Can microneedling work on indented forehead scar that was caused by a fall? (photo)

Question

I went to another doctor previously and he refused to do subcision for me. He repeatedly did CO2 laser only. Is he right?

Nelson Lee Novick, MD · Answer

To improve indented scars from all causes, the object is to elevate it and smooth it as much as possible. Subcision, which I have been performing since 1995, is an excellent method for elevating and smoothing indented scars from all causes, including those from trauma. Professionally performed manual microneedling (no need for the additional risks and expense of RF microneedling) is best reserved for helping to treat very superficial color and texture irregularities--i.e. to blend the surface of scars better with the surrounding normal skin. It's more of a final "polishing" step and would not legitimately be expected to do much for deeply indented scars. CO2 lasers are also best for resurfacing. So, I very much think that both subscision to elevate and smooth and afterward professional manual microneedling for "polishing" would be very appropriate ways to proceed. Hope this helps and best of luck.

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

Harold J. Kaplan, MD · Answer

Hello TW.  We would use subcision with filler for your scar.  Although fractional laser resurfacing is a good option, in many cases it can be limited in the amount of "lift" created, rather it helps with surface texture.  We would use a product like Restylane with the subcision.  See link, middle of first row with circles on the cheek for similar.

Anna Chacon, MD, FAAD · Answer

Microneedling is a procedure that uses tiny needles to prick the skin. This treatment generates new collagen and skin tissue for smoother, firmer, more toned skin. It is mainly used on the face and may treat various scars, wrinkles, and large pores.Microneedling can be effective for indented scars as it can stimulate collagen production, which can help to fill in the scar over time. However, the depth and severity of the scar will play a role in how effective microneedling is.As for your previous doctor's decision to use CO2 laser instead of subcision, it's hard to say without knowing the specifics of your case. CO2 lasers can be very effective in treating scars by vaporizing the top layers of skin to promote new skin growth. Subcision is another method to treat scars that involves breaking up scar tissue, but it might not be suitable for all types of scars or all patients.

Jen Pfleghaar, DO · Answer

Microneedling with RF can we very helpful with scars. Also sometimes natural fillers like prf can also help!

Kristin J. Tarbet, MD, FACS · Answer

Hi there, microneedling is a great option and less invasive than the CO2 laser. 
Microneedling is great for scar revision. In fact, the microneedling device we use, the SkinPen, was first FDA cleared specifically for acne scarring/scars. Multiple treatments are recommended (3 treatments- one month apart to start), depending on the severity of the scar. Remember, it's a process that takes time to rebuild more collagen and elastin (an average of 4-6 months) to start seeing the results.

Can microneedling work on indented forehead scar that was caused by a fall? (photo)

Answers (6)

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