What do you recommend for hypertrophic scars/bumps I've had for 2 years now? (Photos)

Question

I have what seems to be hypertrophic scars. These scars are the result of large pimples that left these raised bumps that dont go away. I've had these bumps for 2 years now.

Nelson Lee Novick, MD · Answer

The kinds of little bumpy scars shown in the photos appear to be papular acne scars. These are most commonly found, as in this case, on the nose and on the chin. In my experience, they usually respond to intralesional anti-inflammatory injections, such as with triamcinolone, in appropriate amounts and concentrations. If response is not adequate, light electrocautery may be used to gently flatten them. No doubt when researching the treatment for this problem or when consulting certain venues, you will be confronted with recommendations for treatment with relatively expensive fraxel lasers or radiofrequency devices. Just keep in mind that the hard science to support these "bells and whistles" lags behind the heavy marketing and advertising hype to promote them. So, exercise a healthy dose of "buyer beware" before proceeding down those routes.  Make sure to consult with a board certified cosmetic dermatologist or other core aesthetic physician. Best of luck

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​

What do you recommend for hypertrophic scars/bumps I've had for 2 years now? (Photos)

Answers (3)

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