Which treatment would correct dent left after forehead cut? (photo)

Question

I cut my forehead 35 days ago. It was originally glued and a steri strip was applied. When both came off however, i was left with a dent. Massaging has helped however i have noticed that the very top layer is still separated. Treatment options?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis.  We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. 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 discuss the best treatment options for your type of skin. .

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the issues you're experiencing with the healing of your forehead cut. Based on the description of your condition, here are some potential treatment options to consider:

1. **Continued Massage and Topical Treatments**:
   - **Silicone Gel/Sheets**: These can help flatten and smooth scars, and might aid in improving the appearance of the dent over time.
   - **Vitamin E or Scar Creams**: These can also be beneficial for scar healing when used consistently.

2. **Consultation with a Dermatologist or Plastic Surgeon**:
   - If the dent persists, it might be beneficial to consult a specialist. They can assess the depth and nature of the indentation and recommend appropriate treatments.

3. **Dermal Fillers**:
   - For more persistent indentations, dermal fillers like hyaluronic acid can be injected to fill in the dent. This is a relatively quick procedure with immediate results, but it may need to be repeated periodically.

4. **Microneedling or Laser Therapy**:
   - These treatments can stimulate collagen production and help improve the texture and appearance of the scar. Microneedling involves tiny needles creating micro-injuries to promote healing, while laser therapy can resurface the skin and improve scar texture.

5. **Surgical Revision**:
   - In some cases, a minor surgical procedure may be needed to correct the indentation. This can involve excising the scar tissue and re-closing the wound more precisely.

6. **Steroid Injections**:
   - If there is any raised scar tissue surrounding the indentation, steroid injections can help flatten these areas. However, this is typically used for hypertrophic or keloid scars rather than indentations.

7. **Patience and Monitoring**:
   - Sometimes, scars can continue to heal and change for up to a year after the injury. Monitoring the scar and giving it more time to heal might show further improvement without additional intervention.

Given that the top layer of your scar appears to be separated, it’s particularly important to have a specialist evaluate this to ensure proper healing and avoid complications. A dermatologist or plastic surgeon can provide a tailored treatment plan based on a thorough assessment of your scar.

Please make sure to consult with a healthcare professional before starting or changing any treatments to ensure they are appropriate for your specific condition.

Nelson Lee Novick, MD · Answer

You're in the right window for treating an imminent scar in which there is actually a chance to erase it: between the end of week four--when the wound is strong enough to withstand treatment --so the end of week twelve--when the scar is considered "mature" and the likelihood for achieving between a 60-80% overall improvement in appearance is what can be legitimately expected from treatment. From the photos provided it is difficult to tell, but if the wound is indented, Subcision can be used to elevate and smooth it. If actually flush with the surrounding normal skin, professionally performed manual microneedling (no need for the added expense and risks of RF microneedling) can be used to better blend the wound in color and texture with the surrounding normal skin.
I just treated a patient exactly like this last week. Six weeks earlier he tripped on the sidewalk, gashed his forehead and had the wound stitched at an ER. 
You would be very wise to exercise buyer beware caution when you will no doubt be hawked this or that  expensive "bells and whistles" fraxel lasers or RF devices, as the hard science to support that use of these gizmos lags woefully behind the heavy marketing and social media buzz to promote them. 
You would also be wise to consult with a board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

Which treatment would correct dent left after forehead cut? (photo)

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Which treatment would correct dent left after forehead cut? (photo)

Answers (3)

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