Can anything be done about this 30 year old scar?

Even after decades, a raised nasal scar that distorts nasal symmetry can often be improved with modern techniques, especially if previous laser treatments were ineffective. Surgical scar revision is the most definitive option for scars that are thick, raised, or cause contour irregularities. This involves excising the scar tissue and carefully closing the wound in layers to minimize tension and optimize healing. Post-surgical laser therapy, such as fractional CO2 or pulsed dye laser, can further refine the scar’s texture and color, helping it blend with the surrounding skin.

For patients who are not candidates for surgery or prefer less invasive options, intralesional steroid injections or 5-fluorouracil can help flatten hypertrophic scars. Silicone gel sheeting and microneedling may also offer incremental improvements in texture and pliability. While perfect symmetry may not be achievable, significant improvement in contour and appearance is realistic with a tailored, multimodal approach.

Consultation with a board-certified dermatologist or facial plastic surgeon experienced in scar management is essential to determine the best combination of treatments for your specific scar. With current advances, even long-standing scars can often be improved, restoring confidence and facial harmony.