Surgical or laser removal for dermatofibroma scarring after shaving? (Photos)

Question

Please help me, I know this isn’t a mole. I have 2 dermatofibromas on the backs of my thighs. My doctor recommended I get it shaven off (bad move), which left horrific scarring. I’m looking to get it surgically removed, but I’m deeply concerned about it leaving a worse scar. Would you recommend I do surgical or laser removal? Will the scar be extremely noticeable? I have no idea who to trust anymore and deeply need someone’s help. I can’t wear shorts anymore. Thank you in advance

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

It's difficult to determine the best solution for you without the benefit of a formal evaluation. Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. 
Options can include:
1. Vascular lasers (BBL, Yellow laser, V-Beam, Excel V) 
2. Fractional lasers (Fraxel, Erbium, CO2, Halo) 
3. Microneedling/PRP 
4. Silicone-based scar gels with growth factors 
5. Excision/revision surgery 
See an expert to develop a treatment plan that works for you. Best, Dr. Emer​

Jeff Rapaport, MD · Answer

In my opinion, There are 2 issues you must consider. 1st is the texture of the scar and the 2nd is the color. A Q- switched , Thulium or Picosecond  laser should improve the color.  This can be followed by a fractionated  CO 2 or Erbium laser for texture.  It does not appear that there is much laxity in the skin in the area of the scar. If you decide to have the scar excised, you will need to follow it with a fractionated laser.  Neither approach is perfect, but should improve the appearance.
Jeff Rapaport MD FAAD 
Realself Hall of Fame

Surgical or laser removal for dermatofibroma scarring after shaving? (Photos)

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Surgical or laser removal for dermatofibroma scarring after shaving? (Photos)

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