Thickened Scarred Skin After Dermabrasion on Cheeks. 1.5 Years Post Op. Not Sure What to Do?

Scars, or excess fibrous tissue, can result from trauma, persistent deep-seated inflammation (as can occur with acne cysts), or surgery, including dermabrasion.

Hypertrophic scars and keloids are scars that project above the skin surface. (Atrophic scars are depressed below the skin surface). Hypertrophic scars, also known as "proud flesh" tend to grow upward but remain confined within the borders of the injured  or surgical area. Keloids likewise project upward, but owing to their hyperproliferative tendency, tend to grow well beyond the confines of the initial site of damage. Both kinds of scars may be itchy, tender and reddish, especially in their initial stages.

Both kinds of elevated scars can be treated via injection of an anti-inflammatory agent, most commonly triamcinolone acetonide suspension. The precise dosing and frequency of treatment can best be determined after examining the scar and gauging response to therapy.

Since the surface of scar may eventually turn off-white or ivory-colored in appearance, even after they are flattened by the injections, a series of fractionated medical microneedling treatments may be tried to help even out the coloration. Home rollers, since they typically contain far fewer needles and much shorter length needles (as compared to the rollers used by physicians), tend not to be particularly helpful. I have pesonally found the use of tyrosine, a substance involved in the production of melanin, to be beneficial when applied in conjunction with the medical microneedling treatment.

 

It sounds like some of the treated areas became hypertrophic which means raised and thickened. Often times, intra-lesional injections of cortisone can improve this significantly. I do not think topical RetinA is going to do much.