Problems After Healing
You made it all the way to the finish line and got your surgical wound closed up! This page is an overview of minor things that might present challenges after you’ve closed the wound. It is rare for a healed wound to completely re-open and break down, but it is possible – if that does happen a Wound Care Center would probably be your best choice.
Splitting
Wound splitting can be a common problem, especially for those with very large wounds. Newly healed skin is very fragile and during your healing phase you probably were very careful about how you sat and moved. Once the major healing is complete and you start moving normally, the strain on the new scar tissue can cause it to pull apart, usually right in the midline. One way to help minimize this is stretching as you get into the later stages of healing.
- Yoga – the gentle stretches are a great way to gain flexibility. Leg lifts and knee bends can also be helpful; the idea is to move your legs away from your body and bend them to stretch the muscles of the gluteus maximus. The skin in the cleft has to be able to stretch as the body moves and damaged skin only regains 70% to 90% of its original tensile strength (how much it can be stretched without tearing) so the wound area will never be as strong as it was prior to surgery. You need to “train” the skin back into stretching in the same way you do a muscle. Eventually, the skin will stretch enough so that it doesn’t split.
- Moisture – the natal cleft becomes a natural air-locked area, which traps both moisture and bacteria and can make the skin “mushy”. Try a medicated powder like Gold Bond twice daily to help keep the area dry.
- One product that has gotten good reviews for healing split scars: Aquaphor Healing Ointment.
Pulling
A sensation of tugging deep in the wound bed is perfectly normal and caused by the new tissue in your healed wound, which does not yet have the ability to stretch very far. Now that the wound is fully healed you are in the Remodeling and Maturation Phase, which can last from 6 to 18 months. All during this time new collagen fibers are being laid down and rearranged and the scar softens. Gentle stretching can help reduce the tension inside the wound.
Itching
The newly healed scar is very tender and will be for many months. This is the peak period for “Pilonidal Paranoia” where every little tug, split, or soreness will send you into a panic of being certain that “it’s back”. Don’t drive yourself crazy, because it is very easy to do! You might try putting some hydrocortisone cream on the scar to alleviate the itching (available at any drug store). It also might be possible that moisture build up has provided a happy home for Candida (yeast infection) which is easy to treat with over the counter medications available at most drug stores.
Tenderness
A tender and puffy scar is something that I have always taken as a warning sign that your scar tissue is not happy about something you are doing. It may be the way you are sitting, clothing you are wearing (like thongs), too much activity that rubs the scar tissue… What I always do at the first sign of tenderness is swab the scar with No Bump RX to take down the inflammation. Then I try and figure out what I am doing to make the area tender — with me it’s usually slouching in my chair while on the computer. See the You and your Scar page for additional tips.
Related Links
The main overview page for our Surgery Aftercare section where you’ll learn all about wound care and healing after surgery.
Your scar will continue to remodel and adjust for the first year after healing. It may get irritated and tender. Here’s why.
Find support from your fellow Pilonidal sufferers around the world.
This page last updated: January 5, 2019
