Indented scar treatment options? (photos)

Question

Hello, I have a scar underneath my eyebrow from using an acne patch that ripped off my skin, leaving a hole. I now have an indented scar that looks to be permanent (it is several months old). I am unable to conceal this scar successfully with makeup, so I am researching my options. So far I have read about soft tissue filler, TCA cross, and scar revision surgery. With the scar being so close to my eye, which procedure do you think would be best? I appreciate any insight, thank you!

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

Jason Emer, MD · Answer

A combination approach will give the most improvement. These types of scars need a combination of Cosmelan, lasers, microneedling/prp, subcision, salt facials and fillers. It may take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Edward Buckingham, MD · Answer

Scars continue to evolve with time and can take 6 months to 1 year to fully mature. Depending on the scar, treatments include injectable fillers, skin resurfacing treatments, and surgical excisions. Additionally care of the scar including use of sunscreen and silicone based products are advised. In office examination is best to discuss options with your provider on which treatment options are best for you.

Nelson Lee Novick, MD · Answer

Scar revision surgery, especially in areas under tension or subjecft to a great deal of movement run the risk for the development of stretch scars and even tram track stitch marks. TCA CROSS, which I have been using regularly for over two decades, is best reserved for treating narrow pitted scars or dilated pores. Filler in this heavily vascularized area runs the risk of serious vascular problems. Subcision, on the other hand, which I have been performing since 1994, has a proven track record for safety and efficacy for elevating and smoothing broader-based, tethered scars in all skin types. Make sure to consult with a board certified cosmetic dermatologist with experience and expertise in subcisions. Best of luck.

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