I had a patient come in recently. She had a lot of scarring on the top of her foot after neuroma surgery, and this is something that we see once in a while, but that’s why before any surgery you always want to ask yourself if you have a history of developing keloids. Keloids are a thickening of the scar that happens on your body. It can be anywhere. It tends to be more common in people that are African Americans and it makes for a very painful scar, so with any type of a surgery you may fix the problem, like taking out this nerve here, but you may still have a painful scar. There are a few products that are available over-the-counter such as Mederma and Scarguard and these can be used to help a little bit with the scarring as well as doing something called cross friction massage where you massage back and forth across the scar. This can help as well. What I have been using recently in my office is actually our laser at a very low amount to heat up the scar and helps to redirect the scar fibers in the proper direction. This can be helpful after a number of treatments. We usually treat it with about 600 pulses and we do this every two or three weeks to help the scarring. Occasionally with the neuroma surgery you develop a scar deep inside where actually a portion of the nerve remains and you get something called a stump neuroma. So in this case, you would actually have to do another incision on the bottom of the foot to remove that remaining scarred nerve, but you have to be careful because if this patient develops a very thick scar, there would probably be one on the bottom as well that you’ll have to deal with.
To Your Health,
Dr. Donald Pelto