Best Treatment of Forehead Scar on a 3 Yr Old?

Doc. recommended Fraxel for my 3 yr old son who has a small scar on his forehead from a fall two months ago. Dermabond glue was used to treat the cut. It's healed but there is a scar there. Is Fraxel the best treatment to reduce the scar?

Doctor Answers 14

Scar treatment in a 3 year old boy

I believe there is a role for topical therapies in this case. Make sure the area is well moisturized for optimal healing. Sunscreen should be applied daily and re-applied every 2 hours when outdoors. 

You have nothing to lose by waiting for the scar to mature. I would re-evaluate in 6 months and then consult with a Board-Certified Dermatologist or Plastic Surgeon for treatment options.

Beverly Hills Dermatologist
5.0 out of 5 stars 18 reviews

Scar treatment in young patients

Since the scar is relatively new, I would recommend over the counter scar treatments like mederma or scar fade gel. While the Fraxel might be helpful, the scar may do fine on its own without any treatment as is usually the case in younger children. You always have time in lets say six months or so to treat the scar if you so desire at that time.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Wait for scar treatment on young child

On a three year old I would wait. The scar might improve on its own and there is no good data on the use of Fraxel in young children.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Scar revision in a 3 year old is not always warranted

The best option for scar revision is difficult to tell without an examination. In a lot of cases, waiting is the best option. When a scar is evaluated for revision, it is important to determine if the problem is texture, color, or location. Each has a different set of options for repair. If you are talking about erbium Fraxel revision, this is best for color. If texture is the problem and your son has light skin, consider dermabrasion.

In any event, if you are concerned about the treatment, get a second opinion. There is no best treatment and it often takes several treatments over several months combined with letting the body heal itself over time to get the best results possible.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Improving scar texture with Plato's Scar Serum

Scar texture may be improved by laser or chemical peel resurfacing. Hyperpigmentation may occur with excessive sun exposure after laser, inflammation, genetic tendencies, and hormones. The mainstay of treatment involves prevention, but in the case of hyperpigmentation, treatment is straightforward. Hyperpigmentation can be treated with a topical prescription regimen applied at home.

For children, we continue to use the Plato's Scar Serum as a safe and effective scar gel for children. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Hard to say without seeing your son's scar

It is impossible to determine the best treatment for your son’s scar without seeing him. If Fraxel was appropriate, it would take several treatments with Fraxel Re:store and one or two with the Fraxel Re:pair (the latter following the first Re:pair almost one year later). The Re:store may be safer than the Re:pair with less risk of scarring for your young son. However, the pain is the concern. Fraxel does hurt, even despite the application of numbing cream.

There is some absorption of the topical anesthetic and it should be discussed with your son’s pediatrician prior to use. A doctor could numb the scar with local anesthetic first if your son would tolerate this. Regardless, he may be too fearful of the treatment even if it doesn’t hurt! Regardless of the type of scar, some element of it will persist despite whatever laser or surgical revision would be done. Make sure you seek a second consultation.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Fraxel Works Amazingly Well on Facial Scars, Even in Children

Hi Molgun,

I have treated many patients’ facial scars with Fraxel re:store, the youngest being 4 years old. They have all responded well with marked improvement. It takes a series of treatments usually separated by 3-4 week intervals. The child has numbing ointment on the scar for about 30 minutes, and the actual treatment takes a minute or two. Children tolerate the treatment very well. The end point is when we have trouble seeing or finding the scar (usually 3-5 sessions).

You may wait and see how the scar matures if you wish, and if it is not acceptable after a few months, have the child treated. Conversely, I have seen the best results in both children and adults when they are treated soon after (2 weeks) sutures are removed.

Certainly there will be other suggestions for treating scars here, but Fraxel is the best way of minimizing facial as well as body scars (breast scars and abdominal scars) that I have seen in my 25 years experience in facial plastic and reconstructive surgery.

Meticulous closure and care of a wound by a board certified cosmetically trained surgeon (ENT, facial plastic, general plastic, ophthalmic-plastic) will minimize scarring. Fraxel treatment just makes it better. I hope to not ever have to use it on my own children, but I certainly would not hesitate to do so if indicated.

Keep a close eye on that child of yours, and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Better to wait until scar heals properly

I would wait and wait ! Kids tend to heal much better over time. The repair and the scar orientation are important factors but I would still wait. Silicone would be my non surgical treatment but it is not that easy to use on a 3-year-old.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Never heard of Fraxel for improving forehead scar in a child

Most laceration of the forehead heal very well on their own after repair. There will ALWAYS be a scar on the forehead after a laceration (cut). AS I always say, "If you have a hammer, all the world is a nail!" I have never heard of using Fraxel in a child to improve the scar. I would run the other way quickly! If the scar is problematic there are many other non-invasive modalities to choose from.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Not standard therapy

This is not a standard therapy but could provide improvement. Has your doctor shown you pictures of other scars he has treated with this technque?

There are some reports in the dermatologic literature that improvements were seen if a scar is dermabraded about 6- 8 weeks after injury. However, this is a different type of scar revision called a resurfacing technique that removes the top layer of skin. Fraxel is different in that it does not remove the top layer of skin. It creates laser holes in the skin similar to aerating your lawn.

I would advise avoidance of sun exposure with sunscreen and topical silicone preparations commonly available over the counter at the pharmacy.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.