Any options for minimizing nostril piercing scars? (photos)

Question

Hello! I had both of my nostrils pierced back in 2021 and had them in for around five months. They never healed properly. On one side, I have an indented mark, not a hole—on the other, there is a slightly raised bump. I’ve become really self-conscious regarding them ;( As of right now, I’m planning on starting a retinal to help with skin cell production, which probably won’t do much, but at least it is something. Any in office procedures that might help? Micro needling, lasers, chemical peels?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and photos. It’s common to have persistent scarring or bumps after a piercing, especially if the area didn't heal well initially. Based on your description and the images, you appear to have two different types of scars: an indented (atrophic) scar on one nostril and a raised bump (likely hypertrophic or a small keloid) on the other.

Here are some treatment options that may help:

1. For the Indented Scar:

Microneedling: A great non-invasive option to stimulate collagen production and smooth out the indentation over time.

Chemical Peels (e.g., TCA): These can improve skin texture and tone, encouraging a more even surface.

Laser Resurfacing (Fractional or CO₂): Highly effective for atrophic scars. It encourages collagen remodeling and can improve skin texture significantly.

Topical Retinoids (like your retinal): Continue use as this helps stimulate skin turnover, though results are subtle and slow.

2. For the Raised Bump:

Steroid Injections (e.g., Kenalog): These are commonly used to flatten hypertrophic scars or small keloids.

Silicone Gel or Patches: Consistent use can help soften and reduce raised scars.

Laser Treatments (Pulsed Dye Laser or Nd:YAG): These can reduce redness, inflammation, and help flatten raised tissue.

Other Tips:

Be gentle and avoid picking or squeezing the area.

Always use sunscreen on scars to prevent hyperpigmentation.

Consistency is key — these treatments take time.

While at-home care can improve the appearance gradually, in-office treatments provide faster and more dramatic results, especially when targeted to your specific scar types.

Let me know if you need product recommendations or how to prepare before any of the above treatments.

Raffy Karamanoukian, MD, FACS · Answer

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

Nelson Lee Novick, MD · Answer

You would be wise to consult an experienced, board certified cosmetic dermatologist scar treatment specialist. The kinds of issues here are quite easy and quick to address. The title to this reply clearly explains how each of these simple issues can be treated in a matter of literally only a couple of minutes. Hope this helps and best of luck.

Any options for minimizing nostril piercing scars? (photos)

Answers (3)

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