Scars in Children

It is a myth that children heal better than adults. In fact, children often scar worse than adults as they have more aggressive healing, very elastic skin, and usually a higher level of activity that often increases the stresses put on the wound. Children often are more anxious and fearful, therefore making it more difficult to treat. They have a short attention span and move around a lot. This leads to greater anxiety for the Dermatologist as well.

Whenever a child has surgery, consider the following to minimize scarring:
1. Have the simplest procedure possible.
2. Make the scar as small as possible.
3. Operate before puberty if the lesion is in a cosmetically important area.
4. For larger areas, consider a staged excision–when part of the lesion is taken out during one surgery and the remainder 4-6 weeks after the first.
5. Avoid visible sutures for non-facial areas (ones that can be seen and are often removed). Stitches under the skin can be used or skin glue for the top layer. If stitches must be removed never leave them in too long–usually 5 days for the face and 7-10 for other areas.
6. Use colorful bulkier dressings.
7. Minimize tension on the wound after surgery by restricting movement and trauma for as long as possible–6 weeks is optimal.
8. If the wound should open up, which does happen with kids, let it heal completely and restart the process.

Robert S. Bader, M.D., Dermatologist

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