Raised and indented scar on nose from a cyst. What are my treatment options? (Photos)

Question

I have a scar on my nasal dorsum from when I had a cyst back in 2017 which I burst. The scar is is like a donut shape - it is slightly indented in the centre where there is a pore and the surrounding tissue is slightly raised and discoloured a lighter shade (white). Are there any treatment options here? I have already tried multiple topical treatments including tretinoin, adapalene and azelaic acid (Finacea gel) with no improvements.

Raffy Karamanoukian, MD, FACS · Answer

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

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. For a raised and indented scar on the nose, especially one caused by a cyst, CO2 laser could be a highly effective treatment option. For indented scars (atrophic scars), CO2 laser can help by resurfacing the skin and encouraging collagen remodeling, which may fill in the indentation over time and improve the overall texture of the scar. For best results, multiple sessions are often necessary, spaced a few weeks apart, to progressively improve the appearance of the scar. I hope this helps and best of luck!

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concern regarding the scar on your nasal dorsum. Given the description of a "donut-shaped" scar with both raised and indented characteristics, here are some treatment options you might consider:

Laser Resurfacing:
Fractional CO2 Laser: This can help improve both the texture and color of the scar by promoting collagen remodeling and reducing pigmentation irregularities.
Pulsed Dye Laser (PDL): Effective for addressing redness and reducing the appearance of raised scars.

Microneedling:
This procedure can help improve the texture of indented scars by stimulating collagen production. It may be combined with radiofrequency for enhanced results.

Scar Revision Surgery:
In some cases, surgical scar revision may be considered to excise the scar and re-suture the area for a more aesthetically pleasing outcome.

Injectable Treatments:
Corticosteroid Injections: These can help flatten raised areas of the scar by reducing inflammation.
Dermal Fillers: Temporary fillers can be used to elevate the indented portion of the scar, providing a smoother appearance.

Chemical Peels:
Medium to deep chemical peels can help improve skin texture and pigmentation, though they may be more challenging on the nose due to the area’s unique contours.

Silicone Gel or Sheets:
Continued use of silicone-based products can help flatten and soften scars over time, although results may vary.

Consultation:
It is important to consult with a board-certified dermatologist or plastic surgeon who specializes in scar treatment. They can provide a personalized assessment and recommend the most suitable options based on your specific scar characteristics and skin type.

Each treatment has its own set of benefits and considerations, so discussing your goals and expectations with a professional will help determine the best approach for your situation.

Raised and indented scar on nose from a cyst. What are my treatment options? (Photos)

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Raised and indented scar on nose from a cyst. What are my treatment options? (Photos)

Answers (3)

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.