What is the Best Way to Treat a Childhood Atrophic Scar and Dent on Forhead? (Photos)

Question

Male, have an atrophic surgical scar and dent in a surrounding area on right side of my forehead. This resulted from a baseball Bat injury as a child and surgeries to try to get rid of a lump left from the initial injury. Any advice would help, open to options and consultations

Nelson Lee Novick, MD · Answer

I'm sorry this has happened to you. Fortunately, there are a couple of simple treatments to improve the scar's appearance. Subcision, a quick, and nonsurgical procedure that I have personally been using for over thirty years, can be used to elevate and smooth the scar. Subcision has a several decades long track record for safety and efficacy. 
Following this, if still desired, manual microneedling (no need for the added expense and risks for adverse reactions from RF microneedling) can be performed, accompanied by the application of Rx pigment promoting topicals, to better blend the treated area in color and texture with the surrounding normal skin. Manual microneedling, which I have personally been performing for over a quarter of a century, also has a proven track record for both safety and efficacy. 
You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. 
Exercise a great deal of "buyer beware" caution when being offered expensive "bells and whistles" fraxel laser and RF treatments, as the hard science to back up their use lags well behind the heavy marketing hype and social media buzz to hawk them. 
Exercise caution, as well, if considering surgical revision surgery. Excsision in areas, such as the forehead, under a great deal of static and dynamic tension risk, the subsequent development of stretch scars and even stitch tracks.
Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and photos—this helps a lot in understanding your concern. Since your scar and dent are the result of a childhood injury and multiple surgeries, the tissue in that area has likely undergone changes in fat, muscle, and skin thickness, which is why the indentation persists.

Treatment options often depend on the depth and quality of the scar, as well as your goals:

Dermal fillers: For moderate depressions, hyaluronic acid or other volumizing fillers can temporarily restore contour and improve symmetry. They’re minimally invasive and provide immediate improvement, though the results are temporary.

Fat grafting: This involves transferring fat from another part of your body to fill the indentation. Results can be longer-lasting than fillers, but it’s a more involved procedure.

Subcision or microneedling: If there’s tethering under the skin, subcision can release scar bands, and microneedling or laser treatments can improve skin texture and promote collagen remodeling.

Laser resurfacing: Fractional or ablative lasers can help smooth the surrounding skin and blend the scar more naturally with the rest of the forehead.

Surgical revision: In select cases, especially with very deep or complex scars, surgical excision or flap revision may be considered, though it comes with more downtime and risk.

Since this is a combination of a scar and a contour defect, a layered approach—sometimes combining fillers or fat grafting with skin resurfacing—often gives the most natural and long-lasting results.

Because every scar behaves differently, the treatment needs to be tailored to your specific forehead anatomy and tissue quality. Even though it’s been years since the injury, improvements are absolutely possible with the right approach.

Kamil Al Rustom, MD · Answer

The Intracell fractional laser could make vanishing completely.One session a month under topical anesthesia, like Emla cream.You need 3-4 sessions of treatment to clear up your scar. Good luck

What is the Best Way to Treat a Childhood Atrophic Scar and Dent on Forhead? (Photos)

Answers (3)

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