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

I've tried professional dermarolling and 2 rounds...

I've tried professional dermarolling and 2 rounds of subcision and filler for isolated boxcar and rolling scars on my cheeks and jawline. I didn't see much improvement.
So now I'm on to spot treatments with the Sciton Profractional laser. Settings for my first treatment were 350 microns at 22% coverage. The procedure was painless thanks to the numbing cream. Afterwards it didn't burn, sting, etc but I bled a lot. 48 hours later I am still quite red (bleeding stopped awhile ago) but feeling good.
I will keep this updated as I go through more treatments over the next few months.

Pictures Added

It's been a week since the treatment. My skin is still red but easily covered with makeup. Still peeling a bit too.

2nd treatment

Just had my second treatment. Settings were 500 microns (800 in a few of the deepest scars), 2 passes at 11%. It hurt a lot more this time.
I haven't seen any improvement but it's still too early to pass judgement.

Recovery and Cold Sores

Recovery seems to be a lot quicker this time. The redness is reducing much faster and I'm done peeling.
Despite having taken anti-viral meds, I have managed to get a cold sore outbreak along my jawline. It hurts!

10 weeks since my last treatment...

Don't think I've seen much on terms of results. The scars seem the same. I'm disappointed so far.
Name not provided

TDC. So far, so good.

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So two things, once and for all, cold sores aren't "caused" by laser treatment. Nearly 90% of North Americans carry the HSV1 virus and many have no visible "out-breaks" but were still, at some point, infected. HSV1 looks like many things and it's not accurate that you can't have it inside the mouth, so I think it's important to clarify that as well. I took a heavy load of anti-virals before my laser surgery, 1,000 mgs, every day for three days prior and then kept going and had no issue. Won't hurt anyone to take this just in case either. Secondly, maybe it's just me, but for sure I wouldn't be doing any at-home acid peels on my face. That just seems like a recipe for disaster. Please be safe. You only get one face.
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So sorry you are not happy with your results so far :( Time really can make a difference, hopefully you will start to see some changes. 
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Thanks Eva.
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Give it four full months, IceAge. I think that sometimes when we don't see as much improvement as we had hoped (usually something more dramatic than what we're actually seeing), it's easy to conclude that there were no changes for the better. July 11th was four full months after my MicroLaser Peel. The improvement was subtle. But then again, all I had was the MLP. If I had been able to combine it with Profractional, I may have seen more improvement. Overall, though, all three laser treatments together have resulted in at least 50%, possibly more, improvement for me. So, I can't imagine that you won't see any improvement at all. After some time has passed, ask someone close to you that you trust for their opinion.
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Thanks PrettyGirl. I guess there has been some mild improvement but not as much as I'd hoped. My expectations probably weren't realistic. I'm not giving up thought. Have to admit though, I think I'll move to a fractional co2 laser for my next round of spot treatments.
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Stop doing these treatments! You will be scared even more. Unfortunately the scarring doesn't show up right away-trusts me.
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IceAge, did you ever have cold sores *before* having your first laser treatment? Are you sure it's a cold sore? I thought those only appeared on a person's lip....
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Yeah, I get them once in awhile. You can get them anywhere around the mouth, not just the lips. I rarely get them on my lips actually. I think the anti-viral did help though. The outbreak wasn't as severe as I've had in the past.
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I asked because I've never gotten those prior to lasering and have also not had any problems after my first two laser treatments. The doctors I've seen have also never advised me to take any sort of anti-viral before lasering. On occasion, I'll hear someone mention taking anti-virals before lasering when describing their pre-op protocol and I always wondered whether that was standard OP or if their doctor advised it because that person disclosed having an issue with the cold sore virus in the past. One thing did happen after my latest aggressive Micro Laser Peel in March - I developed a canker sore, which I thought was a cold sore (inside my bottom lip), until Google cleared things up. What happened was the doc lasered too close to the side of my mouth - unnecessary and just bad technique. I didn't moisturize properly up to the very corners of my mouth because who wants to end up ingesting their moisturizer? After a while, that area developed intense dryness and irritation and I was sort of biting my lip constantly without realizing it. The abrasion against a corner tooth caused the canker sore. Went away soon enough, but I was frantic that I somehow developed a cold sore when I previously did not have that issue. It's too bad that lasering seems to trigger an outbreak for those with cold sores.
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I also wanted to say that your skin looks great after it healed from the laser. I think you have lovely skin. Of course, when it is on one's own face the scar is all we see.
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Thank you for the kind words. You're right. All I see is the scars. They aren't severe but they're there nonetheless.
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Thank you so very much for sharing this. I am in the very same situation, with trauma scars on each side of my mouth. They are tacked down, which make them much like depressed acne scars. I've had subcision -- at least three times each side -- and then filler with subcision, then the fraxel laser 1550 seven times a month apart each time. My last time I had gentler subcision with Sculptra, for its ability to create collagen. I can relate to how much you have gone through with such disappointment -- I've seen very little improvement despite how much financial cost and the strain of having procedures. My skin is otherwise good: I do my own 25 percent TCA peels and I don't have dynamic wrinkles just the creases where the scars are tacked down: they pull on the fascia below and that causes creases. I was going to have a consult with a Clearwater doctor who is promoting her Profractional laser just last week but after talking to them I did not make the appointment. I am searching for an experienced practitioner who does the Co2 laser fraxel, either the Deep FX or the Fraxel Repair. I have searched so much online, everything I've read shows these types of scars are best helped by these lasers or fat grafting. The problem with fat grafting is you cannot know how it will come out, how much you'll need, how much will stay and on the fact, you can get the cottage cheese appearance. I also got pitched having the needling with PRP -- platelet rich plasma. But I just can't afford to spend any more money on anything that might or might not work, I am trying to stick to procedures that are better known. I did read that the results from these fractional lasers will improve over months, so you may see a very good result in three to six months. Please keep us posted and God Bless.
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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?
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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?
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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.
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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
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Wow! Two passes of 500 microns! I would really like to see how this turns out in 4-5 months. Consider posting pics after this second treatment, too, if you aren't in too much pain and don't mind it. I had forgotten to ask specifics regarding what you used for pain. Just numbing cream for these deep Profractional procedures or did the doctor also prescribe a painkiller? I hope you are feeling better after this second treatment. I know the first few days out after a treatment all you want to do is just rest. Take it easy. I will reply to your other posts this weekend.
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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.
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I'm very surprised that Profractional was painless for you. I had the MicroLaser Peel in early March 2014. I was supposed to have both the MLP and Profractional at that time. However, the doctor wanted to do 3 passes of 50 microns deep over both of my cheeks as that is where I have acne scarring (don't know about any other settings, just depth). The MLP was actually so painful at 50 microns that I told her to skip any Profractional treatment this time around. I've had two other separate laser treatments with a different doctor than the one in March, using a fractional Erbium (not sure if it was Profractional) as well as other lasers and it was not nearly this painful. All of my treatments involved only application of topical numbing cream, but my first laser treatment I was given Tylenol. I'm not sure if that is what made the difference. Thank you so much for your post. Please do keep us updated. I am interested in having spot treatments of Profractional as well. P.S. What is "TDC?"
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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.
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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.
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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.
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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.
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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.
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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.
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