What treatment plan will be the most effective for those 2 atrophic scars? (Photo)

Question

Hello, I have 2 atrophic scars, one from a wart removal (on top) that I treated badly - I scraped off the scab repeatedly and the other from a burn (on the tip of my nose). I had one CO2 laser treatment, which slightly improved the condition of the one on the tip of my nose. Should I stick with that or try something else, i.e. co2 + dermapen or try subcision (if it's safe on such a thin area of skin) + co2? Could you give any advice?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

At least from the pictures, Subcision, properly performed by an expert, would be an appropriate treatment for elevating and smoothing the indented scars. Once this is done, which typically takes on average three to four treatment sessions to achieve optimal improvement, then professionally performed, manual microneedling (no need for the added expense and risks of RF microneedlng) can be used to better blend in both color and texture the superficial skin of the treated area with the surrounding normal skin. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

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