3-year-old hypertrophic scar - I've tried massage and silicone gel, what are the best treatment options for my scar? (Photos)

or a 3-year-old hypertrophic scar, especially in a sensitive area like behind the ear, there are several treatment options that could be considered:

Laser Therapy: CO2 laser treatment can be effective in reducing the thickness and improving the texture of hypertrophic scars. It works by resurfacing the skin and promoting new collagen formation, which can help flatten the scar and improve its appearance.

Pulsed Dye Laser (PDL): This specific type of laser targets blood vessels in the scar tissue, which can help reduce redness and size. It’s often used for hypertrophic scars and may be less aggressive than CO2 lasers.

Cryotherapy: This involves freezing the scar tissue, which can help reduce its size. It is sometimes used in combination with other treatments like steroid injections.

Pressure Therapy: Specialized pressure garments or dressings can help flatten hypertrophic scars over time, though they are more commonly used for larger areas.

Steroid Injections: While your doctor advised against steroid injections due to the risk of cartilage deformation, in some cases, very carefully administered injections might still be an option. It's crucial to weigh the risks and benefits with your dermatologist.

Radiotherapy: This is less commonly used but can be effective for stubborn hypertrophic scars. It is usually considered after other treatments have not been successful.

Surgical Options: In some cases, surgical revision might be considered, especially if the scar is causing significant discomfort or functional issues. This approach is often combined with other therapies like lasers or steroid injections to prevent recurrence.

Since pain is a significant concern, addressing nerve involvement or irritation through these treatments might also help alleviate discomfort. It's advisable to continue consulting with your dermatologist or a specialized skin therapist to explore these options and tailor a treatment plan specific to your needs and the characteristics of your scar.

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