What can I do for this pyramid shaped acne scar on my nose? (Photo)

Question

I really don't know what to do anymore this acne scar right on the tip of my nose is making me very insecure. I use 0.1 Tazaratone and have been trying micro needling. I feel that it might have helped a bit but I really don't know what to do anymore.the scar seems to constantly change as in get better to the point I think it might go away then come back as prominent as before. I can't find any treatments that are for my scar type and placement what o you guys recommend I feel hopeless

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented  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 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 lasers 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 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

Nelson Lee Novick, MD · Answer

I have been performing subcision since 1996 for elevating and smoothing all kinds of indented scars, especially those resulting from acne. It is a relatively inexpensive technique that has proven safe and effective for this purpose for well over three decades. 
Microneedling was unlikely to have been of much benefit, since it is best reserved as a final "polishing" step for blending the treated scar better with the surrounding normal skin AFTER subcision has elevated the base of the scar. Likewise, topical retinoids, like tazarotene are best reserved for skin maintenance and promoting new collagen and elastic fiber synthesis in the skin, but is not particularly effective for initial direct initial treatment of scars. So, unfortunately, no real surprises at the lack of success with either of these approaches.
You would be wise to consult with an experienced, board certified cosmetic dermatologist acne scar specialist. Be wary when being hawked all kinds of expensive, so-called "next big thing" fraxel laser or RF treatments being hawked out there as these "bells and whistles" are often "here-today-gone-tomorrow." Hope this helps and best of luck and don't despair..

What can I do for this pyramid shaped acne scar on my nose? (Photo)

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What can I do for this pyramid shaped acne scar on my nose? (Photo)

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