Would scar removal improve appearance of scar on forehead? (Photo)

Question

I have had countless lasers , needleing , retinol, and filler in the area with massive cost and little improvement. Is scar removal likely to help much? Female- 35- scar is 5 years old from cystic acne

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

Fraxel lasers, as you have found out unfortunately the hard and expensive way are hyped up "bells and whistles" and I have been cautioning my regular followers for years already to "buyer beware." Sorry, but no surprises there. Microneedling is a final "polishing" step for better blending treated scars in both color and texture with the surrounding normal skin; it is not a particularly good primary treatment for scars. Again, no surprises there, either. Sorry. Retinol is a weak retinoid and would not really be expected to do much at all for this, and temporary fillers, at best, can give only a temporary results and permanent fillers run the risk for subsequent development of problematic complications even many years down the road. Surgical scar revisions, particularly in areas such as this subject to static tension and movement, run the risk for the subsequent development of unsightly stretch scars and tram track stitch marks. On the other hand, consider subcision for elevating and smoothing the scars followed by microneedling to better blend them in color and texture with the surrounding skin. You would be wise to consult a board certified cosmetic dermatologist scar treatment specialist. Best of luck .

Would scar removal improve appearance of scar on forehead? (Photo)

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