What are these small lumps under skin that have been there for years? Would microneedling with PRP help? (photo)

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

Thank you for you question, CO2 is the best laser for scars, but Erbium is a great alternative. It may take a series of treatments to see improvements and to maintain. Keep in mind that a tailored combination approach will give you the most improvement with acne scars. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Thanks for your question and photo.  It is not possible to diagnose these lesions with 100% certainty without an in-person, up-close evaluation, but from the photo, it appears that they are probably common lesions.  Occasionally we find cysts under moles, or nevi, that have been present for years and tend to wax and wane, but never fully go away even after removing the surface mole cells. They might be small cysts or closed-up pores, called milia, that give a smooth white appearance, and they might be sebaceous hyperplasia, which tend to be yellowish bumps with a small central indentation.  Microneedling after extraction might be a good option for you and might take care of the lesions if they are milia, but we have better luck with hyfercation or chemical peels or even CO2 laser resurfacing if they are sebaceous hyperplasia.  Make sure you show these to your dermatologist who can professionally evaluate them and rule out skin cancers before you have them treated by a spa or aesthetician.  Also ask about post-procedure care.  Sometimes after laser resurfacing or peels, the ointments or balms we use for healing can cause the pores to be occluded and patients can develop small cysts.  They are probably fine, but it would be safest to proceed after an expert evaluation in person by a dermatologist.  Best of luck!