Profractional Laser Spot Treatments for Isolated Cheek and Jawline Scars - Ontario, ON

3 passes at 50 microns each sounds intense. I'm pretty sure you're well into the dermis at that point. How long did it take to heal? Did you get any results? I just had numbing cream. I felt a bit shocked by the laser but the brief pain was very tolerable. I do remember wondering if I could take a whole face procedure though. TDC is a dermatology centre in Toronto.

Did I see your pics on acne.org as well? It was intense, indeed. The 3 passes were just done across both cheeks. The lower jawline and chin had only one pass of 50 microns. The forehead was at 20 microns - far less painful, but still painful. I think numbing cream can have differing degrees of potency. I healed pretty nicely. It took about 4 days to peel off entirely. My forehead at 20 microns never changed color. It looked exactly as if I had never had any lasering done on the forehead. The cheeks remained pink for a good 2-3 weeks, fading gradually over the course of that time. I noticed some immediate improvement (by "immediate" I mean after the peeling stage, and upon close inspection a week or two later) in some large pores. While I do still have many large pores interspersed throughout the area in which I have scarring, I definitely saw a disappearance of pores. In the past, I only noticed drastic improvement after lasering after the end of the 4th month. I guess that is just my collagen remodeling cycle. I'll need to wait until then to let you know. I think, though, that if I had known that I would only be able to tolerate only one of the two lasers because of the pain, I would have chosen to do Profractional. I think Profractional alone might be better for acne scarring than the Micro Laser Peel. I have heard doctors on this forum say two different things regarding the use of multiple passes when lasering. One doctor stated that "stacking" has the effect of having a deeper treatment, another said that more than one pass does not have the same effect as having a deeper treatment. I don't know which is correct. It would seem that if a laser beam can only go as deep as 50 microns under the skin, it can only ever go as deep as 50 microns. I can imagine that multiple passes over the same area of skin will cover more surface area and create better results (remember, with a fractional laser, you're only treating about 20% of the skin with those dots of laser with spaces in between). But how can passing over the skin 3x at 50 microns equate to using a laser that is capable of penetrating 150 microns? Maybe I'll post that as a question for one of the RealSelf doctors. I'd like to do a Profractional spot treatment just as you did.

Btw, I really can't see your scars much in the pictures - if that helps. Only large pores. Even though your pictures are fairly close up, I also know that pictures can be deceptive and not tell the whole story.

Yes, I'm on acne.org too. I think the Profractinal is supposed to be better for scars because it goes a lot deeper. It's only one pass (or it was for me) so that might be why it didn't hurt. I had the numbing cream on for quite some time too. Also, try to schedule your treatments after your period. It makes a huge difference in terms of pain. Don't know much about stacking sorry, but it seems to me that 3 passes at 50 microns can't = one pass at 150 microns unless the laser hits the exact same holes every time. Not likely is it? Best to ask the docs in RealSelf...although I find such a variation in answers it sometimes makes me more confused!! So far I'm happy with the treatment. There is one shallow scar that really bothers me and I've seen a lot of improvement already. The other scars not so much but I'm staying positive.

Thanks...wish I didn't see the scars either, lol. Yeah, pictures can be deceiving. My scars aren't severe by any means but they bother me nonetheless.

Agreed. I've got to try the Profractional. Did your doctor tell you that... about scheduling treatments after your period? My March laser treatment was definitely not after my period. Thank you for the tip. [new paragraph] Don't worry, IceAge. The real improvement will come several months out. That has been my experience. It is supposed to keep getting better up to a year out. Are you having your Profractional treatments done in a series? I have so far never done that. But, rather, go back only after I've seen first seen an improvement with each treatment.

I know the feeling. I think that feeling is multiplied tenfold because we're women.

I had dermarolling sessions and I noticed a considerable increase in pain when I had the sessions just before my period. I talked to the esthetician about it and she said that it was very common. I figure the same would apply to the laser. I am going to have a least one more treatment in May, then I was thinking of breaking for the summer. That's the plan right now anyway. Fingers crossed this works for me!! Glad to hear that you've seen improvement :)

Thanks, IceAge. I'll be sure to ask my doctor about that the next time I have a laser treatment. Hopefully she can explain why that happens. Be sure to post again when you have your next treatment. Fingers crossed for you!

P.S. I had meant to mention that I also had dermarolling sessions but got so focused on the lasering. Dermarolling was the very first thing I ever tried for my scarring. It was actually a dermastamp, rather than a roller. 2.1mm in length. I was persuaded into paying for 10 treatments. Because of the excruciating pain, poor bedside manner of the practitioner, and lack of progress I was seeing, I had only 8 treatments before giving up. I wouldn't say it had zero effect on my acne scarring. I'm sure it helped at some level, but the changes were too subtle or too gradual that I got impatient and eventually tried lasering (later the same year that I gave up on the dermastamping). It was not until after 4 months after my first lasering procedure that I began to notice real and substantial improvement. Five months later, I had a second laser treatment and again noticed real improvement after the end of 4 months. These initial two laser treatments, before my most recent MicroLaser Peel, involved fractional Erbium lasers. I do not know the brand name of the laser used (they used multiple lasers in a single treatment session). They could have used the Profractional (which is only a brand name for a fractional erbium laser). I was told only that one would be a fractional Erbium.

Also, I wish I could have seen "before" pictures of you prior to this Profractional laser treatment because you mentioned you had 2 rounds of subcision. That is some serious surgery, is it not?! I've watched YouTube videos of these treatments being performed by doctors and I don't think I could ever have it done. I imagine that most people who go that route have more severe scarring. I would certainly have many, many sessions of lasering to no avail before trying something like that. That said, I have seen dramatic improvement in scarring by those who've had it done. A guy named Dragz on acne.org is one. I've also seen him post on this forum, too, I think. So, I'm surprised then that you say you didn't see much improvement with that method. I'm also not sure if that particular modality is like lasering, where you must wait at least several months for collagen deposition, or if you should expect to see almost immediate results after the procedure.

Btw, try to stay out of the sun as much as you can this summer since you're having multiple laser treatments. Based upon the experience of my 3 laser treatments thus far, I can tell you that staying out of the sun as much as possible BEFORE having lasering is just as important as AFTER having a treatment. No doctor told me that. This is based upon my own experience. The last thing you want to do is ruin the very expensive investment you just made in your skin. Pre-treating with bleaching cream several weeks before is also helpful for reducing redness/hyperpigmentation.

I have the before pics posted on acne.org. I had one subcision + filler in mid-Jan and another on March 31. I think the collagen growth does take time but you'd think I'd of noticed some difference by now. Especially with the filler. It really wasn't that bad. The first time was more intense with a Nokor needle and lots of bruising...4 or 5 days off work. The second time was with the needle from the filler. Not much downtime...only one day off work. I'm disappointed though. No where near the 50-80% improvement I was quoted.

Really disappointed with the dermarolling. I don't think it causes enough wounding create a significant collagen response. Must admit, I'm worried that laser is going to be the same thing as I can see all of my scars again with no improvement. I can't take another treatment that gets my hopes up and fails. Sometimes I feel like I should just do a spot dermabrasion. We're your other erbium tx ablative?

I will check out your pics on acne.org a little later and let you know what I think.

Yes. I thought all fractional Erbium was ablative, it's just fractional. Not full-field, traditional lasering (the older type of lasering, significant downtime, complications, etc.). Even if there are both ablative and non-ablative fractional erbiums, I had ablative. The docs mentioned this to me. Ok, you've had a lot of stuff done, but the Profractional is your FIRST laser treatment, am I correct? You posted in late April. When exactly did you have the lasering done? Do you know how deep the dermaroller was? Didn't hear you mention it was painful. Mine was terribly painful (and I've had some serious dental work done without anesthesia). Yes, I don't think the depth of the wound that most needle (lengths) create is enough to make a difference. Lasering is much more effective. It will work. Have some faith, IceAge, and give it some time.

Thanks prettygirl, I will try to be patient. The scars have really damaged my confidence. My first tx was April 26 so just about 3 weeks ago. For the first week and a half I didn't even see the scar that bothered me most. It got my hopes up and now I feel deflated. Your message made me feel better. How much improvement would you say you've had? What kind of scarring? Mild, moderate or severe? Thanks.

Dermaroller was 1.5 mm and the stamp was 2.0mm.

Three weeks... you've got to wait at least 3 months! More likely 4 mos. (that's how long it took for me). I had my micro laser peel in early March, so you have even longer to wait than I do. As I've said, I've had prior laser treatments so I'm not expecting dramatic changes with the laser peel. You, on the other hand, had a deep spot treatment AND it was your first time with laser. Don't worry. You should see changes. And even if they seem subtle to you (because you're looking at your face every day), just know that you'll likely need more than just 1 laser treatment. If we're limiting it to just 3 categories of mild, moderate, severe, I'd have to say the scars were moderate. They are not deep (esp. after lasering), but I have a lot close together - if that makes sense - and it's because of that that I describe them as being moderate. Despite the improvements that have taken place, I still hesitate to describe them as "mild" - even though others might. Because, like you, my scars still bother me. I have boxcars and several icepicks. No rolling scars. Cheeks only. What about you?

You will have to let me know what your screen name is on that forum. I couldn't find you.

Wow. Ok, so you had the same painful treatment that I did. Agreed that professional derma-stamping did not get me the results I needed. You will be happier with your laser results.

FreshStart2014

I know, I need to give it more time. Argh, I hate waiting though! Most docs say my scars are mild - boxcars on my left cheek, one ice pick a+ a shallow crater scar on my right. Also, I have a few crater scars along my lower cheek/jawline from severe skin picking (I have OCD). It's mostly the cheek scars I'd like to address. Okay, I'll be patient. Your posts have given me a lot of hope. Really glad you've had some success!

The plastic surgeon (the aesthetician who did the Sculptra/subcision works for him) recommended dermarolling. Actually, he called it needling. Is there a difference? After reading your remarks, I'm reluctant to pay for something that won't work at well as a laser. I think he has the Erbium laser, but I don't know if it is a fractional. Erbium is an ablative laser? So many lasers are on the market now, it's hard to keep up.

I'm pretty sure needling and dermarolling are the same thing. Save your money. I doubt needling will help, especially since your scars are tethered. Stick to your plan of getting C02. Despite their credentials and experience, I don't think docs always know best. I wish I had listened to my gut re: certain tx. Would have saved time, money and disappointment.

Well, I am doing small areas so it wasn't that bad. I asked the tech to concentrate on the scars only for two reasons: my kids get freaked out by the blood and my unscarred areas are still a tiny bit red from the last treatment and I'd like that to fade. Can't imagine doing the whole face...OUCH. They just use numbing cream. It's left on for about an hour. I didn't find myself as numb this time so I'm wondering of that had to do with the increase in pain.

It's so disheartening to try expensive tx that don't help. I was very disappointed with subcision too. And if I were you, I'd skip the needling + PRP. I thought about doing the C02 but decided against it because of the long term redness and the fact that no one wanted to do a spot treatment. I agree though, Co2 seems to be the gold standard. If the Profractional doesn't give me the results I'm looking for, I am considering some spot dermasanding in the fall/winter. Vs traditional dermabrasion, there is less risk for hypopigmentation, greater control of the abrasion depth and it's cheaper. I haven't met with anyone on this yet though. I am keen on trying some TCA peels too. Do you do them at home?

Yes I do my own 25 percent TCA peels. I started doing them because of the scars, before I learned they were more internal scarring, well, let's just say it's been a long and painful process. I watched a few videos on YouTube which were helpful about doing a TCA peel, plus where I bought it, there was a lot of support. It is a 1 percent ph,. which makes the peel very pure. I started off removing the TCA as soon as I saw a frost, now I keep it on for a few minutes after getting an even frost, and I layer it. Two or three times a year. I snake peel -- which is a good sign. But I do have to hide for at least a week. These peels can be done at home, if people knwo to be patient, and do a good prep. It saved me a lot of money, somethign that hasn't been the case while I struggled to find a procedure that would actually help, not just take my money. The peels have made my skin look great, and helped with sun damage. But nothing for the tethered scar. I think it is just very difficult to find a practitioner with a lot of good experience with a Co2 laser, fractional or otherwise, because it has so much longer downtime. It's easier for them to tell people it will be short down time and it will do this that and the other thing, but it will not go as deep no matter what anyone says. I spent yesterday reading on this site and it reinforced what I learned. I hate to have to travel for such a peel, because who wants to be on the road looking like that?

I've heard that TCA can help with very shallow scarring (like the ones on my jawline). I'd like to try home peels but I am frightened by some of the horror stories I've read. All I need is to make my skin worse! What strength did you start off at? And where do you get your peels? PM me if you prefer. How deep are these scars on the side of your mouth? Has anyone recommended an excision? I have no idea if that's a good idea for you...just wondering if that ever came up.

I use 25 percent TCA peel, which I bought from www.skinobsession.com. I only buy from them. I also use an 85 percent Salicylic acid peel, which is a flash peel: no down time. On for sixty second and off and every two weeks as it will keep the skin decongested and clear. The TCA peels are something you want to build up to. Start with 12 percent, and remove it as soon as you see a frost, gradually letting more frost etc. That's how I did it. I did it to help with the scars, but that was before I learned more about the types of scarring and that mine were very tethered down, all the way to the fascia, as they cause creases the way the tissue pulls. That's what makes subcision less effective: you have to have some healthy tissue and the scar tissue goes from just below the skin down to the fascia. I have had some improvement with that, this time I had it done, they used Sculptra because that creates collagen. I had HA fillers but that was a waste because they do not create collagen, just a padding, I would never have more deep cutting. I had scar revision and had I known -- and the plastic surgeon sure as hell shoudl have -- it just cut the scar deeper. Subcision was the better idea, with a fat graft or a collagen building filler. But they want money, and with some that's all they care about. You can get soaked if you don't watch it. I highly recommend TCA peels. They are excellent for overall skin care. Peels -- TCA, glycolic, etc. -- are still the gold standard in skin care. Empire Medical Training has excellent information. I read emails they sent out (but am not a member nor trained) My skin which was good from Retin-A use, really got good. However, the peels do not help tethered down scars. The surface of the skin will look good, but not for the type of scars. Only discoloration, surface scarring and marks, getting rid of spots etc. and general good clean healthy skin. The key to a good peel is prep: you probably already have a good skin care regimen. Doing good exfoliation already helps. A peel done well will not make your skin worse -- unless you do not use it right, or do not build yourself up to it. Prep for a few months using retin-A or lactic acid lotion. That will get your skin started flaking and a peel will go well. I have to hide for a good week. I snake peel, my face is red, sometimes red streaks, then I flake for the second week. Keep it moist wtih Emu oil, don't peel or pick at it. Be gentle, cleanse, and you will get a great peel result. You can also regulate your own peel according to how long you keep it on, the strength, and how many layers you put the peel mix on. I layer a lot, but do not keep it on as long as some. For my scars, I definitely need a laser that will have a greater depth, the Deep FX is what I am looking for. Becasue I do peels, I never saw mucgh after having treatments with the fraxel 1550. She cranked it up, as i had pin point dots that flaked off. But it is non-ablative, does not go deep. That's antoher thing, being told one thing to buy into their stuff, then you find out after that they sell you a bill of goods. If the links do not come out, let me know. Skinobsession is great at coaching beginner peelers and giving suggestions for acne scars. They have peels for that, I think they recommend the glycolic ones. I have nothing to do with it other than I am a customer. But like i said, if you find a good place, stick with it, because there are too many people out there who will sell you a bill of goods. I was looking for the Co2 laser and caleld one place and they said oh yes, we have the Sciton Profractional laser. It's a good thing I looked on this site, because that is not a Co2, but an erbium. I don't know why people cannot be honest. Gina

Thank you for the kind words. You're right. All I see is the scars. They aren't severe but they're there nonetheless.