How to Permently Remove Very Shallow Linear Scars in Face? (photo)

Question

I recently discovered 3 linear scars on my left cheek and one on my right check. About 14 months ago I had my son. So maybe there's a link between me losing weight and these scars. Everyone I talk to tells me microdermabrasion or chemical peels. However, I want something permanent. 3 weeks ago, I decided to purchase a microdermabrasion diamond tome package at a spa. A week after, I broke out and now my skin is just starting to clear up. My question is, what can I do?Does microderm work for scar

Nelson Lee Novick, MD · Answer

Microdermabrasion, as the name implies, is any procedure that very superficially mechanically abrades the skin. Aluminum oxide crystals, synthetic diamond particles, brushes of all kinds, etc. have been used for this purpose for a number of years. The effect is not much different than if you vigorously used Buf-Pufs, Loofah sponges, Clarisonic brushes, or even a vigorous scrub with a wash cloth or gauze pad. For this reason, I find them best for refreshing the skin and giving it a glow. I would not rely on it for treating true scars, which run deeper in the skin. I have no objections to microdermabrasion for anyone seeking a pampering, spa-like treatment experience, but not for those with scars.

	In that same vein, a series of fractionated laser treatments are perhaps slightly more effective in this regard than microdermabrasion. However, here too, in my experience, the results are far from dramatic and often disappointing to patients expecting more from their treatments and economic outlay. (Ablative carbon dioxide laser treatments, on the other hand, are aggressive and can rival true surgery with potential series consequences and prolonged downtime and healing times; these should not be confused with the milder fractionated laser treatments and are best employed when serious skin resurfacing is required).

	On the other hand, subcision can be effective for permanently elevating depressed scars of various types. Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression.

	Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent.

	Fractional microneedle therapy aka medical microneedling works by creating numerous areas of controlled microwounding that set off in turn a cascade of events that result in new, native collagen synthesis, which translates into healthier, thicker skin that improves the appearance of the underlying scars. 

	Of course, consultation with a board certified aesthetic physician who is skilled and experienced in all these modalities and who can create a treatment plan for all skin problems present is the best way to ensure that all your needs will be addressed properly and most cost effectively.

Raffy Karamanoukian, MD, FACS · Answer

This is a very difficult problem, but I have seen some very positive results with the fractional co2 laser using topographic skin resurfacing (TSF). Raffy Karamanoukian Los Angeles

Robert L. Kraft, MD, FACS · Answer

Whatever you purchase over the counter isn't going to do much of anything. Dermabrasion may be beneficial but it isn't called "micro" without reason. Scars usually don't develop on their own; I would recommend that you see a board certified dermatologist who can evaluate if there is any underlying condition which could be treated.

How to Permently Remove Very Shallow Linear Scars in Face? (photo)

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