How to Get Rid of a Crater Scar on Nose?

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 been 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 laser 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 acne 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

Unfortunately, having a biopsy done on the rounded tip portion of the nose or an excision there invariably will lead to a depressed scar. There are two options. You can fill in the depression to elevate it higher wil a filler or you can punch excise it. I would be careful with a punch excision since this can result in pincushioning which could actually be more noticeable. I hope this information helps.

While the scar may look quite deep now, it may certainly fill in and improve considerably over time. I would not recommend any surgical correction for at least 3-4 months from the date of the original biopsy. Even at that time, I would recommend a conservative surgical approach as something more aggressive might worsen the outcome.
If the crater still looks quite depressed, the raised edges may be smoothed down with dermabrasion. Also, the center may be elevated by placing a fascia graft below the skin to elevate the area and essentially replace the missing dermis. I have used this approach before with excellent results. Re-excising the scar or doing a punch biopsy will only worsen this problem and may cause an unnatural notch to the alar rim so I would not recommend them.

there are many ways to deal with this small scar - a local dermabrasion, and or filling the space below with a tiny amount of silicone will probably resolve the scar 60 to 70%.

It is likely that this scar will improve quite a bit over time without treatment. Given the depth of the scar, a filler underneath with or without laser or dermabrasion of the skin over the scar should give nice improvement. Lastly, a few treatments with a pulsed dye laser will reduce the redness more quickly than time alone.

Please do not be overly concerned. I have seen larger "divots" than this one.
The crater can be removed by using a punch biopsy, with the small hole being sutured together. Usually this will suffice, but if not a touch with a laser can smooth out the remaining scar.
Personally, I prefere a punch biopsy nose anyway, especially if the biopsy is done to rule out a skin cancer. Twice in my career I have seen basal cells on the nose which was interpreted as an actinic keratosis ( pre-cancer) by the dermatologist. The shave biopsy was most likely superficial and there was a basal cell carcinoma lurking beneath the atypical surface cells. Plus a punch biopsy in this location is more likely to give a better analysis if you are considering melanoma.
The shave biopsy is preferred if you know the lesion is benign such as a benign mole, or something called a fibrous papule ( a common lesion in middle-aged woman which is actually a type of mole).
I would return to the dermatologist and she most likely will use a punch biopsy to make things right for you.