Sometimes, my forehead scar is bumpy and very noticeable. At other times, it is less noticeable and flat. My goal is for it to look flat in accordance with the rest of my forehead. What would be the best scar removal treatment for this?
Best Procedure to Minimize Forehead Scar Appearance?
Doctor Answers 1
Scar Revision: Replacement of a bad scar with a better scar
On review of the photograph, my guess is that the scar may have been traumatic in origin. The scar is oblique, traversing relaxed skin tension lines (which are horizontal in the forehead) and appears to be hypertrophic (wide and red). Given your more pigmented skin type (type 4 Fitzpatrick), the possibility of hyperpigmentation with a technique such us dermabasion is higher. I would need to see more detailed photographs before giving a defiinitive opinion. In many circumstances, scar revision is a multi step process and generally means that we would be trading a bad scar for a better scar.
However based on what I see from the initial photograph and assuming the scar is over a year old, I would suggest excision of the scar under local anesthesia with an attempt to reorient the incision horizontally (parallel to relaxed skin tension lines). I always reserve selective dermabrasion at a later date in the event of any uneven areas. Prior to doing this, I would pre-treat you with 4% hydroquinone cream (to minimize chances of hyperpigmenatation) in additon to strict sun avoidance (SPF 30 or greater).
I hope this is helpful to you. Best of luck Blue 123.