Looking to get a fibrous papule removed. Which method would cause the least amount of scarring?

Question

I have a small fibrous papule on my nose which is about 2mm in circumference. I’m doing my research and I see that there are a few different methods for removal: shaving, excision, laser, etc. Which method would be least likely to leave a scar, or have the smallest amount of scarring?

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist. Often papules or glands can be treated in-office with a simple procedure. Focused Co2 laser is a good option for papules, but I have had great success also with radiofrequency and electrosurgery ablation.  Both are done quickly in the office, with little downtime and almost no pain or scarring. Best, Dr. Emer.

Michael Cohen, MD · Answer

Dear Kuros456,
it is difficult to say without a medical history and at least a photograph or a physical examination.  Has your skin lesion been evaluated by a board-certified dermatologist?  If not, I recommend that you start by doing that. They will then be able to assess who is best qualified to remove the lesion, depending on what type of lesion this is.  If a dermatologist is not available, then see either a facial plastic surgeon or a plastic surgeon.  Hope this helps.

Monika Soni, MD · Answer

Thank you for your question! My preferred method of removal is with a laser, but the best results will be with whatever your doctor has to most experience with and is most comfortable using.  Find someone who has experience and whom you trust.  Best of luck!

Amy Miller, MD · Answer

Whenever something is removed from the skin there is the possibility of scarring.  Shave or excision will leave a small, probably indented mark.  Certain ablative lasers can be very precise and minimize marks.  A lot of it has to do with the skill of the operator and the spot size and energy setting of the laser.  Often with a laser removal you can get a smooth, level scar but it may be hypopigmented (leave a white spot) because the melanocytes or pigment producing cells are injured in the removal process.
My preferred method of removal is with a laser, but the best results will be with whatever your doctor has to most experience with and is most comfortable using.  Find someone who has experience and whom you trust.  Best of luck to you!
Dr. Amy

Looking to get a fibrous papule removed. Which method would cause the least amount of scarring?

Answers (4)

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