Cancer-related scars and wound care

From diagnosis through treatment, you may need to undergo procedures that cause wounds and leave scars. To protect yourself from infection, it’s important to take proper care of your wounds. Taking proper care of scars that form over wounds may help them heal more quickly and form a shape that’s as smooth and flat as possible.

Wound care

When you undergo treatment, such as surgery, that causes a wound, your care team will provide you with detailed care instructions.

General guidelines (listed below) will help you prepare for what to expect in caring for your wound, but these may differ from your care team’s instructions. If so, follow your care team’s direction, and only use supplies recommended or approved by your team.

• Before and after changing a dressing (the bandage on your wound), wash your hands thoroughly.
• Never reuse a dressing.
• Wash the wound every day with soap and water. Rinse it well, and pat it dry with a clean towel.
• If the wound bleeds, clean it well and apply medium pressure with a cool cloth or an ice pack until the bleeding stops. Then finish the dressing change as instructed.
• Use sterile, non-stick gauze to dress your wound. If possible, use paper tape, not cloth or plastic.
• Try not to put tape directly on your skin. Use a “skin prep” solution to create a protective barrier between your skin and the tape. Or place the bandage over the wound, wrap gauze over the bandage, and tape the gauze to itself. Ask your care team or pharmacist about skin prep.
• If your dressing gets wet or dirty, change it right away. Keep the dressing clean and dry at all times.

These healthy habits may also help:

• Take your medications as prescribed.
• Avoid scratching or rubbing the wound. Don’t remove scabs.
• Incorporate extra citrus fruits, green leafy vegetables, such as kale and spinach, whole grains, meat, fish and eggs into your diet. These foods are rich in nutrients that specifically promote wound healing.

If your wound hurts, tell your care team. They may be able to prescribe medication to help.

Incision care

An incision (cut) made by the surgeon during a surgical procedure will require special care in the healing process. Surgeons close different types of incisions in different ways, and your care instruction will depend on the type of closure used.

Types of closures include:

• Stitches (or “sutures”): The surgeon uses this surgical thread to sew deeper surgical incisions closed.
• Staples: Doctors may use these medical-grade closures in hard-to-reach areas that may be difficult to stitch.
• Adhesive tape: Doctors may use these sticky strips of tape to close minor wounds. The doctor may also place tape strips over dissolvable stitches.
• Tissue glue: Doctors may use this skin adhesive to close both major and minor wounds.

Your care team will provide you with incision care guidelines. The following general guidelines will give you an idea of what to expect when taking care of your incision. If your care team’s instructions differ from what you see here, follow their direction.

Stitches and staples: You can usually shower 24 hours after surgery. Clean the area gently with mild soap and water. Pat it dry with a clean towel. Your stitches or staples may dissolve, or you may need to return to your doctor to have them removed.

Adhesive tape: You can bathe with tape strips in place. Gently clean the area with mild soap and water. Pat it dry with a clean towel. Don’t pull on or remove the strips. They will fall off on their own within two weeks. After that, gently remove any remaining adhesive. If the ends curl up before the tape falls off completely, you can trim them.

Tissue glue: This type of closure has to stay dry and out of direct sunlight until it falls off, usually within five to 10 days.

Scars and healing

Scars are a natural part of the healing process, forming over wounds as they heal. The new tissue that forms the scar will look and feel different from the skin around it.

You can help your scar heal by following these tips:

• Only touch your scar with clean hands.
• Pat, don’t rub it dry after you bathe.
• Use an unscented moisturizer that contains vitamin E on the skin around your scar twice a day. Massage the cream into your scar to help it develop a flatter appearance.
• Don’t pick or scratch your scar.
• Wear loose clothes around the scar.

These healthy habits may also help:

• Eat a healthy diet and try to drink at least eight glasses of water a day (if your care team says it’s safe to do so).
• Don’t smoke. Your scar may take longer to heal and may not heal as well if you do.
• Protect your scar from sunlight. It can burn much more easily than normal skin. Use SPF 50 for the first 18 months and SPF 30 after that. Don’t forget to reapply according to the instructions on the bottle.
• Exercise when your doctor tells you it’s safe to do so.

As your wound and scar heal, pay close attention to make sure they’re healing properly. If the healing is taking longer than expected, or if you see any of the following signs, tell your care team.

• Itchiness, dryness: Your care team may prescribe or recommend creams to treat this.
• Tightness: When tight scars restrict your movement, physical therapy may help.
• Lumps called “keloids:” You might need surgery to improve the look and feel of your scar.

Keloid scars

Keloid scars, characterized by raised or lumpy skin, develop when, for unknown reasons, the body reacts abnormally to a skin injury, such as a wound. Patients may then develop very large and bumpy scars over comparatively small wounds, and they may continue growing for months or even years.

Though keloid scars may hurt or itch at first, they are rarely harmful to your health. Patients choose to get treatment for them not because it’s medically necessary but because they don’t like the way they look.

Treatment options include:

• Topical treatments: Products you apply to the scar itself to help it shrink and become smoother
• Injections: Medication injected directly into the lumpy scar to help it shrink and become smaller
• Surgery: Procedures to remove some of the scar tissue, sometimes followed by injections to shrink the remaining scar tissue

A smaller keloid scar may not bother you at first, but if it continues to grow, you may decide later to get treatment. You can seek treatment for keloids at any time.