Hi doctor,I have been bitten by a dog three months ago. I have multiple scars but the worst one is above the upper lip. Unfortunately, I went to a dermatologist recommended by family and he insisted to apply Yag Laser at 55 days post-bite. I asked if it was not too soon but he said it was harmless and would only be targeting the vessels that were giving the scar the red color. I trusted and it hurt a lot. Immediately after it was horrible looking but the doctor said it was normal and not to worry. The next day I had blisters that resolved two weeks later. One month and a half later my scar that was a red line is now horrible and has local indentations. Seems that I have lost tissue on the blisters site. 15 days ago the dermatologist said it would resolve and I would not be worst than before the laser. Now I returned to his office and he tells me that it may pass but it will take two years. I am devastated and so depressed. It has been psychological hell.Can the sunken areas really fill with time and become a line scar again? I am more than a month and a half now. I have red people burned by YAG laser and never recovered. I have been applying Cica Care (silicone sheet) but I do not see any improvement. The doctor wants me to apply Hydroquinone but I stopped to trust him really. Also in a few months, if the skin does not return to normal level, will scar revision work on this site to give me a virtually invisible scar? I am so scared because the burn area with the scar is now wide. Can the revision be made without lengthening the scar? Do I have hope? What techniques of revision should be approached? Would it require multiple stages? Please help me.
Hello. First of all, sorry for the unfortunate events you are going through. I have seen your pictures (attachment removed to protect patient identity). The first scar was definitely a small linear one which could have been corrected by few non-interventional methods than the lasers as you said it was just 55 days old. However, the YAG laser is known for its potential to decrease the increased vascularity in such scars and help improve the outcome. So I do not think your dermatologist is wrong in suggesting you this. The post-laser picture shows that it second-degree burns, which is a common side effect of YAG, which had to be explained to you by your dermatologist beforehand, and you could have taken a better decision. Right now the scar is having two main problems, that is the depression and the pigmentation which is making it look worse. My suggestion would be to ask for micro-needling with PRP (platelet-rich plasma) or fat nano grafting underneath the scar will give you the elevation in the scar. And as suggested, the Hydroquinone with an Isotretinoin based cream will help in depigmenting it. Both these methods has to done in a proper protocol. Do discuss these things with your dermatologist, or a new skin specialist and let him or her come to the best decision after personal examination of the scar.  For more information consult a plastic surgeon online -->