Is it safe to have a third 5FU injection to my scar?

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

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatments with a PICO laser and/or CO2 resurfacing lasers in area of concern to help break down the pigmentation and even out the skin tone/texture to the scar. I hope this helps and best of luck!

It's understandable that you want to ensure the best possible outcome for your scar treatment. 5-fluorouracil (5-FU) is commonly used to treat hypertrophic scars and keloids, and multiple injections are often required for optimal results. However, the decision to have a third injection should be made in consultation with your physician, taking into account your specific medical history, the current state of your scar, and any previous reactions to the treatment.

Here are some considerations to discuss with your physician:

1. **Assessment of Progress**: Since you have already seen improvement with the previous injections and microneedling, your physician can evaluate whether additional 5-FU injections are likely to provide further benefit.

2. **Safety and Side Effects**: Your physician can assess any potential risks or side effects associated with another injection. While 5-FU is generally well-tolerated, repeated injections can sometimes cause local side effects such as skin irritation, ulceration, or pigmentation changes.

3. **Timing and Healing**: It's been seven months since your last injection. Your physician can determine if your skin is sufficiently healed and ready for another treatment or if more time is needed.

4. **Combination Treatments**: Since you've had success with microneedling, your physician might consider combining or alternating treatments for the best outcome.

5. **Alternative Treatments**: Depending on the current state of your scar, your physician might suggest other treatments such as silicone gel sheets, steroid injections, laser therapy, or other modalities.

Ultimately, the decision to proceed with a third 5-FU injection should be personalized based on your individual case. Schedule a consultation with your physician to review your progress and discuss the best course of action.