Keloid treatment options? (Photo)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

​Sometimes the full scar needs to be surgically revised; this entails surgically cutting, removing and restitching the scar with or without radiation or steroid injections/5fu. I recommend getting a formal evaluation with a cosmetic dermatologist/plastic surgeon to determine if that's the best option for you.

Pigmentation can be treated using Cosmelan peel or lightening creams such as hydroquinone, kojic acid, and retinol. Non-ablative lasers like Fraxel or Halo combined with vascular lasers such as excel V, Yellow laser, BBL, VBeam/Pulsed Dye Laser, and Venus Versa IPL can help if you want to try and avoid surgery. Microneedling/PRP is recommended in combination with lasers and skin care to help with color, texture and tone. Please see an expert. Best, Dr. Emer.​

I have had gratifying results in repigmenting hypopigmented scars from all causes using manual microneedling (no need for the added expense and risks--particularly in skin of color of RF microneedling) combined with the application of topical latanoprost and tyrosine. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist scar specialist. Hope this helps and best of luck.