Appearing unhurried and confident, giving the child, when age appropriate, some control of the situation, and explaining the upcoming procedure can help reduce anxiety Use of distraction techniques and anxiolytics can avoid the need for procedural sedation Tap water can be used instead of saline and is equally effective in reducing the risk of infection Using 6-0 absorbable material is recommended for skin closure whenever possible and obviates the need for suture removal at followup No specific ointments or creams have been found to be helpful in scar reduction However, application of sunscreen after the wound heals may decrease hyperpigmentation of the forming scar The use of epinephrine with local anesthesia during lip laceration repair could obscure the vermilion border landmark The eyebrow should not be shaved during wound preparation as regrowth is unpredictable If the frontalis muscle is involved and is not properly approximated, its function (eyebrow elevation) could be disrupted In repairing the earlobe or auricular rim, if the skin edges are not everted at the time of closure, “notching” may occur Forehead Lacerations Forehead lacerations are common in early childhood These injuries commonly occur after falls on objects or furniture such as coffee tables Most of these lacerations are simple and not associated with any other significant injuries However, careful evaluation of the head and neck for other injuries is warranted Superficial transverse lacerations of the forehead usually have a favorable cosmetic outcome Closure with simple or continuous cuticular sutures using 6-0 absorbable material is recommended Deeper transverse lacerations involving the deep fascia, frontalis muscle, or periosteum should be repaired in layers Absorbable 5-0 material such as Monocryl, coated Vicryl, or gut can be used If the deeper tissue plains are not closed, the function of the frontalis muscle, that is, eyebrow elevation, may be hampered Other facial expressions can also be affected because the skin may tether to the scar tissue, bridging the unrepaired gaping tissues