What treatment would you recommend to remove the scar on my face? PRX T33 or microneedling? (Photo)

Question

Hello, I need help figuring out which treatment would help most with an old scar on my face since middle school, not sure if it is from chickenpox or something else as I don't remember. I am thinking about PRX T33 or micro needling or both combined.

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

Jason Emer, MD · Answer

Depressed scars can be improved with vascular lasers like Yellow laser, BBL, or Excel V when they are red --- and with CO2 spot treatments, fillers, microneedling with PRP, and subcision to help with texture and blending. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

Before jumping to the supposedly latest and greatest expensive laser or other "bells and whistle" device, it might be wise to investigate subcision, which I have been peforming for elevating and smoothing chickenpox scars  (as well as boxcar and rolling acne scars) since 1994.  Subcision has a proven track record of safety and efficacy in all skin types and typically engenders little to no significant downtime following treatment. Professional medical microneedling, which I have also been performing for over two decades, is best reserved for "polishing" and better blending the aforementioned treated area with the normal skin surrounding the scar; it is not a particularly good stand-alone procedure. Make sure to consult with an experienced, board certified cosmetc dermatologist and not just any venue hawking the latest expensive toy it has just purchased. I hope this helps and saves you lots of time, money and disappointment. Best of luck.

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