Are there options that can help remove painful circumcision scars without removing inner skin? 14 years post op. (photo)

I'm sorry to hear about the challenges you're facing with circumcision scars. It's important to address both the cosmetic and functional concerns, especially in the context of future gender-affirming surgery. Here are some potential options to consider for managing and improving painful scars without removing the inner skin:

Laser Therapy: Fractional laser treatments, such as CO2 or Er:YAG lasers, can help reduce scar tissue by promoting collagen remodeling and improving skin texture. This option might help in reducing the appearance of raised scars and improving skin flexibility.

Steroid Injections: Intralesional steroid injections can sometimes help flatten and soften raised scars, reducing discomfort and improving appearance.

Silicone Gel Sheets or Creams: Regular use of silicone-based products can help soften and flatten scars over time. These are non-invasive and can be a good option for managing scar tissue.

Microneedling: This procedure involves creating tiny punctures in the skin to stimulate collagen production, which can improve the texture and appearance of scars.

Topical Treatments: Prescription-strength topical treatments like retinoids or other scar-reducing creams might help improve the appearance of scars over time.

Consultation with a Dermatologist or Plastic Surgeon: Given the specific requirements for your upcoming surgery, consulting with a dermatologist or a plastic surgeon experienced in scar management and gender-affirming procedures is crucial. They can provide personalized advice and treatment options that align with your surgical goals.

Pain Management: If pain is a significant issue, discussing options for managing discomfort with your healthcare provider is also important.

It's essential to have a thorough evaluation to determine the most appropriate treatment plan for your needs while preserving the necessary tissue for your future surgery.