Would a chemical peel or laser help with chickenpox scars on my nose? (Photo)

Question

I have had some chickenpox scarring on the bridge of my nose since I was a child. Would a strong chemical peel like TCA peel help reduce the appearance of these scars. Or would treatments like lasers, microneedling, etc be preferable?

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic skin in Chicago.  That’s an excellent and very realistic question — chickenpox scars can be surprisingly stubborn, especially on the bridge of the nose, where the skin is thin, sebaceous, and heals differently than other areas.  medium-depth or strong TCA peel (20–35%) can: Smooth superficial texture irregularities, Fade pigment around scars, Give mild tightening of very shallow depressions. However, TCA peels cannot fill or significantly raise true atrophic scars, because they act mainly on the epidermis and upper dermis. There is a specialized technique called TCA CROSS (Chemical Reconstruction Of Skin Scars): Uses high-strength TCA (70–100%) placed only inside the individual scar with a fine applicator. Causes controlled collagen remodeling and gradual filling in of pitted scars. Typically done in 3–6 sessions spaced 4–8 weeks apart. Works very well for ice pick or small boxcar scars, including chickenpox scars.

Anna Chacon, MD, FAAD · Answer

Chickenpox scars, especially when longstanding, can be challenging to treat because they are often deeper, pitted scars. A strong chemical peel, such as a TCA peel, can help resurface the skin and improve overall texture, but it typically offers only modest improvement for deeper scars.

For more noticeable results, fractional lasers (such as CO₂ or erbium), microneedling, or a combination of treatments are generally more effective in stimulating collagen remodeling and improving the depth of these scars. In some cases, subcision or fillers may also be considered, depending on the scar type and depth.

In short, while a TCA peel can help with texture and pigmentation, advanced modalities like fractional lasers and microneedling are usually more effective for chickenpox scars, particularly on the nose where the skin is thicker and scars are often more resistan

Falguni Patel, MD, FACOG · Answer

Microneedling might be a better option for the scaring! You will need multiple sessions of microneedling to help smooth out the scarring. After that, you can go in a do a chemical peel to help with any hyperpigmentation from the scaring.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Shanthala Shivananjappa, MD · Answer

For chickenpox scarring on the bridge of the nose, treatments like submission, lasers, microneedling, and chemical peels can all be considered. However, in my humble opinion, the Ultraclear Laser offers several different modalities, including laser coring, which I have successfully used for similar types of scars. This laser is precise and safe, allowing for targeted treatment of the scar tissue. I recommend using the Ultraclear Laser for the best results.

Nelson Lee Novick, MD · Answer

Strong chemical peels of any kind, just like other destructive technologies, such as lasers, runs the risk of scarring and dyspigmentation problems, especially in skin of color. RF microneedliing likewise runs this risk. Manual microneedling while an appropriate treatment for superficial, surface color and pigment irregularities is best reserved as a final "polishing' step after appropriate treatment for the scars has been performed.
I have been treating chickenpox scars--to elevate and smooth them-- since 1995--with gratifying results. The procedure, properly performed by an experienced cosmetic dermatologist typically engenders little to no significant downtime and since all the work is done below the surface of the skin, there is little to no significant downtime and little risk for complications of scarring or dyspigmnetation. 
Unfortunately, the problem these days is finding a physician experienced in performing subcision, since so many are into promoting expensive fraxel laser and RF treatments. Hope this helps and best of luck.

Would a chemical peel or laser help with chickenpox scars on my nose? (Photo)

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