Any procedure to remove a skin cancer will cause a scar and some people will scar more than others depending on their tendency towards keloid scarring and their skin type. Scars tend to settle to a pale mark, either a oval area after curettage and cautery or as a line from excisional skin surgery. If there is a lot of background sun damage, this pale area can become more prominent and noticeable. Background sun damage can include solar keratosis, freckles, pigmentation, age spots and telangiectasias (dilated small vessels on the skin surface). All of these lesions can be treated, either as individual lesions or as part of a field treatment such as efudix, PDT, lazer, IPL or skin peels.
All these treatments can help to improve the outcome after surgery by making the scars less noticeable.
Alternatively, there may be an abnormal scar that forms after surgery, such as hypertrophic scarring or keloid scar. Hypertrophic scarring is an abnormally thickened scar that does not extend beyond the initial injury, and keloid scarring is an abnormally thickened scar that extends beyond the original injury. In some people keloid scars can occur after even minor injuries, such as a piercing or even a pimple that has been squeezed or traumatised (scratched), so its hardly surprising that keloid scars can form after skin cancer surgery. Treatments include massage of the wound, taping with micropore or fixomul tape, silicone gels such as strataderm, and silicone taping.
If non surgical treatments fail to improve the scar then surgical treatments may be used such as steroid injections, shave excision and steroid injection, and re excision with or without steroid injection into the wound