Raised Skin Lesions: Causes, Treatments, and Surgical Options - Dermatology

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Raised skin lesions can be a source of concern for many individuals, particularly when they appear after a previous skin condition, such as acne. Based on your description, it sounds like you may be dealing with a type of scar known as a hypertrophic scar or possibly a keloid. These types of scars can develop after skin injuries, including acne, and they are characterized by raised, thickened areas of skin that can be more prominent than the surrounding tissue.


Causes of Raised Skin Lesions
The formation of raised skin lesions can be attributed to several factors:
1. Inflammation: After an injury or inflammation (like acne), the body produces excess collagen during the healing process. This can lead to hypertrophic scars or keloids, which are raised and can sometimes be itchy or uncomfortable.

2. Genetic Predisposition: Some individuals are more prone to developing keloids due to genetic factors. If you have a family history of keloids, you may be at a higher risk.

3. Skin Type: Certain skin types, particularly darker skin, are more susceptible to keloid formation.

4. Location of the Lesion: Areas of the body that are frequently subjected to tension or movement, such as near the mouth, may be more prone to developing raised scars.


Treatment Options
When it comes to treating raised skin lesions, there are several options available:
1. Surgical Excision: If the lesion is bothersome or unsightly, surgical removal may be recommended. This involves excising the raised tissue. While this can effectively remove the lesion, there is a risk that a new scar may form, and it could potentially be raised again.

2. Laser Therapy: Although you mentioned that you have undergone laser treatment, it’s worth noting that multiple sessions may be required for optimal results. Laser therapy can help flatten raised scars and improve their appearance.

3. Steroid Injections: Corticosteroid injections can be used to reduce inflammation and flatten raised scars. This treatment may need to be repeated several times.

4. Silicone Gel Sheets: These can be applied to the scar to help flatten it over time. They are often recommended for hypertrophic scars.

5. Cryotherapy: This involves freezing the scar tissue, which can help reduce its size.


Surgical Considerations
Regarding your concern about surgical excision, it is essential to discuss the potential outcomes with your dermatologist or a plastic surgeon. While surgical removal can be effective, it is crucial to understand that there is a possibility of the scar returning or forming a new scar that may be different in texture or appearance.
Your concern about ending up with a depression (a "dimple") after the surgery is valid. The outcome can depend on various factors, including the skill of the surgeon, the healing process, and your skin type. Surgeons often use techniques to minimize scarring, such as careful incision placement and suturing techniques.


Prevention and Future Care
To prevent further complications or the formation of new raised lesions, consider the following:
- Avoid Picking at Skin: This can exacerbate inflammation and lead to scarring.

- Sun Protection: Protecting your skin from sun exposure can help prevent discoloration and worsening of scars.

- Moisturization: Keeping the skin hydrated can promote better healing and reduce the risk of scarring.

In conclusion, while raised skin lesions can be concerning, there are various treatment options available. It is essential to consult with a qualified dermatologist or plastic surgeon who can assess your specific situation and recommend the best course of action tailored to your needs.