Is Fraxel Laser the right treatment for me? (Photos)

Question

Hi! I wanted to check I have had one pixel treatment and was great for discoloration in 2021. Then last year I tried Clear and brilliant (total 3) but after my last treatment I started getting indented scars for the first time. This started in September. The scars are not getting better I'm using alpharetta and retinol. Could this be temporary bc of the laser and then retinol. Do you suggest a type of laser that works best for new boxcar acne scars. Thanks so much

Randal Haworth, MD, FACS · Answer

Schedule a consultation with a dermatologist to evaluate the specific nature of your scars. They can determine whether the indented scars are related to the laser treatments, your skincare routine, or other factors.

Continue using products like alpharet and retinol as recommended, but ensure that your skincare routine is suitable for your skin type and concerns. Your dermatologist can provide guidance on the most effective products for your specific situation.

Different types of lasers and treatments may be more suitable for specific types of acne scars. Fractional lasers, CO2 lasers, or microneedling are some options that can be considered for improving the appearance of indented scars. However, the choice of treatment depends on your skin type and the characteristics of the scars.

Best of luck !

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

Acne requires a combination approach to get long-term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling with PRP, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with an expert. Best, Dr. Emer​

Is Fraxel Laser the right treatment for me? (Photos)

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