How to Care for Stitches and Incisions for Faster Healing and Minimal Scarring

 

Stitches are simple in theory but stressful in reality. Once you are home with an incision on your face, chest, or body, you suddenly want clear, reliable instructions for what to do and what to avoid. The truth is that a great result depends on how well you heal, your surgeon and the right post surgery care. Great stitch care is not complicated but you need to do it to see outstanding results. 

Below is the routine I teach my patients every day after I do surgery on them as a double board-certified dermatologic surgeon. Follow these steps and your skin will heal faster, with less redness and a smoother scar.

How Stitches Heal

Understanding the normal healing process helps you know what to expect. The face heals faster than the trunk which heals faster than extremities with arms healing faster than legs.  Here is a general timeline 

Days 1 to 3

Redness, mild swelling, and clear drainage are normal. Crusting appears if the area dries out.

Days 3 to 14

Pink skin starts to close the incision. Moisture is essential.

Weeks 2 to 6

The incision is sealed. Mild itching is common.

Months 1 to 12

Scar softens and fades. This is when silicone and laser treatments work best.

Step by Step: How to Care for Stitches Properly

1. Keep the Area Clean

Clean the incision once or twice a day with cool water and a gentle cleanser. If infection is a concern, Hibiclens (chlorhexidine) is safe and widely used in hospitals.

2. Keep the Area Moist

Healing skin should not dry out. When wounds dry out, they crust, healing more slowly with a more noticeable scar. Keeping stitches covered with ointment and bandage leads to faster and better healing of the skin. 

3. Use the Right Ointment

This is the step where most people unintentionally make things harder on their skin. Many medicine-cabinet staples contain ingredients that often irritate healing skin.

What to Avoid

Neosporin and Polysporin

These products are popular but cause far more allergic reactions than most people realize. They also do not speed healing or prevent infection better than plain petrolatum.

• Bacitracin allergy is common and can caused anaphylaxis with widespread bacterial resistance.
• Neomycin also has high allergic potential and resistance is common. (Bessa et al.; 2016)
• In a randomized controlled trial of 922 surgical patients, plain white petrolatum performed just as well as bacitracin for preventing postoperative wound infections - and caused zero allergic reactions, compared to 0.9% allergy rate with bacitracin. (Smack DP et al., JAMA 1996)

These ointments add risk without meaningful benefit. Just throw them away, I do not have them in my office or home. 

Aquaphor

Aquaphor contains lanolin, a common cause of allergic reaction in healing skin.

• Very high lanolin reaction rates in sensitive or compromised skin
• In a dermatologic surgery study, wounds treated with Aquaphor developed wound redness in 52% of cases, compared to just 12% with plain white petrolatum—a more than four-fold increase in irritation. (Morales-Burgos A et Al. J Drugs Dermatol, 2023)

For open wounds or stitches steer clear of Aquaphor. Even if it is recommended by your provider. There are better options. 

What to Use Instead

Vaseline

Plain white petrolatum remains a simple, safe, highly effective wound-care option—providing an occlusive barrier that prevents water loss and showing equally low infection rates with significantly fewer allergic reactions than bacitracin. (Smack DP et al. JAMA; 1996)

• Shown to heal wounds as well as or better than bacitracin

It is cheap and readily available but there is a better option that actually gives the skin what it needs to repair itself.

Doctor Rogers Restore Healing Balm

Restore Healing Balm is a clean occlusive developed specifically for healing skin with everything the skin needs to heal.

Benefits

• Made from three plant-derived ingredients that provide food, water and protection for the skin as it heals. 
  
• Hypoallergenic, petroleum-free and biodegradable
• In a head-to-head postoperative comparison, plain white petrolatum caused far less wound redness and irritation than Aquaphor (12% vs. 52%), suggesting better tolerability for sensitive or healing skin. (Morales-Burgos A et al., J Drugs Dermatol; 2013)

This is the ointment many dermatology and plastic surgery offices use for post-procedure care. It is what we use after all surgery and lasering at Modern Dermatology.

4. Keep the Area Covered

Keeping stitches covered with the ointment and a bandage keeps the wound from drying out, and prevents friction, contamination, and UV exposure.

In general you want a wound covered until the stitches are removed and the wound is pink and intact (not crusty)

General timelines to keep wounds covered:

• Face: 7 days
• Arms and body: 2 weeks
• Legs and feet: 4 weeks

If you are unsure, keep it covered. It is a face lift or blepharoplasty (eyelid lift) scar keep the incision sites moist with ointment, reapplying multiple times a day and avoid direct sun exposure. 

5. Protect from Sun

Healing skin darkens quickly in the sun, and that pigmentation can become permanent. Keep the area covered until healed and then apply sunscreen daily for the coming months.

6. Avoid Stretching the Incision

Any motion that pulls the skin can widen a scar. Avoid strenuous activity, wide movements, or stretching until cleared by your surgeon. 

7. Begin Scar Care After the Incision Has Closed

Once the area is sealed and stitches are removed, you can start scar therapy.

Proven options

• Silicone gel: Twice daily for up to four months
  
• Silicone sheeting: 12 to 24 hours a day for 3 to 6 months
• Micropore (paper) tape: Reduces thickened scars when used consistently
• Early Laser treatment: I usually start at one month after surgery on the face

Common Mistakes to Avoid

• Using Neosporin, Polysporin, Aquaphor on the wound or healing scar
• Letting the wound dry out
• Removing bandages too early
• Scrubbing or using alcohol or peroxide
• Touching or picking
• Sun exposure
• Using pure vitamin E or onion extract (mederma) on scars, studies show then can make scars more red. 
• Delaying a call to your doctor if something seems wrong

Frequently Asked Questions

1. How long do stitches take to heal?

Usually 1 to 2 weeks for closure, though healing continues for months.

2. How long do dissolvable stitches last?

Anywhere from 1 to 12 weeks depending on the type. They can be pushed to the surface which is referred to as a “spitting stitch.” 

3. How can I prevent scarring?

Keep moist with the correct ointment, consistent coverage, UV protection, and silicone once closed.

4. Signs of infection?

Increasing redness, heat, pain, drainage, or fever.

5. Why is my incision crusting?

Crusting means it is too dry. Add ointment and cover.

6. What should I use if I am worried about infection?

Clean with Hibiclens and apply Restore Healing Balm or plain petrolatum. Prescription mupirocin is safer than OTC antibiotic ointments if worried about infection.

Final Thoughts

The best stitch care is simple. Clean gently, keep the area moist, choose ingredients that support healing rather than irritate it, keep it covered, protect it from the sun, and start scar therapy once the skin is sealed. These small steps make a measurable difference in how quickly your skin heals and how your scar looks long term.

When in doubt, reach out to your dermatologist or surgeon. Healing is an active process, and good guidance makes it easier.

 

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