What procedure would I need for my hypertrophic scar? (Photo)

Question

So I’m trying to figure out what procedure I would need for my hypertrophic scar. I’ve injured my nose in the same place for the past 2 years. I first injured it in June 2022 then I injured it again in August 2023. There’s still a small bump over my nose and it’s not completely flat. Also the discoloration is very apparent and doesn’t look good as well as the texture. I just want to know if I should go the laser resurfacing route or the Laser scar removal route. Or maybe something else entirely.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Intralesional corticosteroid injections, particularly triamcinolone acetonide suspension, has been the gold standard of first line therapy for all kinds of lumpy scars, including keloid and hypertrophic scars. The results are often seen in one to three days following treatment and the injections engender little to no significant post-treatment downtime. For small, papular sized lumpy scars, light electrocautery can be used to flatten them. On the other hand, C02 lasers and fraxel lasers, like so many other of today's heavily hyped, expensive gizmo treatments unfortunately often don't live up to the marketing hype and social media buzz that surround their use. Besides, the use of any of the light-based treatments can lead to dyspigmentation problems, particularly in skin of color. Before wasting any money, make sure to consult an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

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