You'll find hundreds of files on cleft lip, cleft palate here on

This one is about: Keloid and Hypertrophic Scars

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by Carol Edson, RN

Certain individuals are prone to excessive scar formation. This can be a minor problem, or severe enough to require later treatment. For parents of kids with cleft lips, this raises concerns about how the child's face will look after surgical intervention is completed. This essay will offer definitions of these problems, and introductory information on how they might be handled. REMEMBER: the overwhelming majority of scars heal normally over a reasonable period of time and do not present the kinds of problems addressed in this essay.

Hypertrophic scars are raised, red, "angry-looking", as one parent put it. Often after a few months these scars become soft and flat and fade in color. Frequently the only treatment required is patience. If after a reasonable amount of time, they are still a problem, cortisone injections, laser treatment or surgical revision may be used to achieve a more aesthetic result.

Keloids are a form of tumor made up of actively growing fibrous tissue. They are more prevalent in people of color. Keloids are a response to trauma (surgical or accidental). Some become itchy or have a burning sensation which may cause a child to pick at or scratch them. This can worsen the problem.

If you notice that your child's repair scar looks unusual or bothers him/her, speak to your surgeon. The normal evolution of a scar takes six months to a year. This is what we call, "tincture of time." But if a child's scar is enlarging after the first month, discuss it with your surgeon. Most plastic surgeons have photos of the healing process, and can show you what to expect as healing is completed. As always, your surgical team will be your best resource for specific questions about your child's procedures and situation.

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