I am 26 years old, fairly light-skinned Asian girl. I have suffered from severe acne in the past but just recently, with the help of medication, I have managed to control my acne. However, I am now left with deep acne scars on my cheeks. I have been to see a dermatologist and he has suggested one treatment of the Fraxel Laser. I am getting married in 4 months and want to look my best. Can anyone suggest what is the best treatment for acne scars on my skin type?
Best Acne Scar Treatment for Asian Skin?
Doctor Answers 11
Asian skin and acne scars
Many patients come to see me with these similar situations. Here in New York and New Jersey we have a large Asian population. In choosing a treatment regiment the type of procedure and recovery time is important. For short period recovery time, topical treatments such as beta peels and microdermabrasion can lessen the appearance of scars, but only subtly. However, it depends on the extent of the acne scarring. Fraxel restore is a more effective treatment methodology for Asian skin types and it may require 3-5 treatments for good results. Usually 3-4 weeks are needed between treatments. Pretreatment with hydroquinones is suggested as well as sun avoidance and use of sunscreens.
Acne Scarring in Asian Skin
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Asian skin requires special care because of the risk of hyperpigmentation.
A single Combination treatment with subcision, Derma-K Laser Resurfacing, and Fraxel Repair Laser give me the best results. Treatment of acne scars is complicated and requires a combined approach to get the best results. Additional treatments with eMatrix and Perlane can further enhance the results. We are consistently getting 75% + improvement in a single treatment in most of our patients using this technique There are other options, but this works by far the best in my hands. I have treated may Asian patient with this treatment who have achieved great results. It is usually necessary for Asian patients to completely avoid the sun for several months following the treatment until the skin is completely back to normal color. There is always some redness after the treatment that takes a few weeks up to several months to disappear.
Fraxel Dual Laser Treatment for Acne Scars in Asian Skin
Asian skin is for the most in the Fitzpatrick type 4-5 range. Thus aggressive resurfacing would not be an option in most. Aggressive resurfacing refers to Dermabrassion (Not microdermabrasion) and C)2 resurfacing. For that reason Fraxel Dual (Not Fraxel repair) would be a safe choice in Asian skin. I would highly suggest talking to your doctor to plan out the best treatment.
What works best for acne scars?
What is best for acne scars depends on how many scars, how deep they are and what type of scars they are.
If the scars are hypertrophic, like keloids, then injections of a cortisone would probably work best.
If the scars are atrophic, meaning they are depressed below the skin surface, then there are several things that can be done.
For isolated scars, there are dermal fillers, subscission, punch excision and spot fractional resurfacing.
For multiple scars, fractional resurfacing with an erbium laser would work well. Best of all, this type of resurfacing works well in all skin types from very fair to very dark. For patients that develop post-inflammatory pigmentation easily, I recommend pre-treating with a bleaching agent for two weeks before the procedure, then back to the bleaching agent as soon as the skin is healed after the procedure.
Several treatments may be necessary to reach full correction but you should see improvement even after one treatment.
TCA Cross is good for acne scars
This technique involves placement of very concentrated TCA on the scars. There is minimal downtime. It needs to be repeated several times. There were initial studies done on Koreans with no adverse skin reactions so I feel it's safe for you. After the wedding, the Fraxel re:pair is very good for acne scars. I have done several asian skin types without adverse reactions. You need to be on hydroquinones before and after the procedure.
Acne scars in Asian skin
I would consider saline subcision treatments perhaps in combination with spot application of a strong chemical peeling agent to build up the collagen to fill your depressed acne scars. Application of the chemical peel solution should not be done within 3 months of your wedding date as it can take up to 3 months for the dark brown/reddish pigmentation associated with this technique, to resolve. Hopefully you can find a qualified dermatologist or facial plastic surgeon who is familiar with these techniques. Fraxel Re:pair can be beneficial for some rolling scars, but is not great for ice-pick acne scarring.
Depends on scar type and skin colour
The time line of 4 mths possibly too short to look your best, because with all fractional lasers (especially for acne scars), it will require several treatments.
Hope this helps.
Dr Davin Lim
Cosmetic and Laser Dermatologist
Acne Scar Treatment for Asian Skin
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.