What is the best scar removal procedure for my nose piercing and acne scars? (Photos)

Question

I have a scar from old nose piercing as well as some small battle scars and acne I’m extremely insecure about my skin what would be the best procedure?

Raffy Karamanoukian, MD, FACS · Answer

Piercing scars on the nose and face can be improved with a combination of subcision and TCA Cross to reduce the indentation. Best, Dr. KaramanoukianRealself100 Surgeon

Jason Emer, MD · Answer

Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we alreayd pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Michael Kulick, MD, DDS · Answer

From your pictures, the best way to remove your nasal piercing scar is through a scar excision. For your acne, it looks like you still redness of these acne scars. Trying to treat scars with active acne in my experience is not good. You may need to be treated withe a "Blue Light" or ALA. Once your acne is under control, you would need to be evaluated to see which options are best for you. The link below will show you how laser resurfacing and subcission worked for other patients. Best Dr. K San Francisco

Theodore Harrison, MD, MBA · Answer

I agree that microneedling with PRP would probably be the first thing you would want to try for the acne. For the nose a few treatments with intradermal and/or subcutaneous PRP might get that to fill in. Either of these will tale a few treatments
If you are needle averse then treatment with an Aerolase Neo laser would also work for the acne.

Adam E. Singleton, MD · Answer

For scar treatment, usually a combination approach is required to get the best results, as there is no magic bullet treatment. Deep scars, like pockmarks sometimes can be treated with subcision followed by injectable filler and laser resurfacing. Other times complete excision or removal of the scar is required. If the scar from your nose piercing is still able to fit your earring through it, it may need to be excised as well. Resurfacing procedures like fractionated CO2 laser or chemical peels can help the appearance as well. Best of luck
-Dr. Singleton

Kristine Brecht, MD (license suspended) · Answer

Dear BG,Thank you for sharing your photos.Acne scars and other facial scars can be challenging to completely get rid of, but microneedling with prp will help a lot. The more treatments the better over time. Hydrafacial MD will help with acne prone skin. Spf 30+ daily.Best. Dr Brecht Seattle, Wa

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