How Can I Improve The Splotchy Skin Around The Scalp Scar After An Occipital Reduction Surgery?

Q: Dr. Eppley, I hope you’re doing well. A year later after the occipital skull reduction procedure I’ve finally shaved my head and I’m fully satisfied with the results – however, there is a persistent discolored red splotch of skin surrounding the left side of the incision scar – at first I thought I just irritated the skin shaving it, but it hasn’t gone away. Do you know what it could be and if so, is there anything I can do about it?

A:Thank you for the long term follow-up which is now over one year from your occipital skull reduction. In looking at your picture the actual scar line is so minimal that it really cannot even be seen. There is, as you have pointed out, and overall reddish discoloration to some of the surrounding scalp skin. This is not really part of the scar per se but is some generalized scalp skin vascular dilatation. That is not a postoperative phenomenon that I have ever seen before or has  been reported to me before from any type of scalp incision from skull reshaping surgery. Despite its rarity the treatment of it is not rare. Such vascular skin issues are typically treated with a tunable or pulse dye laser adjusted for the wavelength and color of the lesion to be treated. Such tunable wavelength lasers have been around for over 30 years and their initial introduction of use in the 1990s was for a more severe type of  vascular anomaly, the port wine stain. Whether it be a port wine stain, telangiectasias for a generalized vascular rash this type of laser treatment can be very effective at reduction of the color.

Dr. Barry Eppley

World-Renowned Plastic Surgeon