What would be the best procedure to reduce scars from piercing infections? (Photo)

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

Thank you for sharing your photo and details. I understand how frustrating post-piercing infections and resulting scars can be, especially when they impact something as visible as your earlobes.

For scars caused by infections, the treatment approach depends on the type, thickness, and extent of the scar tissue. Here’s a breakdown of options:

Non-Surgical Options:

Silicone Gel or Sheets: These can help flatten and soften scars over time.

Steroid Injections: For raised or keloid scars, small steroid injections can reduce thickness and redness.

Laser Therapy: Fractional CO₂ or pulsed-dye lasers can help improve texture, reduce redness, and smooth the earlobe.

Surgical Options:

Scar Revision Surgery: If the scar is thick or causing distortion of the earlobe, surgical excision with careful closure can significantly improve the appearance. This may be the best approach for deep or extensive scarring.

Combination Approach: Sometimes surgery is followed by laser treatments or silicone therapy to optimize the final result.

Because your scars are from an infection, I would assess whether there is any residual tissue damage before recommending surgery. A skilled dermatologist or plastic surgeon specializing in ear reconstruction can provide the best cosmetic outcome.

At least from the one photo provided, there appear to be two elevations consistent with hypertrophic scarring. If so, then the use of intralesional injections of an anti-inflammatory agents, such as triamcinolone would a simple and tried and true method for flattening the scars. Complete elimination of the scars is unfortunately not possible by any method or combination of treatments currently available anywhere for mature scars over three months old. Surgical removal would be ill-advised in my opinion, as, especially in areas under tensiion, there is a significant risk of stretch scarring and stitch track formation. You would be wise to consult with an experienced, board certified cosmetic dermatologist, scar treatment specialist Hope this helps and best of luck.