What is the Best Route to Remove This Chicken Pox Scar? (photo)

Hi Ramil.  You have a few different options, but the one we would try first is fractional laser resurfacing.  If you try cutting the scar out you are trading one scar for another.  If you try fractional resurfacing you can improve the texture without resigning yourself to another surgery scar.

Two options: Fractional co2 laser to resurface the scar without further cutting; Surgical scar revision to remove the scar and replace it with a linear scar from the surgery. Raffy Karamanoukian, Los Angeles

Just twenty minutes ago, I treated one of my patients for a depressed acne scar  on the lower right cheek in the following manner with nearly complete immediate smoothing of the surface of the scar.

Subcision, a procedure, performed under local anesthetic, that entails using a sharp needle-like device is first inserted to break up the scarred, heavily fibrotic tissue that makes up the base of the scar. Immediately following, a small amount of volumizing material is injected into the potential space just created by the prior procedure. An immediate lifting is seen and the area can be smoothed flush with the surface resulting in the immediate, gratifying improvement seen. As an added plus, six to eight weeks later, neocollagenesis (new collagen formation) occurs in response to both the subcision procedure and the presence of the volumizer--contributing to a  much longer lasting improvement. The entire procedure takes no more than five minutes to perform, requires no scalpel cutting or stitches and entails no significant downtime.

 

Your scar is larger than many chicken pox scars, and moderately atrophic. Punch excision is a reasonable option when other alternatives have failed.

I, too, would recommend (fractional) Fraxel laser resurfacing. It won’t remove the scar completely, but can help blend it and reduce the contour depression. Fraxel laser resurfacing may provide enough improvement that you will be satisfied without surgery.

I would prep your skin with a bleaching agent (ex: 4% hydroquinone) prior to the laser procedures to reduce the risk of post-inflammatory hyperpigmentation; this will suppress pigment formation to reduce the risk of pigment darkening in the area following resurfacing. Sun protection, during the treatment period is also worthwhile for the same reasons.
Best wishes.

The answer is simple- filler for this depressed scar. You will require only one session for at least a 50% improvement in this chicken pox scar. Since your post many years ago, new fillers such as Bellafill have been invented. This has changed the way we manage acne and atrophic chicken pox scars such as these. Filling for scars in this area is low risk, and takes only a few minutes. See a board certified specialist for treatment, All the best Dr Davin Lim Laser and aesthetic dermatologist. Brisbane, AUSTRALIA.