Is there an alternative to punch excision for my scar? (Photo)

Question

My doctor said punch excision is the only way to treat it. But Seeing negative experiences on internet I am doubtful. Also there is very minimal information about this procedure. The doctor also said it will leave a scar.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Punch excisions, like other forms of scar revision surgeries, run the risk for the subsequent development of stretch scars and tram track stitch marks. TCA CROSS, which I literally just performed on ten ice pick sites on my last patient before answering this Q&A, I have been performing for over twenty-three years. It has a proven track record for safety and efficacy in all skin types, and since it requires no cutting or stitching does not pose the same risk for adverse reactions. You would be wise to consult with a board certified cosmetic dermatologist and best of luck.

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