TCA cross for piercing scar? (Photo)

Question

Last year in november I had a TCA cross treatment for a old piercing Hole in my nose. Suddently a darker hue appeared around the Hole and this won’t go away. This makes it much more visible. Using spf 30-50 all year around. The doctor say that I Can try TCA cross again because normally the treat 3x for it to close much more, but He says He cannot promise that it won’t darken my skin! It there any other treatments for closing old nose piercing?

Jeff Rapaport, MD · Answer

Darkening in a TCA cross-created scar on the nose can occur due to post-inflammatory hyperpigmentation or increased melanin production. Treatment options may include topical lightening agents such as hydroquinone, kojic acid, or retinoids, along with procedures like chemical peels or laser therapy to address the hyperpigmentation. Sun protection is also crucial to prevent further darkening. Consulting a dermatologist/scar expert for personalized advice is recommended.
Jeff Rapaport MD FAAD 
Realself Hall of Fame 
Castle Connolly Top Doctor

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

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