Dent after treating keloid with steroid injections. Which procedure can be used to correct this? (photo)

Question

I had a keloid on my nose from a piercing. My dermatologist used steriod injections, now there a hole where the keloid was. I don't know exactly what procedure I need to get but I need this fixed. What procudure can fix this ?

Nelson Lee Novick, MD · Answer

The repeated use of saline injections has proven helpful in breaking up any residual steroid crystals that may be responsible for the atrophy and the simple act of repeated injections may itself induce new collagen and elastic fiber synthesis to elevate and smooth the depression. I must say I am a bit puzzled by the need to query the RealSelf group when you already have a dermatologist. If, however, you are no longer comfortable with him/her, it would be reasonable to seek the services of a board certified cosmetic dermatologist with whom you can continue your care. Best of luck & Happy New Year.

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

Jeff Rapaport, MD · Answer

In my opinion, saline injections would be the first step. Should that not be helpful, Subcision with PRP would be my treatment.  Multiple sessions are needed. Find a scar expert.
Jeff Rapaport MD 
Realself Hall of Fame

Dent after treating keloid with steroid injections. Which procedure can be used to correct this? (photo)

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