How can I improve my skin texture/hypertrophic scars on chin? (Photo)

Question

I developed this skin texture after years of struggling with fungal and cystic acne. Saw a derm last yr who told me it was sebaceous hyperplasia and I had 2 Agnes RF treatments which improved indented scars on my cheeks but didn’t do anything for texture on my chin and around mouth area. The raised bump on my chin feel like thick skin underneath when I touch them. I think they are hypertrophic scars maybe. What is the best treatment for these? Steroid tape/injections or laser? Isotret?

Nelson Lee Novick, MD · Answer

At least from the photos, you appear to have what have come to be called papular acne scars, a kind of acne hypertrophic scars that characteristically appear as small bumps most often on the chin and the nose. They are often confused with sebaceous hyperplasia, but are unrelated to the latter. I have had gratifying results treating these by the use of scalpel sculpting to make the bumps flush with the surrounding skin or flattening them with light electrocautery or via intralesional injections of antiinflammatory agents, the way one would typically treat larger hypertrophic scars. Before selecting treatment, I typically one lesion as a test site for each treatment modality in order to determine which modality yields the optimal result. Going forward you would be wise to consult with an experienced cosmetic dermatologist acne scar specialist. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jeff Rapaport, MD · Answer

Your bumps are hypertrophic papular scars. Treatment should start with diluted steroid injection with 5 FU. Silicone tape at night will be helpful. Should you need additional treatment,  Fractionated Co2 laser is indicated. Isotretinoin is not useful.
Find a scar expert. 
Jeff Rapaport MD FAAD 
Realself Hall of Fame

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

How can I improve my skin texture/hypertrophic scars on chin? (Photo)

Answers (4)

Answer: Acne Scarring -- Needs Combination of Subcision; Fillers Like Bellafill; Lasers Like Fraxel/Erbium/CO2; TCA Cross; Fractora RF

Answer: Acne Scarring -- Needs Combination of Subcision; Fillers Like Bellafill; Lasers Like Fraxel/Erbium/CO2; TCA Cross; Fractora RF

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How can I improve my skin texture/hypertrophic scars on chin? (Photo)

Answers (4)

Answer: Acne Scarring -- Needs Combination of Subcision; Fillers Like Bellafill; Lasers Like Fraxel/Erbium/CO2; TCA Cross; Fractora RF

Answer: Acne Scarring -- Needs Combination of Subcision; Fillers Like Bellafill; Lasers Like Fraxel/Erbium/CO2; TCA Cross; Fractora RF

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Everything you need to know about Agnes RF

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