Can these two chicken pox scars be removed? (photos)

Question

I have been having these two chicken pox scar since I was 18 , and I really like to fix them.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 acne 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

Nelson Lee Novick, MD · Answer

First let me emphasize that, unfortunately, no scar from any cause, whether acne, trauma, surgery or infectious from varicella (chicken pox) can be completely eliminated by any technique or device currently available if they are present for more than three months (i.e. are "mature" scars). Happily, however, we do have some simple and relatively inexpensive techniques available (and I don't mean expensive, heavily hyped lasers and radiofrequency devices), such as subcision, accompanied by the use of a biostimulatory filler for elevating the depressed portion of the scars and medical microneedling supplemented by the use of topical tyrosine and lanatoprost to enhance repigmentation. For more resistant scars, such as those with rigid scar walls or those in whom sufficient elevation of the base is not achieved, the additional use of a radiowaves can be used to create a gentler grade to the palisading walls of the scar and if short bursts are given under the surface via an insulated electrode can enhance the new collagen and elastic fiber production promoted by the subcision. Both types of procedures, unlike surgery, engender little to no significant downtime. I would be very reluctant to recommend surgical excisions, since not uncommonly the ultimate results of this approach are off-white or ivory-colored stretch scars, as well as the development of "railroad track"-like stitch marks--which was unfortunately precisely what I saw last week on a new patient who came to me who had had an excision done on his right and left cheek for acne boxcar scars by a plastic surgeon. For more information on subcision and microneedling, check out the archives of RealSelf.com, and be certain to seek evaluation and treatment by a board certified aesthetic physician. Best of luck.

Robert M. Tornambe, MD · Answer

David, I appreciate your concern. Chickenpox scars can be revised, however they require surgical excision and careful closure.  This is the best option  This usually greatly reduces the prominence and improves the situation. Come see me or another board-certified plastic surgeon in the area to review the best options for you. Good luck.

Michele S. Green, MD · Answer

These types of scars are more difficult to treat since they are wide and flat.  You can improve the scars by adding fillers and having PRP with microneedling.  Please consult an expert in scar treatments for the best cosmetic results.  Best, Dr. Green

Eric T. Carniol, MD · Answer

Dear David, I am sorry that these chickenpox scars are causing you issue. While no scar can be removed, they can usually be made better. There are many different possible treatments from subcision, filler, microneedling, dermabrasion, microdermabrasian, and laser. For the most improvement with the fewest sessions, you may wish to seek out a surgeon who performs subcision and filler. Depending on the feel of the scar, it may or may not need subcision, and then filler will additionally help with contour. I wish you the best of luck!

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