Will my scar improve? Is there anything I can do to help treat it? (Photo)

Question

I fell of my bike and scraped my shoulder a little over a year and a half ago. There was minor bleeding but it did turn really red and scab This is how the scar looks now. Will it heal more over time? How visible will it be? Are there any treatments for it? Thanks

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

Nelson Lee Novick, MD · Answer

Traumatic scars, i.e. those cause by accidental injury can be treated in a variety of ways, depending upon the appearance, location, depth and coloration of the scar. These include scar revision surgery, scarabrasion, subcision and fractional microneedle therapy. Unfortunately, I have not been particularly impressed with the results of laser treatments, including fraxels.In the case of flattened scars with significant color and textural irregularity, such as appears to be the case depicted in the photo,  scarabrasion may be one option to soften and blend the scar tissue with the surrounding normal tissue. Manual dermasanding, performed under local, with sterilized sandpaper can even out surface irregularities of the the scar, although it is ideally performed within eight to twelve weeks following injury (unfortunately, not the case here), a window of opportunity that when exploited often leads to significantly improving the appearance of the scar.Another possible approach to improving flatter scars would be a series of fractional medical microneedling treatments (also known as medical microneedling or dermarolling). This technique is quite effective in my experience for  blending of any surface irregularities or dyspigmention, even in older, more matured scars, as in this case. The sterile needles penetrate the surface of the skin and break up abnormal areas promoting a more even skin tone and texture via microscopic wounding of the skin, which results in new, native collagen formation (neocollagenesis). Treatments are performed under local anesthesia, and in general between two to four treatment sessions, spaced at six week intervals, are required in order to achieve maximum benefit.

Will my scar improve? Is there anything I can do to help treat it? (Photo)

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