I had 3 aggressive melanoma surgeries until I was cut to the bone above my ankle last June.

Two specialists said because I have edema and it’s my lower leg where blood pools, I’m stuck with no scar removal treatments.

I saw this specialist today who thinks he can help with 8 laser treatments (once a month) and monthly micro injections see below with linocaine without epi.

What’s your opinion of the risk of triggering my once pVCs that so far I’m in NSR after a successful PVC ablation by getting injected by the following

While standard glaucoma drops (such as prostaglandin analogs) primarily work to lower eye pressure, dermatologists use related antimetabolite and anti-fibrotic medications (like 5-Fluorouracil or Mitomycin C). In dermatology, these powerful medications are micro-injected directly into tough scar tissue (such as hypertrophic scars or keloids) to break down excess collagen and stop the scar from regenerating.

Footnote: I no longer have keloids after a year of pressured use of silicone sheets. It’s a dark ugly 5” x 1” long scar.

I may have had answered my own question:
[ibb.co]

What a shame about the second micro drug:
The Cardiac Risks of Mitomycin C (MMC)
Though less prevalent than with 5-FU, Mitomycin C is a known cardiotoxic agent.
Mechanisms: MMC can cause free-radical formation and damage heart cells, which can trigger acute arrhythmias and even cardiac arrest in susceptible cases.
Synergistic Effects: Historically, MMC is notorious for compounding the cardiotoxic effects of other chemotherapy agents (like doxorubicin), but it can independently cause pericardial inflammation, angina, and heart rhythm disturbances.
Micro-Dosing & Safety
While a "micro-dosing" approach limits the initial localized dose, the medications still enter the bloodstream and can trigger toxic effects—especially if a patient has underlying cardiovascular disease or risk factors. Symptoms of chemotherapy-associated cardiotoxicity often include chest pain, palpitations, shortness of breath, or sudden fainting.
For comprehensive information regarding chemotherapy-related heart complications and how they manifest, consult reliable cardio-oncology guidelines such as those published by the ⁠American Society of Clinical Oncology (ASCO).

5-Fluorouracil (5-FU)5-FU is well-documented for its cardiotoxicity. While its most common side effects are angina and coronary vasospasm, it can also disrupt electrical stability in the heart, leading to both atrial and ventricular arrhythmias.The Mechanism: 5-FU causes endothelial dysfunction, which can lead to sudden coronary artery spasms, localized ischemia, and direct toxic effects on the heart's electrical system.Incidence: When given in systemic cancer doses, cardiotoxicity occurs in roughly 1% to 19% of patients. With micro-doses (e.g., used topically in ophthalmology, dermatology, or scar treatment), this risk is drastically lower, though rare cases of cardiac sensitivity can still occur.

Use with laser:
“Avoid certain supporting equipment: While the laser itself is safe, some aesthetic treatments use supplementary electrical devices (e.g., grounding pads or certain radiofrequency (RF) skin-tightening attachments) that can interfere with pacemakers.”



Edited 6 time(s). Last edit at 06/29/2026 10:44PM by susan.d.

Susan,

I can't answer your questions, but I can relate my experience, and some memories triggered by your narrative.

A month ago I had a large (1cm) squamous cell on my cheek removed via Moh's. I had probably 20-30 lidocaine injections, and my resulting scar took 1 staple and 32 stitches, resulting in a scar that runs from near the corner of my eye to below my jawline. In the last week, after 9 years of beautiful NSR from Dr. Natale and a Watchman, afib has broken through. I've learned that trying to connect the dots for causation are, for me, mostly a fool's errand. But your experience leads me to more questions.

Regarding Fluorouracil - I did a month long treatment on my face around the time I believe my afib first started, around 15-17 years ago. When my scar settles down and the weather cools, I'm to do another round of Fluorouracil on my face. I had no clue whatsoever the connection between the heart and Fluorouracil. I'll have to ask TCAI about that and any recommendations/suggestions/alternatives. Thank you for sharing this - it's given me previously unknown information to help ask appropriate questions of the health care folks treating me. Unfortunately, I may be headed for my 3rd ablation, 2nd with Dr. Natale.

I have had + or - 30 skin cancers taken off my upper body and head. I have been using Fluorouracil for many, many years to help prevent the development of the cancers. My left forearm covered today. I have never found a relationship between my afib and the cream. I typically use the cream about 4 times a year for about 3 weeks each time or until I get a good reaction. I see my dermatologist every 3 months.

Personally, I don’t think a topical cream is the culprit here—but hey, what do I know? I’m just guessing. Obviously, creams can absorb into the skin, but does it really compare to multiple micro-injections? It seems logical that micro-injections would reach the bloodstream much faster than anything you rub on the surface.

Because of that, I’ve decided I just have to suck it up and live with my latest scar.

To give you some context. I like to call it “ Living with the Battle Scars (And Finding Peace in NSR)” I’ve had around 24 or 25 surgeries and ablations (I’ve honestly lost my scoresheet at this point). My abdomen alone looks like a game of tic-tac-toe, with six different vertical and horizontal scars crossing side to side. I’ve also had the right side of my face surgically peeled back to remove a tumor behind my ear before being sewn back together. All this to say: I’m no stranger to scars. Usually, I just classify them as "it is what it is" and move on.

But for some reason, this newest one right above my ankle really angers me.

Ultimately, I don’t think I should mess with it; I just need to adjust. Right now, it looks like a big dog chewed on my leg and swallowed. Because the skin flap opened up during recovery, the scar is completely concave. I know, there are far worse things in life.

I just don't want to ruin my luck by getting micro-injections if there's any risk to my heart. After everything, I am finally in NSR! I recently wore an 8-day Holter monitor, and it showed no AFib or PVCs. I'm thrilled, and I don't want to jeopardize that.

Alternatively, I could try just doing laser treatments for the scar without the injections, but I have a pacemaker.
Has anyone here had laser treatments while having a pacemaker? Do you know if it’s safe? Would love to hear your experiences.