Is laser the best way to remove my scar?

Question

I had a melanoma in situ removed and have a 6" scar. The procedure was done one month ago. There are inner stitches that won't dissolve for 3-4 months. At what point can I have a procedure? Is laser the best option? If not, what options are better? TIA.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis.  We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. 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 discuss the best treatment options for your type of skin. .

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

We have known for several decades already that the old adage of "Wait for a year for the scar to mature before having any work done" is not really the best advice. The ideal window of time is between the end of week one following the causative event (surgery, injury, infection) when the healing wound is strong enough to withstand treatment and the end of week twelve, when the scar is considered fully mature-- after which no known treatment is likely to completely erase the scar.  
Without a photo, I can only comment in the most general terms, but professionally performed microneedling (no need for the added expense and risks of RF microneedling) can be used to help better blend in both color and texture the treated area with the surrounding normal skin. 
While Dr. TikTok might be hyping the latest "next big thing" expensivw laser or RF treatment, the reality is that the hard science to back up the use of fraxel lasers or any of the other, expensive energy-based gizmos out there, lags woefully behind the heavy marketing hype and social media buzz to promote their use. So, "buyer beware" when considering these approaches. You would be wise to make sure to consult a board certified cosmetic dermatologist scar treatment specialist. And, one more piece of advice. Don't go into to any consultation asking for any new faddish gizmo because to your later frustration, disappointment and financial loss, you are likely to get what you ask for. Hope this helps and best of luck.

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