Will micro needling improve nose tip boxcar scar? (Photo)

Question

I need advice on effective treatments for a small, shallow boxcar scar on the center of the tip of my nose. Microneedling, laser, subcision, tca cross, rf micro needling? I don't know what will work in this area, and I'd like advice on what would give the best bang for my buck.

Anna Chacon, MD, FAAD · Answer

Thank you for your question and photo. Treating boxcar scars, especially in delicate areas like the tip of the nose, can be challenging due to the limited skin mobility, thicker sebaceous skin, and proximity to cartilage. Based on the location and nature of your scar, here’s a breakdown of the most effective options and considerations:

Raffy Karamanoukian, MD, FACS · Answer

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

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For a small, shallow boxcar scar on your nose, both Morpheus8 and CO2 laser resurfacing are excellent options. Morpheus8 can provide targeted treatment by combining microneedling with radiofrequency energy, which can help stimulate collagen production and improve the texture of the scar. On the other hand, CO2 laser resurfacing is more aggressive and can effectively resurface the skin, helping to reduce the appearance of scars. It's particularly effective for boxcar scars and can yield significant results, but it may require some downtime. I hope this helps and best of luck!

Will micro needling improve nose tip boxcar scar? (Photo)

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Will micro needling improve nose tip boxcar scar? (Photo)

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