What are my scar revision options for a facial piercing hole? (photo)

Piercing holes, like large pores and wide pit scars can be treated by a variety of methods. These include punch removal,  electrocautery of the inside  walls of the piercing, and the CROSS Technique. The latter consists of the instillation of a TCA in an 80-100% concentration, a procedure that leads to irritation and subsequent closure of the opening. Electrocautery accomplishes the same end by wounding the inner walls of the piercing and allowing them to heal together. Punch removal, which in this case would likely be able to be closed by one stitch, actually excises the small opening and allows the walls to heal together. Should some aesthetically troubling irregularity still persist following any of these approaches, the surface can be improved by either manually dermasanding the surface or performing fractional medical microneedle therapy.For further information on any of these methods, you can check out the archives of Realself.com. Consultation with a board certified aesthetic physician with extensive experience in all these approaches is strongly advised.

Facial piercing scars can be surgically revised to remove and close the piercing scar hole. Raffy Karamanoukian MD FACSLos Angeles

While many dermatologists do not perform cosmetic surgical procedures some are excellent and devote their practice to cosmetic dermatology. Many facial plastic and plastic surgeons will also be able to help you.  As a facial plastic and cosmetic surgeon I learned numerous small techniques from my cosmetic dermatology colleagues. The medical issue is to completely remove the skin tract (the lining of the tunnel) and then to allow the wound to heal. Personally, I would first gently epilate (vaporize) the tract and just let it heal in, perhaps using one or two small sutures to approximate the skin edge opening. Best of luck.