Is this scarring from a biopsy or could it be something else? What treatment options are available? (Photos)

Question

About three years ago I had a punch biopsy on my nose for a spot that was there. The pathology came back benign and noted a fibrous area. Over time the area around the scar has appeared more raised and almost puffy looking or like there is something else under the skin. Is this just scarring or could there be something else going ok. I am concerned that it appears like a growth of some sort. Are there any suggestions for what this is and also treatment options.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your history and photos. It’s completely understandable to be concerned when a scar changes over time, especially in a visible area like the nose.

From what you describe—a punch biopsy three years ago, a benign fibrous result, and now a raised, puffy area—it’s possible that what you’re seeing is a hypertrophic or firm scar, which can occasionally become more raised or thickened over time. Scar tissue can continue to remodel for months to years, and in some cases, it may feel like there’s something “under the skin.”

Other possibilities, though less common, could include:

Dermal cysts or small benign nodules forming in the area
Fibroblastic growths such as keloids (though these are less common on the nose)
Very rarely, recurrence of the original lesion (though this is unlikely given the benign pathology)

Treatment options for raised or puffy scars can include:

Topical therapies: Silicone gels or sheets to flatten and soften the scar over time.
Injectable treatments: Steroid injections can help reduce thickness in hypertrophic scars.
Laser therapy: Certain lasers can improve texture, redness, and firmness of scar tissue.
Minor surgical revision: In select cases, carefully excising or revising the scar may be an option to improve appearance.

It’s important to evaluate the area in person to confirm that the raised area is scar tissue and to rule out any other underlying growths. Even though your biopsy was benign, changes over time should always be assessed to ensure the safest and most effective treatment.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. 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 discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Is this scarring from a biopsy or could it be something else? What treatment options are available? (Photos)

Answers (2)

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