35% TCA Peels for Raised Hypertrophic Scar?

Question

Does 35% TCA peels help the little raised hypertrophic scar on my cheek? It was treated by Fraxel Laser for 6 times but only with a little improvements and it is softer now.

Jeffrey Zwiren, MD · Answer

A TCA peel of any strength will not improve a hypertrophic scar. Proper treatment of this area and scar require an accurate diagnosis. If this is truly a hypertrophic scar and not a keloid then the treatment could be quite different. It is somewhat unusual to develop a hypertropic scar on the cheek. If the scar is continuing to grow, itches and actually destroys normal skin then it is a keloid. If it is a hypertrophic scar then a scar revision may be an option. It depends upon the direction of the scar. If the scar goes perpendicular to the lines of relaxed skin tension then some consideration could be made for procedures such as a Z plasty or W plasty. These are surgical techniques that can be used to change the direction of a scar into a more favorable position.

Bryan K. Chen, MD · Answer

I agree wtih Dr. Sikorski that TCA peels or any chemical peel for that matter are not appropriate for treating hypertrophic scars and may even make the scar worse.  Cortisone injections and laser/light devices such as the pulsed-dye laser can be helpful.
Good luck.

Lenore Sikorski, MD · Answer

Hypertrophic scars can be treated by vascular lasers and by injections of kenalog or 5 FU and topical cortisones and silicone gel sheeting. TCA peels are not considered standard of care for treatment of scars.

35% TCA Peels for Raised Hypertrophic Scar?

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