Can this scar be flattened without excising more skin? (Photo)

Question

I had some skin removed from the side of my scalp and it left a slightly raised, squishy area. Is there any option to help flatten this without excising anymore skin. Surgery was roughly 10 months ago.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photo and story. I can see the slightly raised area you’re describing, and it’s understandable to want it to look flatter, especially since you’ve already been through surgery. At about 10 months out, the scar is still in the active healing and remodeling phase, so there are non-surgical options that may help improve it without needing to remove more skin.

Some possibilities include:

Steroid injections (corticosteroids): These can help soften and flatten raised or thickened scars over a series of treatments.

Silicone gels or sheets: Regular use can gradually improve the scar’s texture and reduce thickness.

Laser treatments (fractional or vascular lasers): These can target both texture and redness, helping the scar blend in better with surrounding skin.

Microneedling or radiofrequency microneedling: Stimulates collagen remodeling and may help smooth out irregularities.

Compression therapy: Sometimes gentle, consistent pressure can help flatten softer, raised scars.

While it may not be possible to make the area look completely the same as the surrounding scalp, many patients do see meaningful improvement with these treatments over time. I’d recommend seeing a dermatologist or plastic surgeon who specializes in scar management—they can evaluate the scar in person and suggest the best approach.

You’ve come a long way in your recovery, and the good news is that there are ways to help this look better without going back into surgery.

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

Nelson Lee Novick, MD · Answer

The post-surgical bump in this case is likely to be a hypertrophic scar. If so, then the use of intralesional injection of an appropriate anti-inflammatory agents can help to flatten it without the need for any further surgical intervention. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist and best of luck.

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