Remove scars from skin picking (Dermatillomania)? (Photo)

Question

Thanks in advance for any advice! My long story is I've been in recovery (3mths) from a 10 year Vicodin addiction! And depression (a lot of it because of the Vicodin abuse). During that time, I also had a lot of anxiety and picked the skin on my arms and legs. I FINALLY got it under control and everything is mostly healed. It took over a year after I stopped! The scars are so embarrassing. Is there any sort of laser treatment that would get rid of these, or at least diminish , them?

Jason Emer, MD · Answer

I have found the best treatment for hypopigmentation requires a combination approach.  Nothing "cures" this completely but you can get improvement with Fraxel or viva and microneedling with PRP.  I suggest only seeing an expert as skin care and sun protection will be essential as well.  Best, Dr. Emer

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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