How can I remove an atrophic scar on the nose from injury? (Photos)

Question

The scar was formed as a result of an injury in August. After the wound healed, a hole formed. Under certain lighting, the depression looks worse with shadows cast over it. I have tried laser 4 months after healing but in vain. I also did collagen injections, but to no avail. What options do you think I have in order to hide/remove this?

Nelson Lee Novick, MD · Answer

No surprise that the laser treatment didn't work. I have been cautioning readers for years that relatively expensive fraxel laser and RF treatments are backed far more by heavy marketing than any hard science. Subcision, a simple and relatively inexpensive technique for elevating and smoothing all kinds of indented scars (from injury, as in this case; acne; chickenpox, etc.) has a nearly three decades track record for safety and efficacy. Make sure to consult with a board certified cosmetic dermatologist and ask to see his/her personal before and after subcision photos before agreeing to proceed. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question and photographs. It's difficult to evaluate your skin through this type of forum, but from what I can see, it looks like you have atrophic scarring. If laser therapy and collagen injections failed, then other treatment options include injectable fillers or scar revision. I highly recommend you consult with a board certified dermatologist or facial plastic surgeon to have your scar evaluated and to discuss appropriate treatment options. Take care and good luck.

How can I remove an atrophic scar on the nose from injury? (Photos)

Answers (3)

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