Treatment for Facial Chicken Pox Scars?

Dermaroller micro needling is a great way to even out any depressed
chicken pox scars. We see many teens and adults in my practice with the same
concerns. 2-4 treatments may be required to achieve the best results. It is best you consult a medical professional
to asses these scars. Length of the roller needles will also be recommended to
you at that time.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. 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 decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I need to see and evaluate the scars to determine the best treatment modality for it.  Experience treating scars is paramount.  I have written the chapter on scars and scars revisions in Plastic Surgery text that every single US plastic surgeon need to read prior to graduating from their program.  Hope that helps lead you to better decision on how to proceed.

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.