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Scar tissue - Surgery or Steroids

Posted by suchitra on 9/20/04 at 22:58 (160231)

Hi Dr.Ed!

You posted the following message in reply to my queries about scar tissue on the ball of my foot formed after surgery to remove a glass splinter. I have a few questions:

1. Why, after one year of being fine following the surgery, did scar tissue suddenly appear in the last two months?
2. The lump seems to be getting bigger. Will shaving it make it bigger in response. (It feels better for two days when I shave the callous)
3.Who can administer the steroids cocktail you suggested?
4. Can a plastic surgeon remove the lump better than a regular foot surgeon (i.e. without allowing more scar tissue to form in place)?
5. Should the doc who took out the splinter not have made such a deep incision into my foot, should he have let the splinter work it's way out?

Sorry about the multiple questions. Thank you so much!


My 'cocktail' for dissolving scar tissue usually involves use of a combination of an enzyme, hyaluronidase and a steroid, triamcinolone acetonide. Availability of the substances can be an issue. Vitamin E oil can help coupled with very regular deep massage, massaging for a longer time with modest intensity but not short and hard as to cause pain. The PT modality, ultrasound can help if available.

Re: Scar tissue - Surgery or Steroids

Ed Davis. DPM on 9/21/04 at 22:30 (160307)


We get a lot of messages so I do not know what question brought about my answer -- it may be helpful to bring up more of the original post.

Speaking in generalities, when scar tissue forms after surgery, that is scar tissue that is excessive, additional surgery is usually not preferred since surgical removal of scar tissue can simply create more scar tissue. The medications which I mentioned would be useful for reducing scar tissue when injected carefully into an area of excess scar tissue by any qualified practitioner. Often, I tend to prefer specialists who are more familiar with a specific area than generalists.

Re: Scar tissue - Surgery or Steroids

Julie on 9/22/04 at 02:04 (160320)


Suchitra's original post explained that she had had surgery to remove broken glass from her foot. She had stepped on a piece of glass which shattered inside her foot. The surgery was successful, but later (about a year, I think) she developed what she thinks is scar tissue: a hard, callous-like lump. She said she was in great pain from it, which made me wonder if a fragment of glass might have been left inside. I suggested that, but she replied that had been checked out and it was definitely scar tissue.

She is in India, and I judge from her posts that she does not see the board very often, so I thought I'd explain. Depending on where in India she is (she hasn't said) there might be difficulty, outside the major cities, in finding the medications to inject.

Re: Scar tissue - Surgery or Steroids

Ed Davis,DPM on 9/23/04 at 10:20 (160383)

Thank you. Amazingly, hyaluronidase is not made in the US any more and we must have it compounded or go outside of the country(many would be amazed at how restrictive things have become in the US). India has a thriving pharmaceutical industry and believe that it is not unlikely that she can explain the 'formula' to a local practitioner who will know how to obtain the ingredients or similar ingredients.

Re: Scar tissue - Surgery or Steroids

Julie on 9/23/04 at 10:47 (160386)

Good - I hope she can explain it, and get what she needs and that she can avoid surgery.