Q: Hello Doctor,
2 months ago, I was in an accident and I lacerated my face right below my lip, down my chin. 2 days later it got infected, I took stronger antibiotic, and 3 days later, my stitches were removed. Now, scar tissue is extremely hard under the surface, and I have a slight hypertrophic scar on my chin. The scar tissue under the surface is really painful (laceration went completely through) when I talk or smile and it interferes with my speech. I asked my general practitioner and she referred me to an ENT, which the appt. is not until the end of next month. She went ahead and injected the inside of my lip (inside of mouth) with steroids where the scars were the hardest. My question is…when should the injection start flattening the scars..and…if she just injected the inside of the lip, will it help with the scar on my chin, or does the hypertrophic scar on my face have to be injected directly?
A: Hi Deglover,
Usually the effects of steroids become apparent over two weeks. If the scar tissue softens and flattens with the steroid injection, I will typically schedule the next injection in 2-4 weeks. In some areas, I’m worried the scar tissue will flatten out too much and become an indentation, so I will dilute the steroid injection to a weaker dose to prevent the scar from flattening too much and causing a dent. For some raised scars, the diluted steroid injection to not strong enough, so I will increase the concentration of the steroid injection for the next session. If the diluted steroid resulted in a flattening of the scar without overdoing it, I will simply repeat the same dilution and amount as I did the first injection.
It doesn’t matter too much whether the injection is being performed from the inside of the mouth or from the skin surface, as long as the steroids in getting to the raised scar area. The goal is to soften the scar and make it flat. Causing an indentation from the steroid injection itself is a possibility, but one that we try to avoid.