Treatment options for wart removal scar on knuckle? (Photos)

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented 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 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 lasers 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 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

Thank you for your question and photos. It’s not uncommon to develop a raised, red scar (often called a hypertrophic scar) following wart removal, especially on areas like the knuckles that are constantly in motion and subject to friction.

Here are some treatment options to help improve the appearance and texture of the scar:

Topical Silicone Gel or Silicone Sheets
These are first-line treatments for hypertrophic scars. Regular use can help flatten the scar and reduce redness over time.

Steroid Injections (Intralesional Kenalog)
If the scar is raised and firm, a series of corticosteroid injections directly into the scar can help soften and flatten it gradually.

Laser Therapy
Pulsed dye lasers (PDL) or fractional lasers can target redness and improve texture. These are particularly helpful for scars that are red or vascular in nature.

Microneedling
This can stimulate collagen remodeling and improve the appearance of raised or uneven scars, especially if combined with serums or PRP (platelet-rich plasma).

Scar Creams with Ingredients like Onion Extract or Retinoids
These may help with color and texture when used consistently over time.

Surgical Revision (in more stubborn cases)
If the scar remains particularly bothersome or raised, a minor surgical procedure may help excise the thickened tissue and create a flatter scar, though there’s always a risk of recurrence or scar formation again, especially on joints.

Pressure Therapy or Silicone Banding (for active scars)
If the scar is still in the healing phase, applying consistent pressure or occlusion with silicone may assist in remodeling.

Healing takes time, and consistent treatment is key. With a tailored approach, the scar can be significantly improved or minimized.