Can I Get Rid Of My Scalp Scars?

Q: I have two scars, one on each side of my head from previous surgery (about 1.25 inches by 0.25). I was wondering if it was possible to make them less noticeable?

A: While all lacerations and surgical incisions leave scars, scalp scars are unique in what makes them visible. That is the fact that they occur in skin that contains hair. Any loss of hair along an incision or scar in the scalp will result in a wide and visible scar. The same scar somewhere else on the body may not be as noticeable as there is only the color change in the skin that draws attention to it. Scalp hair follicles are frequently injured during incision and lacerations and sometimes even from the suturing and stapling that is done to close them. It is actually fairly uncommon to not have scalp hairs injured dueding handling.

Scalp scar revision is done by cutting out the non-hair bearing scar and bringing the edges of the scalp that contain hair together. The scar will end up better and less noticeable if the distance between the skin that contains hair ends up less wide. My Indianapolis plastic surgery experience is that most scalp scars can be made better but there are certain surgical manuevers that must be done to increase the chances of improvement.

Handling of the unscarred scalp is critical to not injure new hair follicles that will make up the edges of the scar closure. Scalp scars do not tolerate tension very well at all and the tissues must be elevated sufficently to allow for as tension-free closure as possible. In some cases,a straight line closure must be changed to an irregular one, such as a w-plasty pattern, to distribute the tension better and get ‘fingers of hair’ to interdigitate with each other.

Dr. Barry Eppley

Indianapolis, Indiana