Deep pick scars on my nose. And an excision scar that opened up over a course of years (Photo)

Question

I have a lot of deep pick scars and enlarged pores on my nose. I also have a deep open strophic scar caused by an excision scar from 2005 that opened up wider and deeper over the years. I’m searching for a solution to fix these issues.

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

TCA CROSS is a simple, relatively inexpensive treatment for ice pick scars and dilated pores. It has a  well over two decades of use and a track record for safety and efficacy in all skin types and I have personally been using it with gratifying results for that period of time. The indented widened surgery scar on the nose here is certainly not surprising. I have been cautioning my regular followers for years that excision and punch-excision surgeries in areas that are subject to a good deal of muscular movement or are under static tension tension--such as the nose--are prone to the development of stretch scars and even tram track stitch marks. Sorry.  Happily, the use of subcision, another simple and relatively inexpensive technique that I have been performing since 1995, when it was first introduced, works well for elevating and smoothing depressed scars from all causes. If needed or desired, MANUAL (not RF) professionally performed microneedlng can be performed as a final "polishing" step to better blend the surface texture and color of the treated areas with the surrounding normal skin. Hope this helps and best of luck. You would be wise to consult with an experienced, board certified cosmetic dermatologist.

Deep pick scars on my nose. And an excision scar that opened up over a course of years (Photo)

Answers (2)

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