How can I remove the stitch mark on my forehead? (photo)

Question

I got an accident. When I was in 9 years old. Then I got stitch on my Forehead. Now that became a problem to my proffesion. How can I remove that stitch mark??

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Unfortunately, I must start off by saying that as of now, there is still no way to totally erase any kind of mature (greater than three months old) scars, whether resulting from trauma or any other cause, for that matter. That having been said, there are ways that scars may be improved and made less visible. From the photo, it appears that there are two main aspects that need to be addressed. One is the depths of the main scar and of the stitch ("railroad") tracks. The second is the persistent reddish color. Subcision lifting of both the linear portion of the scar and f othe  tracks can help to deal with the indented elements of the scars. Once this is improved, microneedling (aka fractional microneedle resurfacing) can be used to better blend the surface tone and texture of the treated regions with the surrounding normal skin. Referring specifically to post inflammatory erythema, i.e. redness (PIE), in the November issue of Dermatology News, a dermatology trade journal, one expert wrote, " ...microneedling has also been effective in reducing PIE.... microneedllng induced skin tissue injury and neocollagenesis have been shown to clinically improve the abnormal vascular proliferation that occurs in PIE."

Make sure to consult with a board certified aesthetic physician.  Best of luck.

Jonathan Zelken, MD · Answer

Dear badusha,

I imagine you are now a grown-up if you are having problems with your profession. I see a widened, hyperemic scar with "train tracks". The forehead generally heals well. The orientation of the scar makes it tricky to conceal the scar in lines of relaxed tension, but a simple excision and closure with buried suture, or fine permanent suture taken out within a week, should serve you well. I really wish you the best - you should be happy. Seek the help of a skilled plastic surgeon.

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