Best way to treat old atrophic facial scars? (Photo)

Question

I had facial moles removed 15+ yrs ago and now 2 prominant sunken scars on my face. They are svery noticeable when I wear makeup as it settles into the sunken areas. I've tried scar creams and recently Bioeffect EGF serum but not noticed any benefit. I've had 1x radiofrequency microneedling and 1xpolynucleotide injection . I was wondering if laser treatment or injectable substances might work better? Also if its worth continuing topical EGR serum? Many thanks

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

Nelson Lee Novick, MD · Answer

I'm sorry that this has happened to you. Should the need arise to remove any additional moles, I strongly urge you to investigate "Scalpel Sculpting," which can even be successfully used to remove flat moles.  Subcision, which I have been performing since 1995, is an inexpensive technique for elevating and smoothing indented scars from all causes, including those following surgical procedures.. Once elevation is achieved, then professionally performed, manual Dermastamp microneedling, which I have been performing for over 24 years (no need for the added expense and risks of RF microneedling), can be used to better blend the superficial, surface textural irregularities with the surrounding normal skin. 
No doubt you will be hawked the use of fraxel lasers or RF microneedling needling devices for this issue. Just be aware that the hard science to back up the use of these expensive "bells and whistles" gizmos lags woefully behind the marketing hype and social media buzz to promote them. 
Hope this helps and best of luck.

Best way to treat old atrophic facial scars? (Photo)

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