Can I treat hypertrophic bleph scar with dermabrasion or via CO2 laser after having permanent makeup? (Photo)

Question

Hello I have a hypertrophic upper eyelid scar i am considering treating with c02 laser (if I am a good candidate) to smooth the edges and blend it better. I wanted to know is it ok to treat skin with c02 laser if you have permanent makeup in there? I had skin toned ink put into the scar since it was white a year ago. Skin toned ink does have white ink in it which I know can change color with pico laser since I had laser tattoo removal before on my body. Thanks for your help and time

Randal Haworth, MD, FACS · Answer

You can but medical dermabrasion would be to aggressive for the upper eyelid and microdermabrasion used in the spas would be ineffective. A hypertrophic scar in that area in my experience is best treated with kenalog “steroids” injections. Of course, its best to consult with your original surgeon or a board certified dermatologist or plastic surgeon.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nadir Qazi, DO · Answer

Regarding your question, if you have a hypertrophic upper eyelid scar and are considering treating it with CO2 laser, it's important to know if it's safe to treat the area if you have permanent makeup in the scar.
CO2 laser can be effective in smoothing the edges and blending the scar better, especially when combined with laser assisted drug delivery such as kenalog, but it's important to consult with your dermatologist before proceeding with any treatment. They can evaluate your skin and the scar to determine if you are a good candidate for the procedure, and whether it's safe to treat the area with permanent makeup.
As you mentioned, skin-toned ink can contain white ink, which can change color with pico laser. It's possible that the CO2 laser could also affect the color of the permanent makeup in the scar. Your dermatologist will be able to advise you on the best course of action, and whether any additional precautions need to be taken to ensure your safety and the best possible results.
In summary, if you have a hypertrophic upper eyelid scar and are considering CO2 laser treatment, it's important to consult with your dermatologist before proceeding with any treatment. They can evaluate your skin and the scar to determine if you are a good candidate for the procedure, and whether it's safe to treat the area with permanent makeup. With the right precautions and care, you can achieve smoother, more blended results that will help you feel more confident in your appearance.

Milan Doshi, MS, MCh · Answer

Thank you, beautyqueen2023 for your question and photographs.
 Photographic evaluation is incomplete without personal examination to give the most appropriate answer
 However from the photographs, it seems that,
You can undergo CO2 laser treatment on the scar. However, you should inform the healthcare provider to do Laser CO2 on your scar only and not to go above or below so that your permanent makeup is not affected.

Please consult a board-certified dermatologist near you and discuss this in detail.
Wish you an alluring look.

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