What can I do for this hypertrophic scar? (Photo)

Question

Hit my head 7 months ago, didnt go to the ER for stitches, healed with hypertrophic tissue. Using silicon strips daily, dermarolling, etc. nothing is helping. Help?

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Unfortunately, I have not found silicone sheeting or gels to be particularly effective in dealing with these kinds of scars. Professional medical dermarolling, which I have been performing for over twenty-three years, is best reserved for treating very superficial surface texture and color irregularities of the skin and would not be indicated for hypertrophic scars. So, unfortunately, no surprises there, either. It has been used in the professional setting, however, for permitting better penetration of topically applied anti-inflammatory agents at the time of treatment. However, the intralesional injection of triamcinolone, an anti-inflammatory agent, has the most consistent track record for getting the job done. Make sure to consult a cosmetic dermatologist and best of luck.

Daniel Barrett, MD · Answer

Dear Jubilant8747,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from scar revision. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kulakarn Amonpattana, MD · Answer

The scar from accident must be checked if there is any retain foreign body. The hypertrophic scar itself need time to heal. The timeline may vary depend on individual factors.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question and photograph. A variety of treatment options are available for keloid scars such as intralesional steroid injections, topical steroid creams, or scar revision. I highly recommend you consult with a board certified dermatologist to have your skin evaluated and to discuss appropriate treatment options. Take care and good luck.

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