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Can laser resurfacing lead to worse scarring later?

Q:

About a month ago I had a laser resurfacing treatment for bad acne scars related to dermatillomania. Unfortunately, I recently developed a pimple that I picked at, and now I have a large red spot that feels like it's burning. There is no swelling, drainage, or crusting--just a red spot the size of a nickel that burns when my skin rubs against it. Since laser resurfacing involves collagen synthesis, could this be my skin reacting to a new wound?

A:

Compulsive Skin Picking or Dermatilloma can be a tough condition to overcome. Laser resurfacing can make your skin a bit more prone to breakdown until it is healed. A new sore could represent a local infection. If it is not resolving seek evaluation. A culture of the wound and antibiotics may be required to allow the wound to eventually heal.

Best,

Gary R Culbertson, MD, FACS

A:

Laser Resurfacing and Scarring – The key element with laser resurfacing is that the procedure needs to be done by a skilled plastic surgeon or dermatologist that has experience and expertise in laser resurfacing especially in patients with acne scarring. This requires a deeper laser resurfacing with concomitant filling of the deep scars or scar revision procedure. Laser resurfacing should be healing by 10-14 days, but there is a small risk of scarring. However, in the hands of someone who has significant laser expertise, this is an infrequent occurrence.

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