Is it possible to treat this scar that is 3 years old? (Photos)

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 hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.


Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for sharing your history and photo. Even though your scar is now 3 years old and has progressed to a keloid, it is not too late to improve its appearance and symptoms. Scars like this can still respond to treatment, though older scars often require a combination approach for best results.

Treatment Options:

Steroid Injections: Corticosteroid injections are a mainstay for keloids and hypertrophic scars. They can soften the scar, reduce redness, and improve itchiness. Multiple sessions are often needed.

Silicone Gel or Sheets: Continuing with silicone can help flatten and soften the scar, even on older scars, and prevent further thickening.

Laser Therapy: Fractional or pulsed dye lasers can help with redness, thickness, and texture of the scar. These are often combined with injections for better results.

Surgical Revision: In some cases, removing the scar surgically followed by immediate postoperative care (steroids, silicone, or pressure therapy) can improve contour and appearance—but surgery alone without follow-up care can lead to recurrence.

Other Treatments: Cryotherapy or radiation are sometimes used in resistant cases, though typically after other methods are tried first.

Key Points:

While the scar is mature, it can still improve in texture, color, and symptoms with proper treatment.

Patience is important—keloid and hypertrophic scar management is gradual and often requires multiple modalities.

Early intervention with combined therapies usually gives the best long-term result, even for older scars.

You haven’t missed the opportunity—there are effective ways to help both the appearance and discomfort of your scar.

It is not too late to improve a keloid or hypertrophic scar. The use of a varying combinations, concentrations and amounts of intralesionally injected anti-inflammatory agents to shrink and flatten the scar is a good way to start and usually works after a series of three or four treatment sessions.
For more resistant scars, Scalpel Sculpting can be used to remove the bulk of the projecting scar, which can again be followed by intralesional injections to the base of the scar to minimize recurrence. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.