What's the best treatment for papular/hypertrophic acne scar on nose? (Photo)

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Bleomycin, a chemotherapeutic agent, has been effectively used off-label in dermatology for treating various skin lesions, including papular scars on the nose. The advantages of using bleomycin for such scars include:
Effectiveness in Scar Reduction:
Bleomycin works by inducing apoptosis (cell death) and fibrosis modulation, which can help flatten and smoothen raised papular scars.
Non-Invasive Administration:
Bleomycin can be delivered via techniques like intralesional injection or microneedling, which are less invasive compared to surgical methods.
Minimal Systemic Side Effects:
When used in localized low doses, bleomycin carries a low risk of systemic side effects, making it relatively safe for small, targeted areas like the nose.
Targeted Action:
The medication is highly effective in targeting abnormal fibroblast activity in scar tissue, thereby improving the texture and appearance of the skin.
Alternative for Resistant Scars:
Bleomycin is often effective for scars that do not respond well to other treatments such as corticosteroids or laser therapy.
Cost-Effective:
Compared to some laser treatments or surgery, bleomycin is a more affordable option for managing papular scars.
No Downtime:
The procedures associated with bleomycin typically have minimal recovery time, allowing patients to resume daily activities quickly..
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