Shockwave Therapy to reduce hypertrophic nose columella scar?

Question

Hello, Doctors.....I have had a lumped up hypertrophic scar located on the columnella of my nose (near the nose tip and soft triangle area of my nose) for a few decades n ow that had been caused by injury.....No good options to help flatten this scar out seem to exist that would not cause possible further problems given the scar's location....Shockwave therapy is a new non-invasive option to target only the scarred tissue and not surrounding normal tissues....Opinions, please?

Anna Chacon, MD, FAAD · Answer

Thank you for your question. Hypertrophic scars, particularly in delicate and visible areas like the columella of the nose, can indeed be challenging to treat. Shockwave therapy, also known as extracorporeal shock wave therapy (ESWT), has been explored as a treatment option for various types of scars, including hypertrophic scars.

Shockwave therapy works by delivering mechanical pulses to the scar tissue, which can potentially improve blood flow, reduce inflammation, and stimulate collagen remodelling. This non-invasive method is appealing because it targets the scar tissue without affecting the surrounding healthy tissue.

However, it is important to note that while some studies and anecdotal evidence suggest potential benefits, the efficacy and safety of shockwave therapy for hypertrophic scars, particularly in sensitive areas like the nose, are still being evaluated.

Other treatment options you might consider include:

Silicone Gel or Sheets: These are often used as first-line treatments for hypertrophic scars and can help flatten and soften the scar over time.
Corticosteroid Injections: These can reduce inflammation and soften the scar tissue, although they carry a risk of thinning the skin.
Laser Therapy: Certain types of lasers can help reduce the thickness and redness of hypertrophic scars.
Microneedling: This technique can stimulate collagen production and improve the appearance of scars.
Surgical Revision: In some cases, surgical removal of the scar followed by meticulous wound care can yield better cosmetic results.
It is crucial to have a thorough consultation with a dermatologist or plastic surgeon who can assess your specific case and recommend the most appropriate treatment plan based on the scar's characteristics and your overall health.

Best regards,

Raffy Karamanoukian, MD, FACS · Answer

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

Shockwave Therapy to reduce hypertrophic nose columella scar?

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Shockwave Therapy to reduce hypertrophic nose columella scar?

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