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Scarring from blackheads/acne. Would a punch excision help? (Photo)

L
lacrymosa777Jul 8, 2022

Backstory about 4yrs ago i had a blackhead that left a hole in my forehead and refused to close. After microneedling, tca chemical peels, tretinoin, etc. Nothing has changed I was recommended a punch biopsy by my old derm if everthing else fails but my new derm won't do it since its on a very noticible part of my face and thinks the scar from that might be worse. They refered to do cosmetic consult but appts are till the end of the year. Now I think I should just do the punch? Other recs?

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Dr. Nelson Lee Novick, MD
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Dr. Nelson Lee Novick, MD
Dermatologic Surgeon, Board Certified in Dermatology
4.7 | 119 Reviews
Answered on Jul 10, 2022
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Nelson Lee Novick, MD

At least from the photos provided, the predominant issues are ice pick scars and dilated pores. If this is indeed so, then TCA CROSS, rather than subcision (best for boxcar/rolling scars) would be indicated. TCA CROSS, which was developed in South Korea over two decades ago, is also safe as well...

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Nelson Lee Novick, MD

Punch excision of indented scars, which is a form of surgical removal followed by stitching, runs the real risk for the subsequent development of stretch scars and even tram track stitch marks, especially when performed in areas under tension or subject to a great deal of movement. I have a...

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Raffy Karamanoukian, MD, FACS

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...

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Nelson Lee Novick, MD

So sorry for your distress. As any reader who follows my posts would know, I gave up doing punch excisions many years ago, precisely because very often, particularly in areas subject to muscular tension or movement, such as the cheeks, they often result in unsightly stretch scars (and not...

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Jason Emer, MD

Punch excision followed by laser would be best, you need co2 and then long term halo with TCA cross. at home peels like cosmelan, enlighten and aerify along with dermarolling (Emerageskin roller with anteage MD AERIFY ampules weekly) should be started now (see link to emeragecosmetics). if y...

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Jason Emer, MD

For chickenpox scars, I recommend a combination of lasers, subcision and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

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