What is the cause of these small holes/indents in my forehead? What are the treatment options? (photo)

Question

There are 2 indentations in my forehead. I recently just got the other 1. I never had chicken pox, trauma, acne or needling in this area. There is nothing underneath it like a cyst or tumor. I suspect it's something to do with sun exposure as I got a bit sunburned and this appeared right after the skin healed. But not positive because I couldn't find anything on the web in regards to that. What is the cause of this and the medical terminology for this? What are the treatment options? Thanks

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

William Groff, DO · Answer

Hello and thank you for your question. These depressed scars look like the ones left behind by chicken pox or acne. It is possible they have become more prominent over time. The good news is there are plenty of ways to address these scars, particularly since you just have a few of them and they are easy to distinguish. Treatments that target the individual scars will likely produce the best results in your case. 
Subcision is a minimally-invasive procedure that releases the fibrous bands beneath the scar, allowing the depression to smooth out. Injectable fillers can also be carefully placed in the dermal layers below the scar to lift and smooth the depression from the inside out. You might also want to consider a full skin rejuvenation procedure like Fraxel or RF microneedling, which stimulate collagen production to create a smoother, more vibrant look to the skin overall. Make sure you work with a board certified dermatologist who is an expert in scar revision to ensure your treatment is tailored to your precise needs for the best possible results.

Jason Emer, MD · Answer

Depressed scars can be improved with vascular lasers like Yellow laser or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

What is the cause of these small holes/indents in my forehead? What are the treatment options? (photo)

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What is the cause of these small holes/indents in my forehead? What are the treatment options? (photo)

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