Best treatment for acne scars on dark skin

You have a problem that is quite common.  Acne scarring in darker individuals responds well to Fraxel.  Be sure your doctor understands the finer points of dealing with dark skin, and has experience treating acne scarring on dark skin. Be sure you are pre-treated with a melanin suppressing preparation for 6-8 weeks before you begin treatment.  In addition, you should wear high SPF sunscreen before and during your treatment period.   There are certain settings for Fraxel in the higher FItzpatrick skin types like your self, and you will likely need more treatments than a person with lighter skin.  An additional benefit to you will be that your skin tone can even out with the Fraxel treatments.  You might ask around and get a referral from friends or acquaintances who have been similarly treated with good results.  This is a good way to find a good doctor.  Don't be shy about asking if the doctor has the experience you need.  Good luck!

What you seem to be describing is what is referred to as post-inflammatory hyperpigmentation (darkening of the skin) which is very common in people who experience acne, and more common in people with darker skin tone. Post-inflammatory hyperpigmentation, known as PIH, is used to describe the discoloration of the skin that follows an inflammatory wound. When a wound such as a pimple occurs, the skin is triggered to produce an excess of melanin (protein in skin that gives skin its color) at the site thereby causing hyperpigmentation in the area. For those with darker skin tone, there is even a greater risk for developing PIH, because there is more melanin in the skin. Although PIH will fade over time, it may take longer in those with darker skin tone. Often, with time, decrease in sun exposure, and a good sunscreen, PIH can improve. A combination of 4% hydroquinone and tretinoin cream can be effective in lightening the areas as well. In our clinic, I have had patients with darker skin tone who have PIH from acne scarring use Obagi Nu-Derm with some success. In terms of laser treatments for acne scarring, there is a risk for developing hypopigmentation, and so it is important to do a skin test prior to any laser treatment. My advice is to establish care with a dermatology provider and know that it may take some time to see improvement with treatment.

Medical Roll CIT (Collagen Induction Therapy) is an exciting new tool for the treatment of acne scarring.  It uses a rolling device to create hundreds of tiny puncture to the skin which acts to cause the collagen to become thicker and more uniform, thereby improving most types of acne scars. Since it does not injure the epidermis, as does many other treatment regimens such as lasers and dermabrasion, the risk of hyperpigmentation in dark skinned patients is almost nill.  It also allows applied therapeutic chemicals to traverse the skin barrier far more effectively.  Very few clinics have yet to adopt this exciting new therapy, although it has been available in Europe for quite some time.