Treatment for Facial Chicken Pox Scars?

The size depth of chicken pox scars are important factors in deciding which techniques or combination of therapies is best for improving their appearance.

Small chicken pox scars can be treated by a method known as punch excision, in which the area is anesthetized locally and the scar punched out with a cookie cutter-like instrument and sutured closed with very fine suture material that is removed in just a few days to minimize the risk for the development of stitch tracks.

Alternatively, they may be treated by punch elevation, in which the scar is anesthetized locally, and once again punched out. However, instead of completely removing the scar, the scar is lifted up to the slightly above the skin surface, fixed in place, akin to plugging the hole with the scar itself. When healed the area may then be treated with manual dermabrasion or dermaplaning to smooth and blend the plug with the surrounding normal skin. Sometimes, once the scar is punched out, a plug taken from the normal skin behind the ear is used instead to fill the hole, a variation of the above known as punch-grafting. 

For larger chicken pox scars, I prefer a combined approach consisting of subcision followed by medical microneedling. The subcision, which is performed under local, entails using a needle inserted under the scar to break up the abnormally thick bands of fibrous tissue--allowing the overlying freed tissue to "float" to the surface. This can be followed with manual (Dermaroller) or motorized (Dermapen) medical microneedling to better blend the somewhat abnormal-appearing surface skin of the scar.  

In my experience, except for the most superficial scarring, resurfacting procedures used alone, whether  laser, traditional dermabrasion or chemical peels do not yield significant estheitc benefit. 

We agree with Dr. Hall and would suggest the following possible solutions:CO2 Laser ResurfacingErbium Laser ResurfacingExcision (surgical removal)DermabrasionGo to several consultations to get differing opinions for what might work best in your situation. Good luck.