Why Does My Scar Itch After Foot Surgery?

That’s one I get a lot. If I had a nickel for every time a NYC podiatry patient asks me that after foot surgery for bunions, hammertoes, heel pain or tendonitis, I’d come home with a few bucks at the end of the week.  While I wish I could give a definitive answer, that may be a bit elusive, so I can offer an educated guess, with the aid of my extensive knowledge of your foot and our information superhighway.

After any type of injury, the skin heals in phases, from the initial step of clotting to the chronic remodeling that occurs weeks and even months after injury or surgery.  In the initial phases, the body is concerned with damage control- stopping the bleeding and preventing infection.  As the wound progresses, a solid seal of soft tissue is laid down, which is eventually remodeled from unwoven and disorganized scar tissue into anatomical skin layers, with the same structure and integrity of the initial skin and soft tissue cover, depending on the level and extent of damage.  Itching is a common sensation in the earlier phases of healing, and there are a few theories that attempt to explain this phenomenon.  One theory is that the itching is due to the histamines that are present in any area of inflammation and whose purpose is to modulate inflammation and to dilate the local small blood vessels. Another theory posits that the small nerve fibers in the skin are damaged and as they are repaired, they emit signals that are perceived in the brain as itching.  And yet another theory holds that as a scab forms over the wound it pulls the wound edges, causing an itchy sensation.  These are all theories, any or all of which may be true, but they have not been proven conclusively.

So kids, there you have it.  If you feel like your foot is crazy itchy after foot surgery, a wound or a cut, it’s not just in your head, it’s for real.  Please, please, do not itch that wound like crazy.  Use a topical corticosteroid or Benadryl cream, or take an antihistamine.  In fact, take two antihistamines and see me in the morning.

See you in the office.

Ernest Isaacson

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