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Question of Surgeons - Donor Scar


Guest dude1

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DONOR SCAR ITCHING

 

I have a question I hope one of the surgeons who read this forum will answer. Why would a donor scar itch several months after surgery? What can be done to alleviate the itching? I find myself habitually scratching the area usually at night (it wakes me up). The site seems to have healed nicely but I find it unusal that the itching would still be present.

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DONOR SCAR ITCHING

 

I have a question I hope one of the surgeons who read this forum will answer. Why would a donor scar itch several months after surgery? What can be done to alleviate the itching? I find myself habitually scratching the area usually at night (it wakes me up). The site seems to have healed nicely but I find it unusal that the itching would still be present.

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  • Senior Member

Itching of the donor scar several months after surgery is distinctly uncommon in my experience. If your surgeon used any absorbably sutures underneath the skin to help hold the wound together, all of the commonly used types of materials would have been long since absorbed (Vicryl, the commonest one used, usually absorbs at around 7-8 weeks) and is probably not the cause of your symptom.

Two things come to mind: The first and most likely is that you might have what we call, for lack of a better term, an "itch that rashes." Even thought there is probably not any visible rash per se, this refers to a situation in which the daily physical scratching of the site becomes the CAUSE of the itching. If a person has poison ivy and never ceases to dig it up daily, he will have a itching (and a rash) ad infinitem. The second possible cause would be a mild case of seborrheic dermatitis in the scalp, which is most pronounced in the area of the donor scar. Usually persons with this condition do notice more dandruff than those without it. The first cause I referred to above can be helped by using some steroid lotion or cream along the scar (especially at night), keeping any nitetime showers more to the tepid temperature (rather than really hot), keeping the bedroom a little cooler, and a little Benadryl (25-50mg) at bedtime to help with sleep and reduce the itching sensation. Obviously, what will help in this situation the most is to keep your hands and fingernails out of the area.

If the above doesn't help after a few weeks, you certainly should have your doctor examine the area. If it is seborrheic dermatitis, you will need to get a specific treatment regimen from your doctor.Good luck!

Mike Beehner, M.D.

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Also try a shampoo with Jojoba oil in it. (Just go to www.google.com and type in jojoba oil shampoo, and you'll get a bunch of sites that sell it). That helped me quite a bit, as did cortisone cream on the donor site before bed. I had itching for a month or 2 post op.

Results of my 1424 FU transplant procedure on 8/16/02 can be viewed at...

http://community.webshots.com/user/ttaco

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Dr,

 

Thank you for your excellent answer. I did have some seb. dermatitis which has since been brought under control. The itchiness seems to be concentrated at the corners of the scar or over and behind each ear. (I'm assuming the seb. derm. has fully gone away for now.) The sutures were not the absorbable kind and were removed about 10 days after surgery. I'm using an anti-histamine at night which seems to work for a few hours. Can the scar sometimes take up to a year to fully heal or the body stop producing histamine as part of the healing process?

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Dear Dude I,

Obviously, there are much greater changes in scar healing during the first few weeks, but I believe these changes continue for probably a year and possibly even a little longer. If you have ever seen a friend or relative's hernia or appendectomy scar (from the pre-laparoscopy days), you would have noticed that it remained pinkish in color until around 1 year had passed. Obviously, in these wounds (and in all wounds), there continues to be a long healing process.

For histamine to be released there has to be a true antigenic allergy to the substance that caused it. I tend to doubt that in most cases an itchy donor scar or even seborhheic dermatitis is related to that type of chemical release and reaction, but rather is due to physical factors in the skin itself (drying, scaling, slight redness in some areas,and the component of the "viscious circle" of itch-scratch-itch-scratch that I referred to.

Mike Beehner, M.D.

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