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scarredupforehead

Moderate scarring on forehead and temples have significantly degraded my quality of life. Best treatment option(s)?

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I started breaking out on my forehead in my early teens, and I am now 25 years old, with a moderate amount of boxcar scarring on my forehead and temples (some of them might also be rolling scars, I'm not sure). It could be worse, and in some types of lighting is barely visible, but it looks horrid in other types. I've had two microneedling sessions done as of now, and though I have noticed a slight improvement in the overall texture of my skin - enough for me to continue with the treatments - it doesn't seem like microneedling will do much, if anything, to significantly improve these boxcars.

 

I've done a bit of research online, and it seems like there's a broad consensus that indented scars of this nature should first be tackled with subcision + fillers. However, the forehead/temple region is supposed to be a risky place to undergo such procedures. Reading about this stuff is demoralizing, because just when I begin to think that I can be reasonably confident that a certain approach will improve my scars, I read a post talking about how a certain person has tried that approach and it was a huge waste of money. I thought it might be worthwhile to seek the opinion of users on this forum. 

 

I'd be so appreciative of any useful advice.

 

Here are a few pictures in progressively worse lighting:

 

 

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i had subcision and filler three times and chemebrasion one time. 

Subcision in this region is not a problem, if the doc uses a cannula. Filler placed superficially is not dangerous as well. I had very good results on my cheeks. The scars on my forehead came back after a while, not even the filler made a big difference. I didnt have more than 20% improvement on the forehead. I think it just doesnt respond very well... 

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8 minutes ago, acnescars2000 said:

The scars on my forehead came back after a while, not even the filler made a big difference. I didnt have more than 20% improvement on the forehead. I think it just doesnt respond very well... 

 

1 hour ago, scarredupforehead said:

I've done a bit of research online, and it seems like there's a broad consensus that indented scars of this nature should first be tackled with subcision + fillers.

A couple thoughts on subcision + filler.

Having little to no cushion, would there be a lot of tethering on the forehead? In my mind, unless you have a really deep scar, there's no need for subcision. 

Filler never works out well for boxcars due to their distinct hard edges. It's best to flatten the edges first.

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@Sirius Lee What would you recommend to flatten the edges? Do you think I should continue with microneedling? Like I said, nothing much has really changed with the scars, but  I've noticed a slight improvement to the overall smoothness of my skin after two treatments. I've read that it can take up to six microneedling treatments to see significant improvement, and some of the scars on my forehead - the ones farther from the center - are fairly shallow. But I have my doubts about how effective microneedling will be for the more deeply indented scars clustered more towards the middle of my forehead, above my nose/brow.

53 minutes ago, acnescars2000 said:

i had subcision and filler three times and chemebrasion one time. 

Subcision in this region is not a problem, if the doc uses a cannula. Filler placed superficially is not dangerous as well. I had very good results on my cheeks. The scars on my forehead came back after a while, not even the filler made a big difference. I didnt have more than 20% improvement on the forehead. I think it just doesnt respond very well... 

I appreciate your input.

Would you say your forehead scars were significantly better or worse than mine? 

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5 minutes ago, scarredupforehead said:

@Sirius Lee What would you recommend to flatten the edges?

My method is different from the conventional treatment, which might I add is up to now pretty dismal when it comes to the forehead and temple scars. The reason is people are too hung up on filling the pits rather than flattening the edges. But it's not the pit that is the problem. It's the shadow created by the scar border that actually makes the scar stand out like a sore thumb.

When it comes to boxcars, it's plain and simple. You need TCA Cross, period. Start out at 100% and work your way down as the scars improve. How many treatments? Considering your scars, you need at least 4. That's roughly 1 year of investment with 3-month treatment intervals.

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5 hours ago, Sirius Lee said:

My method is different from the conventional treatment, which might I add is up to now pretty dismal when it comes to the forehead and temple scars. The reason is people are too hung up on filling the pits rather than flattening the edges. But it's not the pit that is the problem. It's the shadow created by the scar border that actually makes the scar stand out like a sore thumb.

When it comes to boxcars, it's plain and simple. You need TCA Cross, period. Start out at 100% and work your way down as the scars improve. How many treatments? Considering your scars, you need at least 4. That's roughly 1 year of investment with 3-month treatment intervals.

Starting to agree with you re: the scar borders being so problematic. It's why lighting impacts a scar's appearance so much

Edited by Skin Pessimist
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