriptive!) What can she do to minimize scarring while it heals? Is there anything that can be done so that skin heals in a way to make the “dent” less obvious? Should she go to a dermatologist or plastic surgeon? Has anyone had any experience with wounds like this? Anecdotes, advice, reassurance would be greatly appreciated! I've read through this and found it helpful but was wondering if there was anything more you might add?

posted by bahama mama to health & fitness (20 comments total)

I'd have it looked at, just to see what is possible. Believe it or not, it might be able to be stitched. My sister was bitten in the lip by her dog (it was her fault; she jerked an arthritic lab/sharpei mix by its collar and got in its face) and it took a chunk out of her upper lip the size of a dime and half the depth of her lip.. She went to the emergency room, and a good doctor there did what could best be described as an emergency cleft-lip repair. This caused a small, fine scar that ran along her philtrum so it's barely noticeable, and it didn't even require a scar revision later.
posted by lleachie at 7:01 AM on May 1, 2008

I ran into a brick wall once, split open the flesh over the bridge of my nose. Mostly invisible now, years later. It healed as an indentation maybe 1/2mm deep; no scar tissue "above" the level of ths skin. I never felt it was a big deal, these things happen.

Search for previous ask threads about scarring - some good advice back there about vitamin caps (ah, I see you've already done that - next time I'm at risk of scarring, I'm going to try vitamin E).
posted by Leon at 7:33 AM on May 1, 2008

I had chicken pox as a teenager, and a cluster of angry, angry pocks between my eyes and on the bridge of my nose (which were then "aggravated" by my glasses, to put it politely) caused a healing/scarring situation that I think is somewhat similar to what you're describing.

At the time (~15 years ago), all my doctor could/would recommend was applying copious amounts of vitamin E to aid the healing process. I ended up with several small scars in that area, but they were all far less deep than the original sores -- the skin did a remarkable job of filling itself in, probably thanks to the vitamin E. The "filling in" seemed to continue for quite awhile -- the scars became continually less noticeable (more filled in, less pink) for several months after the initial healing of the sores seemed to be complete. Now many years after the fact, they are hardly noticeable at all.

That said, there's no reason not to have it looked at, right? Who knows what else has become available in the last 15 years?
posted by somanyamys at 7:35 AM on May 1, 2008

Go to a good drugstore and get some antibiotic gel. There's a product, Mederma, specifically made to reduce scarring, and it does work. Keep it well coated with the goo, even if it requires wearing a bandage, looking weird now but better later. In fact, given the location, call a dermatologist. And, no picking at it.
http://www.goaskalice.columbia.edu/2534.html
http://ask.metafilter.com/80465/Cover-or-reduce-an-old-scar
http://www.curezone.com/forums/fm.asp?i=804213
posted by theora55 at 7:48 AM on May 1, 2008

Vit E
posted by pieoverdone at 7:56 AM on May 1, 2008

They sell scar minimization creams. Mederma is a popular brand. I've used it on a wound and it looks okay now, but honestly its hard to tell if it does anything. Considering a tube only costs 10 dollars or so, its not exactly an expensive investment. Also, its a good idea to put sunblock on it. This will help minimize discolorization from UV rays until the new skin can begin to block them on its own.
posted by damn dirty ape at 8:03 AM on May 1, 2008

Plastic surgeon. This is (a part of) what they do.
posted by i_am_a_Jedi at 8:49 AM on May 1, 2008

See a dermatologist.

But in another anecdote, the nasty scrape on my shinbone did eventually go from pink to skin-color and filled in for years after the injury.
posted by desuetude at 8:50 AM on May 1, 2008

I had this happen when I was about 8. And I still have a scar and dent today and age 35. I never went to a doctor... my fear of all things needle related made that scenario a nightmare. So when the bleeding stopped, my mom relented. It healed fine, but left a scar At this point there is no red discoloration, and people seldom seem to notice it until I mention it. But if she's wondering if it will fade entirely, my experience is no. She should see a plastic surgeon.
posted by kimdog at 9:03 AM on May 1, 2008

Not sure if it's even available yet, but this guy grew back a part of his finger that got sliced off, so it might be worth checking into what he used...
posted by Grither at 9:04 AM on May 1, 2008

I should specify I had nearly the exact same injury. I ran into the corner of a table, and took out a chunk of skin right between the eyes at the top of the bridge of my nose.
posted by kimdog at 9:05 AM on May 1, 2008

The key thing is to keep it moist. Neosporin does this well. Do NOT let it "breathe." It's a myth that allowing a wound to breathe promotes healing.

If it dries out a scab will form. Scabs cause the worst scars. Keep it clean, coated in neo and bandaged. It will heal faster and you will find that, with time, the scar will fade and prolly won't be that noticeable.

There have been a few mefi discussions on this topic, but I don't have time now to dig them up.
posted by wsg at 9:53 AM on May 1, 2008

wsg has it. keep it moist. also, mederma is NOT for an open wound.
posted by misanthropicsarah at 10:26 AM on May 1, 2008

In addition to the advice that has already been given, I would add that once the wound has healed sufficiently, she should be diligent about using sunscreen on the area. Better yet, wear a hat in addition to the sunscreen. I don't have a degree in dermatology, but I think it has something to do with scarring and the production of melanin.
posted by kaybdc at 10:38 AM on May 1, 2008

You don't mention how old your sister is - the younger, the better.

My then-five-year-old little brother got hit square in the face with a clay pigeon flinger (you know, to shoot with a gun), half his face a pulpy mess, but now there is nary a scar visible (he's in his late forties now).

Young skin is very forgiving.
posted by DandyRandy at 1:47 PM on May 1, 2008

Er, Mederma is for flattening out a raised scar; yours is recessed. See a dermatologist; he/she should have ideas on how to help.
posted by Asparagirl at 2:17 PM on May 1, 2008

Nthing i_am_a_Jedi and kimdog's suggestion of seeing a plastic surgeon sooner rather than later. If your sister has significant tissue loss on her nose, it might scar really badly.

I suffered a similar injury falling off a BMX, and even after a repair by a plastic surgeon on the same day, the scar is quite noticeable 10 years later.
posted by roofus at 2:41 PM on May 1, 2008

Thanks for all the advice! I have passed it on to my sister and she is quite grateful.
posted by bahama mama at 11:30 AM on May 2, 2008

Hi. I know this was an old question of yours, but I was in a severe car accident several months back. The entire left side of my face was cut into 8 pieces. Several down to the bone. It looked like what you described with the "dug out with a spoon" analogy. They weren't sure if they had enough skin to cover it. It was terribly devastating when I woke up and saw it. Over 900 stitches. (and I was wearing a seatbelt!) Anyway, my plastic surgeon told me that it takes a year for the scar to set enough to surgically repair. She told me to keep it moisturized at all times and to massage it several times a day. I've been using scar zone with aloe and green tea twice a day, and rubbing it with vitamin E every 3 to 4 days. You would be shocked at the before and after of these scars! Also it's good to keep it out of the sun as much as possible. My scars are 5 times smaller already. Tell her to give it a try, and best of luck!
posted by ks1234 at 8:17 PM on June 12, 2008

There is a great product called Scaraway that can help reduce her scar and conceal it at the same time. It is a very thin, self adhesive fabric patch that has a silicone gel lining that goes against the skin. You don't need to use any tape as it stays in place on it's own. (Sticks well and very comfortable. Did not shift around under my clothes) Has to be used only after it is healed. I have used this item on 2 c-section scars. The first one was several years old, then I used it on a new c-section scar. I looked up info on it to see how it works and found that it is an FDA Class 1 medical device that you used to be able to get only through doctors. It is proven safe and effective to shrink, fade and flatten old scars and to prevent new ones. I found out about it through my OBGYN. I had never heard of this kind of treatment before. It is the same kind of product that burn centers and surgeons use. I think it will be a great help because the tan colored nylon type fabric blend with skin tone and covers while it helps reduce the scar over time. Scaraway did wonders on my c-section scars. The itching and tenderness of my scar was helped in just a few days and I started to see a change in the appearance (redness was fading and bumpiness smoothing out) in a few weeks. I read that the average treatment time is 12 weeks. Some people more, some less, depending on the person, skin, scar etc. Everyone is different. I wish more people knew about this cause I lived with the first scar for too long not knowing there was something I could do for it.
posted by LindaS at 10:17 AM on October 5, 2008