Is there anything I can do about this white scar/hypopigmentation? (Photo)

Question

I got this scar in April 2023. It's gotten better since then but there's still pigmentation that has yet to return. I know hypopigmentation is a lot more difficult to treat than hyperpigmentation. I've tried many things and currently am doing red light therapy, micro-needling, silicone scar tape, and sometimes Latisse too. I have uvb wand as well but never really use it. I just am curious to know if there's anything I can do or just let time do its thing and hope for the best

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience and concerns. You’re absolutely right—hypopigmentation is significantly more challenging to treat than hyperpigmentation, especially when it involves loss of melanocyte activity following trauma or inflammation, as seems to be the case here.

If your scar began in April 2023, and you’ve seen some improvement, that’s encouraging. Pigment recovery can be very slow, often taking 12–24 months, especially in deeper or dermal-level injuries.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For treating hypopigmentation, CO2 laser resurfacing could be a beneficial option to consider. This treatment can help improve skin texture and stimulate collagen production, which might enhance pigmentation over time. It’s often effective for various types of scars and can promote more even skin tone. While it’s great that you’re already using red light therapy, microneedling, and silicone scar tape, CO2 laser resurfacing might provide a more significant improvement. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

This is a time to consult with an experienced, board certified cosmetic dermatologist and to stop with experimentation. Red light Therapy,  home microneedling, silicone patches and gels were unlikely to do much of anything from the get-go. So no surprises that these didn't work. I have had gratifying results using a combination of professionally performed, aggressive, manual microneedling (no need for the added expense and risks of RF microneedling) accompanied by the application of Rx pigment enhancing topical medications. Several treatment sessions are typically required. Hope this helps and best of luck.

Is there anything I can do about this white scar/hypopigmentation? (Photo)

Answers (4)

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