I am looking for best acne scar treatment. I have lighter skin color than other Indians. I had 4 fraxel Restore sittings (Repair not available in India) but with no results. Please advise me on the best treatment where I can expect 60% improvement. I am little scared with the risks for Indian Skin. What would be the best place (country) to get treated for the same? I have attached my image which may help to advise me in the treatment.....
Does Any Laser Suit Indian Skin and Can Give Results to 60% Improvement for Acne Scars?
Doctor Answers (5)
Sublative rejuvenation is a new alternative to lasers. It is an energy based device but uses radiofrequency instead of laser, so having more melanin in the skin isn't an issue. It has been performing well for acne scars in our hands and is relatively new. Syneron makes this device and calls it the ematrix. Guaranteeing that something needs to give you 60% improvement is a bit unrealistic. Even the very best results published in the medical literature are usually 50-75% for acne scarring. The best way to look at it is to get a signifcant enough improvement that others and yourself would really notice. Like Dr. Lupo I am surprised you have not had results with Fraxel Restore but it can happen and it also does depend on the settings they used. You do need to have a high energy level to achieve improvement in acne scars. The one scar on your cheek that is very wide and deep is going to be difficult to correct as you have lost so much volume, so you may need to have a filler injected into this to get the skin surface to look even. As with many acne scars you may need multiple modalities to achieve good results.
A combination of resurfacing and filler will help.
For the smaller scars, resurfacing is still a good option. Sometimes, it may take some time for the fraxel sessions to show results. Dermaroller is also a good choice for your scars. You may also consider TCA CROSS.
For the larger depressed scar, fillers/ fat transfer are options. I have been using fractional resurfacing devices in skin types similar to yours, and they are quite safe!
And yes, like other doctors before me, I would also add that your should set your expectations realistically!
Fractional CO2 Laser for Acne Scars
The fractional CO2 laser is one of the most effective treatments for acne scarring and can be safe for skin of darker complexions. The deeper the laser goes, the better the effect. However, the deeper the laser, the more likelihood for post inflammatory hyperpigmentation. Visit with a physician who is experienced with this laser in order to determine candidacy. Remember that laser is the correct treatment for all different types of acne scars. It depends on what kind of scars you have.
Regarding expectations: I think that you need to have a more realistic outlook on what you can expect from an outcome. With acne scarring, 60% improvement is considered a grand slam home run. There is NO treatment that will get rid of your scarring completely. I think you should try to expect 20-30% improvement with each treatment to be more realistic.
Again, results of lasers will vary based upon the operator. The laser is a tool, just like a scalpel, and can yield different results in different hands.
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People of color require infra-red lasers for scar treatment
People of color require infra-red lasers for scar treatment. These include the YAG laser, Fraxel, and Affirm. They have less tendency to cause darkening of the skin. They must be repeated several times to get good results and often they are combined with subcision and with peels.
Traditional dermabrasion is an option
I am more than a little surprised that you had no results with Fraxel Restore. I have found it is safe and highly effective on darker skin. Traditional wire brush dermabrasion, following pre-procedure retinoids, and post-procedure sun protection will help. Post-inflammatory hyperpigmentation is the greatest risk.