Why Didn’t Microdermabrasion and Chemical Peels Improve My Facial Scar?

Q: Dr. Eppley, I have a depressed scar across almost the whole of my forehead, cheeks and chin. I have tried chemical peel and microdermabrasion, but all seem to burn that arena alone precisely. I think the tissue or skin in that area is pretty damaged and I would like to have it excised.

A: Based on our description of a long depressed facial scar, I am not surprised that microdermabrasion or chemical peels were ineffective for its improvement. Neither of these are appropriate treatment strategies for scar reduction. I am glad that you went through those though so you could prove to yourself that scar excision, radical as it may seemed initially, is usually the only effective treatment for a depressed scar. A depressed scar by definition has a thinner and more atrophic skin composition and a surface contour discrepancy to that of the adjacent normal skin. No treatments are really going to lower the shoulders of the edges of the normal skin to match the depressed scar and that would not be appropriate even it could. Removing the abnormal scar tissue and leveling the skin edges by bringing normal tissue together (surgical scar revision) is almost always a better approach…even if it is surgery and does take time to heal and for scar maturation to occur.

Dr. Barry Eppley

Indianapolis, Indiana