Scar Treatment Questions and Answers

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Question:

Are there any procedures such as tattoing, etc. for the lightening of skin? What was Michael Jacksons procedure for the lightening of his skin?

Answer:

You can lighten the skin with various bleaching agents, the most utilized was hydroquinone in a 4% formulation (need a prescription) or over the counter in a 2% formulation. Much higher percentages can be utilized for more permanent results and there is speculation that this is what Michael Jackson used but I have no confirmed information about his treatments. Kojic acid is another chemical that may help lighten the skin. Other treatments would include laser treatments or chemical peels. There are tattoo artists skilled in hiding scars with flesh colored tattoos, but I am not sure how this would work if a large surface area were involved.

Amy Taub, M.D.
Lincolnshire, IL

Question:

I am 18 years old and have dealt with mild acne since i was 13. My skin has scarring and i would like to know if a chemical peel would be recommeded. I have little to no acne now, and would like to rid my face of the red scar patches. Is a peel worth it?

Answer:

You call them red scar patches. Does this mean they are mainly red, or red and indented. The redness makes me think you may be a candidate for a procedure called photorejuvenation, a new treatment for rosacea and sun damage. If there is red in the scar this procedure will help to remove it, plus stimulate the skin underneath to grow new collagen. Find a practitioner in your area or more about this at www.aslms.org or photorejuvenation.com or at esc-med.com. Microdermabrasion can help smooth out superficial scars (indents) but needs to be performed multiple times. Similarly, mild chemical peels would need to be done in a series. Neither peels nor microdermabrasion will help with redness.

Amy Taub, M.D.
Lincolnshire, IL

Question:

I'm in the Navy and just recently went to the doctor for numerous small blue 2-3mm flat to slightly raised lesions on the vulvar/labia area. They told me it was Hemangiomas and that there was nothing they could do, even though they don't cause me any pain or discomfort. However, is there anything that can be done to get rid of them? What are my options?

Answer:

You could have them lasered with a vascular lesion laser (there are many including pulsed dye, KTP, intense pulsed light and more) or you could have them cauterized (more likely to leave small scars but would be effective. If you are looking for a treatment I would recommend you ask your base physicians about seeing a dermatologist with laser experience. Usually the Navy derms are very on top of things!

Amy Taub, M.D.
Lincolnshire, IL

Question:

I have a couple of questions wrapped into one. When I was younger, I had pretty severe acne which left me with many scars on my face. Some of them are purplish, and others are what look like little "pits". Although they've faded quite a bit, I still find them hard to look at in the mirror each morning. What is my best bet to get rid of them? Also, I've noticed that I've been developing more facial hair (which I find disgusting) and it's to the point that I can't handle plucking and waxing anymore. I've heard of laser hair removal-what is this exactly? Is it painful? Is there any kind of miracle treatment that will cure me of my scars AND hair? If not, which should I try to clear up first? Approximately how expensive are the treatments? Any advice is greatly appreciated.

Answer:

3 of the best choices for the acne scars would be laser resurfacing with either a carbon dioxide or an erbium yag laser, surgically removing the scars and then having a more superficial laser such as photorejuvenation, mild peels or microdermabrasion, or having treatments with the Cool Touch Laser. You need to find a laser specialist and aesthetic dermatologist. I would go to the American Society for Laser Surgery and Medicine website www.aslms.com and they have listing of their members in all geographic locations. Your hair, if dark, would best be removed by a laser as well (unfortunately a different one than we use for scars). The most expensive option is laser resuracing which would probably run more than $2500 for a full face. Most of these solutions for scarring will probably run into the $1000 range. But it would be better to consult with an experienced aesthetic dermatologist and laser surgeon to determine what it best for you. Good luck!

Amy Taub, M.D.
Lincolnshire, IL

Question:

I was interested in getting several dome shaped moles on my face removed. They are benign, but affect my esteem. I don't want to go under the knife for scarring reasons. How succesfull is a laser treatment. What type of laser should I look for. Do you know of any Docs. in Northern New Jersey, NYC area that perform laser mole removal. Thank You...

Answer:

Laser mole removal is experimental and doesn't work particularly well. Often the moles reoccur. So, in this case, I can't recommend lasers. Usually in my office we do a technique called a "shave removal". This essentially planes the mole off the surface and although it does involve a scalpel, does not require stitches. 95% of the time, dome shaped moles don't return when removed this way and often heal up very nicely. Of course your dermatologist would need to tell you what technique would be best for each mole, as some just aren't quite right for shave removal. I would get a few opinions on how they would be removed and go with the doctor whose description of the procedure made you feel the most comfortable and who seemed to care about you and your result.

Amy Taub, M.D.
Lincolnshire, IL

Question:

For the past 6 months or so I've had reoccurring fluid build up in my chin area. I thought it might be due to a clogged hair folicles at first, but it reoccurs so I'm thinking a cyst or boil? Stangely, I asked my General doctor about it recently and he felt nothing, which shocked me. it feels so fluid filled to me but not to anyone else who I'm constantly asking "don't you feel this?" Could I just be the version of a dermatologists hypo-condreact? What's worse is I constantly make it worse myself by attempting drainage. (I know I should just warm soak). Question: if I see a dermatologist will he/she be able to determine a cyst or something even if it's not "flared up" at the time? I'd really appreciate any imput you have to offer. Thank you.

Answer:

Without seeing it it is tough for me to say.. I am going to assume it is there because you say it is. I would make an appointment with a dermatologist(you can alays cancel it), but you could always also try some over the counter stuff like benzoyl peroxide, to see if it would go down with some treatment. Try not to play with it as this does make it worse and can lead to infection or scarring. You could try some acne stuff at my website, www.skinfo.com where there is something called the complete anti-acne treatment and if you gave it a few weeks (the time it will take you to get in to see a dermatologist) you'd know if it were going to respond to something topical.

Amy Taub, M.D.
Lincolnshire, IL

Question:

I have a scar on my elbow and one on my knee that occasionally turn red and raise. What causes this? They are not that way all the time.

Answer:

They are probably keloids or hypertrophic scars, both of which are scars which still are biologically active despite the acute healing phase being completed. Nobody really understands what causes this, yet they can also cause discomfort such as pain or itching. Yours is unusual in that it waxes and wanes. Often they just get worse with time and require some form of treatment to improve their appearance and also diminish the symptoms. Treatment options consist of injections of cortisone, laser, or silicone gel sheeting placed daily on the wound for months.

Amy Taub, M.D.
Lincolnshire, IL

Question:

What is the best way to remove small moles on my face? They are flat moles and I was wondering if a skin peel or laser would work?? Or is there another way?

Answer:

Dear Connie, It is hard to know without seeing them if they are true moles (which are usually raised) or some other kind of pigmented lesion. Usually, lasers which just remove pigment are very useful for these flat lesions and they can be removed without a scar or white spot. If they are true moles, they will recur with this type of treatment. The only good way of removing a true mole is by removing it along with its "roots". The problem is that this leaves a scar - usually a good one - but a scar nonetheless which is about 11/2 times as long as the mole was in diameter.

Question:

When I was younger I had pretty bad acne. Now I have deep and numerous pores. Is there anything I can do to smooth them out?

Answer:

There are a number of things you could do for enlarged appearing pores or acne scars. You could consider a microdermabrasion treatment, a very gentle "sanding" of the topmost layer of the skin. This helps the skin to smooth out over the course of a number of treatments. You could consider a few "Beta-Lift" peels, which place salicylic acid in the pores to exfoliate them and allow them to shrink. You could also start on a skin care regimen such as with a retinoid (like Retin-A or Differin- both are prescription) or you could try an overy-the counter version of retinol (such as Afirm 2X available at my website, www.skinfo.com) or a combination with an alpha hydroxy acid cleanser. Or let the skinwizard tell you what to do at www.skinfo.com- click on the skinwizard and answer 3 questions (your skin care goal would be "toning") and it will guide your selection of a skin care regimen for your individual needs.

Amy Taub, M.D.
Lincolnshire, IL

Question:

On july 10th I had moh's surgery under my left eye, it was quite extensive and I've been left w/ a diagonal scar under my left eye beginning 1/4 of an inch under my tear duct and going towards my left ear. The scar is approximately 2 inches in length and I am having dermabrasion on the 19 of Sept. I would like to know what to expect, will I be in any discomfort, will it swell, and how long does it generally take to heal. Thank you for your time. I have visited a website on dermabraision and did get some information but I guess I feel I just need a little more positive thoughts. Thanks again.

Answer:

Dear Margaret, I understand that you will be having dermabrasion on this scar. If the scar is narrow and not too depressed, this may help a little. In that area, dermabrasion is not the best treatment since the lower eyelid skin is very thin and fragile and does not lend itself well to mechanical abrasion. I would suggest that you visit with a plastic surgeon in order to explore the possibility of either scar revision if the scar is wide or thick and, if optimal from that viewpoint, laser resurfacing so that an adequate depth of resurfacing can be performed without danger to this very thin skin or your eye.

Question:

I am 25yrs old I gave birth to my only child in 1995, Me and my husband have not used protection for the past 6yrs and have not been able to become pregnant. I have seen a dr. who says My fallopian tubes have scar tissue in them. My question is how and why does this decrease my chances of becoming pregnant and how can we overcome this?

Answer:

Dear Virginia You need to address these questions with your doc since he/she is the one familiar with your case. But a prior infection can cause this, and your treatment may be surgery or more likely in vitro (test tube baby). Good luck Fady I. Sharara, M.D VCRM

Question:

I have pitted scars from plucking ingrown hairs on my chin area, not knowing that plucking was making them worse. I have been having laser treatments for the ingrown hairs which has made a big difference and has helped me alot. Although I am still left with these small (not red) scars that are not deep, but bothersome to me and have heard alot of bad things about chemical peels which I do not think I want to have done. I have looked into laser treatment for resurfacing and was wondering if that is the way I should go, although these scars only on the chin area are not deep nor are they red, so I am stuck as far as where to turn, where to go, as the laser place has suggested the peels giving me all the side affects. I am ivory skin colored with dark hair, facial hair all over, which most is blode and not bothersome, aside from the dark ones that started appearing on the chin area, had hormones tested and that was not the case, was told that this was and is hereditary. Can you please give me some guideline as to where to start, if laser resurfacing would be the best route to go, so forth?

Answer:

Laser resurfacing is a really intensive treatment which I would use only as a last resort. Chemical peels vary by the strength and the chemicals that are used. Mild chemical peels- salicycilic acid 20-30% (Beta-LIft Peel) or glycolic peels 30-40% virtually have no risks and in a series may help you. Another option would be microdermabrasion, which I favor as a treatment for this type of problem, but you will also need multiple treatments, at least 5-6. Finally, you could try to find someone who has a Cool Touch II Laser. These are known to improve acne scars without much risk. Go to the web site www.aslms.org to find a laser practitioner in your area.

Amy Taub, M.D.
Lincolnshire, IL

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