Dermabrasion for thick African American skin? (Photo)

Question

I have very thick African American skin. I have deep scarring on both sides of my nose. The scarring is small, but deep. I have had countless microneedling treatment but the scarring is still there. A plastic surgeon mentioned dermabrasion. I researched it and it says it not safe for black skin only fair skin. But do you think if done lightly and since my scarring is rather small could it work for me? If not dermabrasion can you suggest something that should work?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

From the photos provided, the primary problem appears to be dilated pores and ice pick scars and for these issues it is hardly surprising that microneedling was not particularly effective. I have been performing microneedling for over twenty-two years, and it is best reserved for treating very superficial, surface skin texture and color irregularities and not really effective (as you found out the hard way) for deeper ice pick scars and very dilated pores. TCA CROSS, however, has an over two decade proven track record for treating these issues in all skin types.  TCA CROSS should not be confused with conventional TCA peels, however, which can be quite problematic in skin of color. Likewise, dermabrasion does carry the potential risk for dyspigmentation problems.  Make sure that you consult an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

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