When One Deep Scar Still Draws Your Eye
Sometimes your skin improves, but one or two deep scars still catch the light, show through makeup, or pull your attention back to a chapter you are ready to move beyond.
Punch excision in Los Angeles is designed for those persistent indentations. It removes an individual deep scar and closes the area so it can heal as a smaller, flatter mark. At SHI, we know your scars do not tell the whole story, so Dr. Salar Hazany and our team evaluate each scar’s shape, depth, and place within your broader scar pattern before recommending a surgical approach like punch excision.
Could Punch Excision Work for Your Acne Scars?
Punch excision works best for individual scars with clear borders and enough depth that surface-focused treatments may not fully address them.
You may be a candidate if you have:
- Deep, narrow ice pick scars
- Narrow or deep boxcar scars with sharply defined edges
- Isolated indentations that remain prominent after other acne-scar treatments
- Scars that appear darker or deeper when light creates a shadow across the skin
- Little to no active acne in the planned treatment area
Punch excision may not be the right starting point if you have:
- Widespread shallow texture or rolling scars with sloping edges
- Raised keloid or hypertrophic scars
- Active breakouts that could create new scarring
- Pigment changes without a deep structural indentation
- A medical or skin condition that could interfere with wound healing
Rolling or tethered scars may respond better to subcision, while broader-texture or narrow scars may be better suited to laser skin resurfacing or CROSS treatments.
What Punch Excision Can Change—and What It Cannot
Punch excision does not erase every trace of a scar. It exchanges a deep indentation for a controlled surgical wound that may heal as a smaller, flatter mark and blend more favorably with the surrounding skin.
The procedure can:
- Remove the deep core of a selected ice pick or boxcar scar
- Reduce the depth and shadow created by an isolated indentation
- Create a flatter foundation for later resurfacing
The procedure does not:
- Prevent active acne from causing new scars
- Correct rolling scars that are primarily pulled down by fibrous bands
- Guarantee completely unmarked or poreless skin
Understanding that tradeoff is central to deciding whether punch excision fits your scars and your goals.
How SHI Determines Which Acne Scar Treatment Fits Your Skin
The right procedure depends on what is causing the indentation: a narrow column of scar tissue, a tether beneath the skin, a broader surface irregularity, a pigment change, or lost structural support. SHI evaluates those differences before deciding whether to remove, release, resurface, or support a scar.
How SHI Selects a Punch Technique
When surgical revision is appropriate, the scar’s width, depth, edges, location, and available tissue for closure help determine which punch technique may be considered:
When Another Acne Scar Procedure May Be a Better Fit
Punch excision is highly targeted, but many patients have a combination of scar types. The comparison below shows why another treatment—or a planned combination—may better address the concern surrounding an isolated deep scar.
Your treatment plan may use one procedure or sequence several approaches through SHI’s Acne Scar Phase-Out System.
What Happens During Punch Excision?
Your Consultation:
We review your medical and treatment history, examine the scars from different angles and lighting conditions, and determine whether excision offers a better tradeoff than another acne-scar procedure.
Before Your Appointment:
Follow the personalized instructions provided by your clinical team. These may include limiting sun exposure, wearing daily SPF, and pausing certain irritating skincare products before treatment.
During Punch Excision:
The treatment area is numbed with local anesthesia. A punch tool is selected to match the scar, and the scar tissue is removed through the depth required for complete excision. The wound edges are then carefully aligned and closed with sutures before ointment and a dressing are applied.
Most punch excision appointments take approximately 30 to 60 minutes, depending on the number and complexity of the scars being treated.
After Your Appointment:
You will leave with detailed wound-care instructions and a follow-up plan. Sutures are generally removed within one to two weeks, depending on the treated area and how your skin is healing.
Plan for Healing After Punch Excision
Your recovery will depend on the number and location of the scars treated and how your skin responds. Although individual timing varies, you can generally expect:
- First 24 hours: Keep the dressing dry and follow your personalized wound-care instructions.
- Days 1–3: Mild redness, swelling, tenderness, or bruising may develop around the treated areas.
- Days 7–14: The surface continues closing, and sutures are typically removed during this period.
- Around week 4: If the area has healed appropriately, laser resurfacing may be considered to help the revised scar blend with the surrounding skin.
- Months 3–6 and beyond: Collagen remodeling continues as the new scar gradually softens and becomes less noticeable.
Many patients return to non-strenuous work within one to two days, although visible sutures, scar location, and individual healing may affect your preferred social downtime.
To support healing:
- Clean and cover the treatment site exactly as directed
- Avoid baths, hot tubs, and swimming for seven days
- Do not pick at scabs or disturb the healing wound
- Limit direct sun exposure and use sunscreen once approved by your provider
- Contact SHI if you notice increasing pain, warmth, swelling, discharge, or fever
You may experience complications after punch excision, though proper treatment planning and follow-up care can help reduce these risks:
- Infection
- Changes in skin pigmentation
- Wound separation
- A widened or raised scar
- A small mark where the scar was removed
Specialized Scar Care for Patients Across Los Angeles
Punch excision is a small procedure where millimeters matter. Dr. Salar Hazany is a board-certified dermatologist with specialized fellowship training in Mohs micrographic surgery, cosmetic dermatology, and laser surgery. His surgical background informs SHI’s attention to scar tissue behavior, wound-edge alignment, closure, and long-term remodeling.
Patients choose SHI for:
- Care led by Dr. Salar Hazany and a team focused specifically on acne and non-acne scars
- More than 3,000 patients treated through SHI’s proprietary Acne Scar Phase-Out System
- Treatment plans that combine chemical, surgical, injectable, and laser approaches when appropriate
- Professional photography used to track changes across treatment stages and lighting conditions
- Personalized planning for different scar patterns, skin types, and skin tones
SHI serves patients throughout Greater Los Angeles from its Beverly Hills office at 421 N. Rodeo Drive, with an additional location in West Hollywood. Patients also travel from across California and beyond for specialized scar care.
Questions About Punch Excision? Our Dermatologists Have Answers
SCAR HEALING & MANAGEMENT CENTER LOS ANGELES
At SHI, Searching Ends and Healing Begins
If previous treatments have fallen short—or you want a specialized plan from the start—a personalized evaluation can show you which scars are suited to punch excision and which need another approach.
Meet with the Scar Healing Institute to understand what may be possible for your skin and build a plan around the scars you actually have—not a one-size-fits-all procedure.
