How to improve appearance of old Scar removal/treatment recommendations? (photos)

Question

I am an African-American male, Type V on Fitzpatrick scale. I have several scars on my face from injuries/accidents from when I was a teenager. I am now 28. The scars are not raised and are fairly smooth now. While I know scars are permanent, I am wondering if there is still anything that can be done to improve their appearance to make them less noticeable all these years later. Does anyone have any suggestions?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

This requires an in-person evaluation.typically this needs excisions then laser. but you can start peels at home and dermarolling for now (see link).

Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. 1. Vascular lasers (BBL, Yellow laser, V-Beam, Excel V) 2. Fractional lasers (Fraxel, Erbium, CO2, Halo) 3. Microneedling/PRP 4. Silicone-based scar gels with growth factors 5. Excision / revision surgery   See an expert to develop a treatment plan that works for you. Best, Dr. Emer​

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