What should I do for old depressed scar that is hypopigmented and textured? (Photo)

Question

I got this scar between my eyebrows when I was 4. It's super noticeable since it's white and textured and depressed. I've tried laser treatments and microneedling but nothing seems to drastically change the appearance. What should I do?

Raffy Karamanoukian, MD, FACS · Answer

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.

Massaging your scar can reduce inflammatory mediators that are responsible for chronic inflammation and scar overgrowth. It’s a rather simple technique that inactivates celluar inflammation mechanisms that can lead to keloid and hypertrophic scars. Start by applying a thin coat of Plato's Scar Serum twice daily to the scar and gently massaging the scar footprint. Be gentle, taking care not to slough off newly formed skin and reducing shear force on the dermis. This is ideal for new and old scars. 
•	Twice daily application of a scar gel. 
•	Scar modulation with gentle massage.
•	Intralesional injections in case there is overgrowth of scar tissue.
•	Vascular lasers for neovascularization of scars.
•	Stimulatory injections for scar atrophy. 
Scar gels work well, but should be combined with a physician-directed protocol to reduce scar formation and reduce scar visibility.

Best, 
Dr. Karamanoukian
The Scar Doctor
Realself100 Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  Based on your photograph, you may benefit from a surgical scar revision of your radix scar.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Jeff Rapaport, MD · Answer

Ablative fractionated low density laser should improve the texture of the scar. Combining this with brimoprost or eximer laser can usually improve the hypopigmentation. Find a scar expert.Jeff Rapaport MD FAADRealself Verified All-star

Shobhan Manoharan, MBBS, FACD · Answer

If you have had lighter laser treatments with little result, you should see a scar expert who can consider using an Erbium:YAG or CO2 ablative laser to resurface the whole glabellar cosmetic unit to give you a better result.  Following this with bimatoprost drops, RECELL  and phototherapy may repigment the area also.  Best wishes, Shobhan.

What should I do for old depressed scar that is hypopigmented and textured? (Photo)

Answers (4)

Answer: Fractional or ablative laser resurfacing

Answer: Fractional or ablative laser resurfacing

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

What should I do for old depressed scar that is hypopigmented and textured? (Photo)

Answers (4)

Answer: Fractional or ablative laser resurfacing

Answer: Fractional or ablative laser resurfacing

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.