What is the best course of action for potential hypertrophic/papular scars on the nose, after failed treatment so far? (photos)

Question

I used to get a lot of pimples on my nose, and they seemed to have left raised skin-colored "bumps" scattered on every side of my nose. Past doctors have diagnosed it as sebaceous hyperplasia, but I went through 2 months of accutane with no changes, so was told to stop it. I saw other doctors who diagnosed it as raised acne scars, and thus far have undergone: 2 sessions of erbium laser (spot treatment) and 1 session of light steroid injection. I still have zero change in scar elevation

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 been 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 laser 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 acne 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

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! It may be worthwhile to consider interventions like chemical peels such as glycolic acid or TCA. Additionally, you can try steroid creams for an extended period to see if it is inflammation. Have you tried a course of antibiotics? If it is scarring, a CO2 laser done lightly may help to level the areas. The consideration with anything is making it worse or causing pigmentation changes. Visit with a facial plastic surgeon with expertise in scar treatment to see what can safely be done for you. Hope this helps.

What is the best course of action for potential hypertrophic/papular scars on the nose, after failed treatment so far? (photos)

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What is the best course of action for potential hypertrophic/papular scars on the nose, after failed treatment so far? (photos)

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Everything you need to know about Scar Removal

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