Keloid (maybe?) scar - how can this be treated? (Photo)

Question

I’m a 24 year old 140 pound female. I have fair skin. I have done Accutane 6 years ago and I get hormonal breakouts.

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

Nelson Lee Novick, MD · Answer

The treatment of first choice, regardless of whether one is dealing with a small keloid or hypertrophic scar is the intralesional injection of anti-inflammatory agents, such as triamcinolone and 5-FU in varying concentrations and amounts, depending upon the circumstances. More resistant scars can undergo Scalpel Sculpting to debulk them followed by the aforementioned injections. Topical medications can be added to the regimen, if necessary to suppress recurrence. You would be wise to consult with a board certified cosmetic dermatologist. Best of luck.

Anna Chacon, MD, FAAD · Answer

Treating keloid scars can be a complex process due to their persistent and recurring nature. Keloids are a result of an overactive wound healing process, where the body produces excess collagen leading to raised, thickened patches of skin. Various treatment options are available, often used in combination to increase effectiveness.
Corticosteroid injections are commonly used as a first-line treatment for keloids. Steroids, such as triamcinolone, are injected directly into the scar tissue to help reduce inflammation and slow down the production of collagen, thus helping to flatten the keloid over time. Multiple sessions, typically every 4 to 6 weeks, may be necessary.
Silicone sheets and gels are another popular treatment option. When applied to the keloid and worn for several hours a day, they can help to flatten and soften the scar. Silicone sheets create a moist healing environment which can help reduce the size, hardness, and color of keloids.
Cryotherapy, which involves freezing the keloid with liquid nitrogen, can also be an effective treatment. This process can help to reduce the size of the keloid by damaging the collagen in the scar tissue. Cryotherapy may be used in combination with steroid injections for more effective results.
Laser therapy, particularly pulsed-dye laser therapy, can be used to reduce the redness and improve the texture of keloids. It works by targeting the blood vessels in the scar tissue without damaging the surrounding skin. Multiple laser treatments are often necessary.
Surgical removal of the keloid is another option but is generally considered a last resort due to the high recurrence rate of the keloids. If surgery is chosen, it's often combined with other treatments such as postoperative steroid injections or radiation therapy to reduce the chance of the keloid returning.
In some cases, pressure therapy using custom-made pressure garments or earrings for earlobe keloids, or radiation therapy, might be recommended.
Each of these treatment options has its own benefits and potential side effects, so it's crucial to discuss these with a healthcare provider or a dermatologist to determine the most appropriate treatment plan based on the size, location, and characteristics of the keloid, as well as the individual's personal preferences and overall health.

Keloid (maybe?) scar - how can this be treated? (Photo)

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Keloid (maybe?) scar - how can this be treated? (Photo)

Answers (3)

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