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Scar Revision in Children

The treatment of scars in children follows many of the same surgical principles as adult scar revision, but is more complicated in that timing is crucial in order to avoid progression of the scars with ongoing development. Children require special care and we work alongside your obstetrician and pediatrician to maximize your child's outcome. 

Not all scar revision procedures are surgical. Our office specializes in the use of non-surgical scar revision procedures including ablative lasers, non-ablative lasers, fractional RF, microneedling, pigmentation modulation, IIT, and topical therapy to exact improvements in a specific scar. If you are considering surgery for your child for another reason (birthmark, developmental or medical issue), we can work alongside your surgeon to optimize results before and after your treatment. 

Mole Removal in Children: Atypical moles can form during gestation and appear on the skin of babies at birth. If the moles are large, they are often at risk for malignant degeneration in adulthood and are candidates for removal. Large congenital melanocytic nevi can cause both cosmetic and medical problems and many pediatricians recommend times excision and layered closure of the mole in order to minimize longterm scarring. Dr. Karamanoukian is on active staff at Providence St. John's Hospital and can work alongside your pediatrician to help you decide on timing and suitability of mole removal for a congenital mole. Most procedures can be performed electively in an outpatient setting. 

If your child has a small mole that has abnormal features, Dr. Karamanoukian and your pediatrician may recommend less invasive mole removal options that employ hyfrecation, cauterization, laser, or shave biopsy techniques. The goal of mole removal is to safely remove the mole, obtain a surgical specimen for evaluation, and to minimize longterm scarring. 

Preventing Scars: There are many scar treatments that can help reduce the potential for abnormal scar development in your child. Many of the same protocols used in adults are used in children. These scar modulation protocols include the application of steri-strips in the early phase of wound healing, pulsed dye laser to help reduce scar formation, application of polysiloxane gels such as Plato's Scar Serum, massage therapy, and surgical scar treatment (if necessary for any mechanical tethering or dimpling of the scar). We often advise against silicone scar sheets for children in favor of silicone gel such as Plato's Scar Serum because silicone gel sheets seem to be less tolerated by children who peel off the sheets intentionally or with play. Many parents seek immediate consultation with Dr. Karamanoukian for scar treatments after an injury in order to maximize the potential for healing without scars. 

Scar Gel for Kids: 

The health of your kids is a big concern for parents. If your child or toddler has had a injury that has resulted in or may result in a scar, there are non-surgical options to decrease the visibilty of an old scar and reduce the onset and duration of a potential scar. Silicone scar gels are an excellent option for parents seeking safe options for their children. Plato's Scar Serum contains polysiloxanes, which are safe to use in children of all ages. The mechanism of action of polysiloxanes is yet unclear to scientists, but some clinicians believe that the hydrophobic nature or silicone allows it to naturally disrupt fibroblast deposition of abnormal scar tissue. Twice daily application followed by gentle massage allows the scar to smoothe and hastens the remodeling phase of scar maturation. Our Los Angeles plastic surgery center recommends Plato's Medicinals Scar Serum twice daily as an effective scar gel for kids and toddlers. 

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