Two red scars on arms for over 5 years, that will not fade - how can these be removed? (Photos)

Question

I have two small but stubborn red scars on my body, one on my left arm and one on my right arm. They have been red for over five years and have not improved at all despite multiple Vbeam laser treatments and consistent use of silicone gel and sheets. These scars are extremely frustrating and affect my confidence. I feel like I have tried everything and nothing has worked. I am looking for a real solution and would appreciate any expert advice on what to try next.

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

Anna Chacon, MD, FAAD · Answer

For persistent red scars that have not responded to treatments like Vbeam laser and silicone gels, there are several additional options you can consider to improve their appearance:

Non-Surgical Options
Pulsed Dye Laser (PDL): While you've tried Vbeam (a type of PDL), consider consulting with a specialist to ensure the settings and treatment plan are optimized for your specific scars.

Intense Pulsed Light (IPL) Therapy: IPL can help reduce redness by targeting blood vessels within the scar tissue.

Microneedling with Radiofrequency: This combination can stimulate collagen production and remodel scar tissue, potentially improving both color and texture.

Topical Treatments: Consider topical formulations with ingredients like retinoids, vitamin C, or niacinamide, which might help improve skin texture and reduce redness over time.

Steroid Injections: These can sometimes reduce redness and flatten raised scars by decreasing inflammation and altering collagen synthesis.

Cryotherapy: Applying extreme cold to the scar can sometimes reduce its size and appearance, though this is more commonly used for raised scars.

Surgical Options
Scar Revision Surgery: This involves surgically removing the scar tissue and re-closing the wound to create a less noticeable scar. This option is typically considered when other treatments have failed.

Laser Resurfacing: Ablative lasers can help resurface the skin and improve the appearance of scars by removing the outer layers of skin and promoting new skin growth.

Additional Considerations
Consultation with a Dermatologist or Plastic Surgeon: Given the persistence of your scars, a specialist can provide a tailored treatment plan, potentially combining several modalities for optimal results.

Patch Testing: If considering new topical treatments, a patch test can ensure no adverse reactions occur, especially if your skin is sensitive.

Exploring these options with a qualified professional can help determine the most effective approach to minimize the appearance of your scars.

Nelson Lee Novick, MD · Answer

Higher resolution photos and a some history as to what led to the development of the reddish spot would be very helpful in order to recommend appropriate treatments. What I can say is that in my experience scar gels and sheets have proven of little value and constitute more "busy work" than they are worth. So no no surprise with the lack of benefit there. What's more, I am not surprised by the lack of success with the V-Beam treatment, as well, since the use of so many of the so-called light and energy-based gizmos that are hawked out there is supported far more by marketing hype and social media buzz than hard science.
If this is indeed some form of persistent post-inflammatory erythema, you might consider professionally performed, manual Dermastamp microneedling (no need for the added expense and risks of RF microneedling) accompanied by the application of prescription topical anti-redness medications. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Two red scars on arms for over 5 years, that will not fade - how can these be removed? (Photos)

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Two red scars on arms for over 5 years, that will not fade - how can these be removed? (Photos)

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Everything you need to know about Scar Removal

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