Can my keloid/hypertrophic scars from my nipple piercings be removed successfully? (Photos)

Question

I used to have such nice nipples! My nipple piercings did not heal, they've formed hideous keloids or hypertrophic scars, how can they be removed? I've tried steroid shots in the past at a dermatologist. (Didn't work)

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars. 
•	Twice daily application of a scar gel. 
•	Scar modulation with gentle massage.
•	Intralesional injections in case there is overgrowth of scar tissue.
•	Vascular lasers for neovascularization of scars.
•	Stimulatory injections for scar atrophy. 
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best, 
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon

Kenneth Hughes, MD · Answer

Hello, thank you for your question. For keloid formers, there is not a way to prevent keloids. In general, the longer the scar or the greater the number of scars, the greater the chance for keloids. The keloids may require multiple modalities to achieve the best results. Laser may help to some extent with some types of scarring issues. As an author of Scars and Scar Revision in Reoperative Plastic and Reconstructive Surgery, I am well versed in the potential treatment options. One treatment may be helpful for one patient while another treatment may help another patient.

Harold J. Kaplan, MD · Answer

The best and most direct way to effect a fairly quick improvement is by using steroid injections such as "Kenalog" to flatten and debulk the scarring.  We have had good success with these treatments and are cost effective for the majority of patients.  Although this is a common procedure, not all practitioners are experienced enough to use the proper amount of medicine.  There is now downtime, and when done correctly, you should have visible improvement in the first 2-4 weeks.

Jason Emer, MD · Answer

Scars need aerify, enlighten, or Cosmelan peels post surgery. Vivatia foam, Restorsea 10x, skinceuticals phyto +, Cosmelan 2 cream, and reveskin fortified bleaching cream all help.  Scars can be punched out and removed in the office.
 
No medical insurance covers keloid removal. You have a chance of recurrence with surgical removal but lasers can help reduce the look.
 
There are many options for hypertrophic/red/discolored scars:
1. vascular lasers (yellow laser, vbeam, excel v)
2. fractional lasers (fraxel, erbium, co2)
3. microneedling/PRP
4. silicone based scar gels with growth factors
5. excision +/- radiation
See an expert. Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear BKLdn,
if kenalog shots didn't help with your keloids, then you can try surgical removal in order to try to reduce the scars. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Can my keloid/hypertrophic scars from my nipple piercings be removed successfully? (Photos)

Answers (5)

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