I have acne and am currently taking accutane but I am already looking into my options so I can be as informed as possible when the time comes 6 months post-accutane. Since the scars are mild I don't want to take much of a risk (some of the stories here are scary!). What are the best treatments for this type of acne scarring?
Best Treatment for Mild Acne Scarring?
Doctor Answers 4
Acne Scars Treatment
I have had excellent results with the Fraxel both re:Store and re:Pair for acne scars. The re:Pair is a little more aggressive, but if you have associated problems with your skin beyond the acne (such as finelines, wrinkles, enlarged pore, and mild skin laxity), you may consider the re:Pair. I will be posting photos in the near future. You should seek out an experienced phsycian who has an expertise in both traditional treatment of acne scars (such as dermabrasion or chemical peels) and laser treatments (including the Fraxel). Only after an in perosn examination would the physician then be able to tell you which would be the best and safest way to go depending on your goals and expectations.
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Filler or Fraxel
You might look into the new Collagen filler Evolence Breeze when this gets FDA approval or Juvederm Ultra. Fillers are much less expensive and conservative than laser procedures.
Fraxel Repair might give you a somewhat better result but as you imply there may be some degree of risk. I have seen some excellent results and some where I could not see much of an improvement at all. This type of treatment would require some down time.
Medium depth peels, with TCA 35% would also be effective.
A year wait before peels or lasers would be required. Fillers can be done at any time.
Wait minimum of 1 year after completing accutane prior to scar revision
Any treatment which requires healing will be impaired by the recent use of Accutane and protentially result in worse scarring. Therefore resurfacing procedures are generally deferred for a minimum of 1 year after cessation Accutane.
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Proceed with care after Accutane
There are many great options for acne scars after Accutane, but you should wait one year before considering any type of laser. Fraxel Restore is my personal favorite for most skin types, but even light peels or SilkPeel, which are less expensive, can give very nice results.
It is not so much which procedure to choose, but the doctor performing the procedure that determines the outcome. My opinion is that a board certified dermatologist well versed in cosmetic treatments is always the best choice when the skin is involved because of the extensive background we have in skin physiology and surface wound repair. It is always best to research the doctor even more than the procedure. The care and judgment is critical to a safe outcome, so no scary things happen! Good luck!