I have a pitted chicken pox scar on my forehead. I would like it to be removed. What is the best way to do so? (Photo)

The gold standard for depressed, pitting and even crater-type acne, chicken pox, and similar indented scars is dermabrasion (not micro-dermabrasion) whereby the skin is sand down with a diamond tip burr to the deeper layers leaving a raw surface for about a week before new smooth skin regenerates. Note, this procedure should only be done by a trained surgeon in an operating room not a nurse nor a technician in a spa setting.Once your wounds are healing then scar therapy may be considered. Although the results of scar therapy vary from person to person and scar to scar, the results are typically permanent.Not infrequently potential patients avoid surgery because fear of an unsightly scar. To remedy this, I now utilize and formulate compounded topical creams to treat, relieve and minimize scars for each of my patients:• new scars• old scars• surgical scars• keloid scars• stretch marks• hypertrophic scars• hyperpigmented (dark) scars• various acne scars, burn scars and more...These scar removal creams contain prescription strength medications each individually known to reduce and/or reverse the scarring process but never before compounded together into one high potency formulation. These medications are added to a base of anhydrous silicone (the most common ingredient in everyday topical scar therapy) and Pracaxi oil, found in the Amazon rainforest and known for its anti-inflammatory, antioxidant, antibacterial, and antifungal properties. Many health insurance plans actually cover the cost of the creams and they can be delivered directly to the patients door step. In other words, no need for multiple trips to the doctor for expensive and painful laser treatments, or wasted money on minimally effective over-the-counter topical scar therapy gels or silicone sheets that are unsightly and/or fail to stay on. Instead, with just two applications a day my patients now perform scar therapy in the comfort of their own home. Glad to help.

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 been 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 laser 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

I find the best treatment for these types of scars is scar revision.  The issue with chicken pox scars is the contour deformity (depression) in the skin.  That's what catches the eye as being unsightly.  While laser resurfacing can improve the scar, it won't totally fill in that depression.  Facial fillers such as Restylane or  Juvederm can work well but these are temporary treatments that will need to be repeated.  If you can excise the scar totally (including the depression), the resulting scar is usually significantly better.  Oftentimes, scars (especially in the forehead) can be hidden in a natural skin crease.  I would urge you to go in for a consultation to discuss your particular case.  Good luck!

Your chicken pox scar can be improved with a few different options. I would recommend laser resurfacing as the best option because this can lead to the most reliable and permanent improvement with minimal risks (in the hands of a well trained laser expert). Fillers can also plump the scar up but would only lead to a temporary correction. Lastly, the lesion can be surgically removed but you would trade the pox scar for a linear surgical scar. 

The most straightforward way to remove this would be to simply excise it with the long axis of the scar paralelling the natural wrinkle lines. The reason why chicken pox scars tend to be noticable is that shadows form in them because they are depressed. A revised scar is still a scar, but it will be in the same plane as the remainder of your skin and will be less noticable.