Vertical Scar on Forehead, What Should I Do? (photo)

Question

So about two years ago I fell and got a nasty scar in the middle of my forehead and it runs vertical. I've gotten a few laser treatments but i feel like i probably am going to need a scar revision of some sort because it hasn't improved much after 3 treatments. I also have a lump of scar tissue underneath the scar. I'd really like some opinions on what I could do to make it less noticeable as it really affects my confidence and self-worth. I've attached a picture. let me know! thanks

Jeffrey J. Roth, MD, FACS · Answer

Thank you for enclosing a photo.  This area of the body can be difficult with scars as the forehead is on a significant amount of tension.  One criteria that plastic surgeons always ask is how long the scar has been there.  Scars typically look the worst at 4 months and better at 10 months.  Usually we do not like to perform scar revisions on those scars less than a year of age.  A good exam is necessary to determine how tight your skin is, and also what is going on with any skin depression you may have. With a revision, the old scar is typically cut out and then the edges are placed back together without undo tension. You will trade a scar for a scar, and hopefully your new scar will look better than your old scar.  There are a few modalities for depressions as well.  Best to see a board certified plastic surgeon.

Raffy Karamanoukian, MD, FACS · Answer

Two viable options for your forehead scar include fractional co2 laser and/or surgical scar revision with excision of the scar and layered closure.

George Bitar, MD · Answer

Thank you for your question. It would be interesting to know the time since your laser treatments because the scar is still red.  This suggests that your scar is still in the healing process.  Nonetheless, you scar is fairly wide.  Scar revision would likely help to reduce the width of the scar. Best wishes.

Harold J. Kaplan, MD · Answer

Hi Reggie. We cannot see what the texture of the scar looks like with the photo you posted but if you are concerned about the redness, we would highly recommend a pulsed dye laser treatment. We use the Cynosure V-star.

Darrell L. Henderson, MD · Answer

If your makeup wont hide your scar,becuse of the bump then revision could be an option. Sometimes changing the direction of the scar with a z-plasty is indicated.

Darryl J. Blinski, MD · Answer

Yes I agree a scar revision is indicated in your case. Especially after the non invasive laser failure.

Norman Bakshandeh Day, MD, FACS · Answer

At this stage allowing the passage of time for the scar to mature and soften is proably best. If the closure was not done in layers then a revision is best

Remus Repta, MD · Answer

Hello,

	Thank you for the question and photos.  There are a number of plastic surgery reconstruction cases where we use forehead tissue for reconstruction of the nose.  When the forehead is close properly the result incision is usually much better than the scar that you have shown.  This resulting incision can be further blended with laser down the road since the amount of scar and width of the scar is very small and thin and the laser can be focused on the color variation of the incision.

	Dr. Remus Repta

Steven Wallach, MD · Answer

A scar revison might be possible depending upon hwo the original wound was closed and  the history of the injury.  Some lasers may help as well.

Joshua L. Fox, MD · Answer

You stated that you have used laser on it without help but didn't state which laser.firstly for the underlying scar one can utilize intralesional triamcinolone acetone or other treatments.  We have had excellent success utilizing several lasers to revise scars .  s. These include the Fraxel, the pixel, erbium, and v beam lasers. The Fraxel being the workhorse in our practice. Several doctors can utilize the same laser and get very different results depending on the laser's settings .  
Obviously plastic surgery scar revision is another excellent option .
You really need a consultation to better evaluate the scar and it's treatment options.

Vertical Scar on Forehead, What Should I Do? (photo)

Answers (10)