Pediatric scar care - dermatologist or cosmetic dermatologist recommendation?

[Anonymous]

My child had a traumatic facial injury and has a substantial scar on their cheek, they are 6 years old. We have been to several plastic surgeons who have given varying advice, and recently someone recommended a cosmetic dermatologist who is not located in the DC area. We had a consult, but I have some concerns because they work mostly with adults. I realize this is a very specific question, but would love any referrals to dermatologists who have experience with facial scarring, particularly in children. Thanks.

[Anonymous]

Not for a scar, but Stephen Baker did plastic surgery on my son. He has an office in McLean and privileges at Georgetown. Great with kids.

[Anonymous]

Really sorry to hear your child had a traumatic injury. I have a facial scar and I would advise going to the best facial plastic surgeon you can find. If needed, they can do a scar revision to help minimize the appearance, particularly if it was initially sutured in an ER and not by a plastic surgeon, then use silicone gel or sheeting to cover it. Then later once the scar is completely healed, you can do laser treatment to improve the scar texture. You also need to avoid sun exposure, so sunscreen and hats even in the winter (small blessing that it's winter, not spring!). And it's really important after a scar revision to keep your hands off of it and let it heal. Seems obvious, but I have a spot where I accidentally bumped the scab and it's noticeably less smooth even a decade later.

With facial scarring, I'd want the most skilled surgeon over a lesser surgeon that specializes in pediatrics. Ideally you'd find both in one, but that's what I'd prioritize if my child had an injury like mine.

[Anonymous]

My daughter had a serious scar on her face that I insisted be stitched by a plastic surgeon in the ER. When the stitches were removed 2 weeks later she told me to use on a 3 day rotation for a year: Moderna with spf, retin a and a smashed vitamin E pill (one day 1, other day 2, last one day 3, repeat). Keep it out of the sun at all costs. She said it would look bad for first 6 months but then by 12 months it should greatly improve and she was right.

This was 10 years ago. If you’re looking for laser treatments, I believe you need to be 12 months out (this is what a cosmetic dermatologist would be for). Otherwise I would stick with a cosmetic surgeon.