Should I consider microneedling for a 1 month old depressed, atrophic scar? (photos)

Question

1 month old depressed (atrophic) scar on nose from my cat. How long should I wait before I consider microneedling or medical intervention?

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 had a patient last year with exactly the same situation: four weeks after a cat scratch to the nose. I explained to him that the ideal window for treating any imminent scar is between the end of week four (when the wound is strong enough to withstand treatment) and the end of week twelve (when the scar is considered "mature") after which only a sixty to eighty percent over-alll improvement from any treatment or combination of treatments can be expected. My patient was treated at the four week point with complete erasure of the expected scar. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. And be wary if offered any of the latest, "next big thing" expensive fraxel laser or RF treatments, as these are unfortunately lacking the hard science to support all the heavy marketing and social media buzz that promotes them.  Hope this helps and best of luck.

Kristin J. Tarbet, MD, FACS · Answer

Microneedling is a great option for scarring. The Skin Pen is our microneedling device of choice. It was the first FDA approved microneedling device for acne scarring/scars.

Should I consider microneedling for a 1 month old depressed, atrophic scar? (photos)

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Should I consider microneedling for a 1 month old depressed, atrophic scar? (photos)

Answers (3)

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.