Hi, I need to know the best way to treat this indented scar? (photo)
Doctor Answers 5
Indented Scars Respond Well To Subcision, Fractional Medical Microneedle Therapy + Biostimulatory Filler
Indented or depressed scars, whether from trauma, acne, or infections like chicken pox generally need to be addressed with several minimally invasive modalities in order to achieve a truly gratifying result. Unfortunately, topical preparations, despite the markeing hype, do little if anything, in my experience.
For the depression, I typically begin with subcision, a technique whereby a sharp needle or trochar is used to break up the the downwardly tethering scar tissue below the skin surface. The intention is to allow the scar to float upwards and become flush with the surrounding skin and to promote new, native collagen synthesis (neocollagenesis) below the base of the scar to provide permanent support. In general, two to four treatments, spaced at six week intervals, are needed for optimal correction. The results of subcision are permanent.
To provide a more immediate improvement, I also typically inject a small amount of biostimulatory filler, such as Radiesse, immediately after subcision. This is to provide immediate support--and visual improvement-- for the base of the scar, while awaiting neocollagenesis, which can take about a month to a month and a half to occur. A biostimulatory filler is chosen to enhance and supplement the neocollagenesis.
Finally, depending upon the color and texture of the surface of the scar, a series of fractional medical microneedle treatments might be considered to help to lighten the scar and make its appearance more uniform with the surrounding normal skin.
There are no contraindications or additional considerations for using any of these techniques in people of color.
For more information on any of the above approaches, check out the archives of Realself.com. and be sure to seek out consultation and treatment by a board certified aesthetic physician with expertise and experience in scar treatments.
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Treatment of a forehead scar
Raffy Karamanoukian MD FACS
Indented scar treatment
Once your wounds are healing then scar therapy may be considered. Although the results of scar therapy vary from person to person and scar to scar, the results are typically permanent.
Not infrequently potential patients avoid surgery because fear of an unsightly scar. To remedy this, I now utilize and formulate compounded topical creams to treat, relieve and minimize scars for each of my patients:
• new scars
• old scars
• surgical scars
• keloid scars
• stretch marks
• hypertrophic scars
• hyperpigmented (dark) scars
• various acne scars, burn scars and more...
These scar removal creams contain prescription strength medications each individually known to reduce and/or reverse the scarring process but never before compounded together into one high potency formulation. These medications are added to a base of anhydrous silicone (the most common ingredient in everyday topical scar therapy) and Pracaxi oil, found in the Amazon rainforest and known for its anti-inflammatory, antioxidant, antibacterial, and antifungal properties. Many health insurance plans actually cover the cost of the creams and they can be delivered directly to the patients door step. In other words, no need for multiple trips to the doctor for expensive and painful laser treatments, or wasted money on minimally effective over-the-counter topical scar therapy gels or silicone sheets that are unsightly and/or fail to stay on. Instead, with just two applications a day my patients now perform scar therapy in the comfort of their own home. Glad to help.
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Indented Scar Therapy
1. Superficially placed filler, particularly Belotero
2. Normal Saline injections to life the scar
3. Microneedling therapy: you will likely need 4-6 treatments
4. Surgical Scar Revision
I would recommend using Belotero to start with and then evaluate your improvement.
Consult with a Board-Certified Dermatologist or Plastic Surgeon.