Would do anything if it will help with my acne scars - is there any solution? (Photo)

Question

Can anyone help? I never had "bad" cystic acne but breakouts in teens/early 20s led to numerous scars. Over years I've tried SO many things, which haven't helped & actually increased/created new scarring. 6+ Microneedling: caused crepiness/small icepick scarring/new atrophic scars. TCA peel 20% created new atrophic areas. 1 subcision + Sculptra: no help; 1 area of atrophy is worse. Is laser only option? My skin seems to heal with scars so I'm worried but want help.

Raffy Karamanoukian, MD, FACS · Answer

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.
 
As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I'm not at all surprised by the lack of success with the treatments here; there are so many issues that need to be cleared up. First, one does not necessarily have to have had severe acne to develop acne scars. Secondly, traditional microneedling (no need for the added expense and risks of RF microneedling), which I have been performing for over twenty-three years, is best reserved for treating residual superficial, surface color and texture irregularities, like a final "polishing" step; it is not particularly effective as a primary treatment for acne scars. TCA CROSS, which involves using concentrations of TCA between 80-100%, and which I have also been performing for nearly a quarter of a century, is a treatment of choice for ice pick scars and dilated pores. TCA 20% is a mild peel that would not have been expected to do much of anything for boxcar, rolling or ice pick scars. So, again, no surprises with the lack of success there. Subcision, on the other hand, which I have been performing since 1995, has an excellent track record for elevating and smoothing boxcar and rolling scars in all skin types. However, only RARELY is one treatment session sufficient to achieve any visible or optimal results; typically two to six treatment sessions may be required to do so. So, even if your physician was an experienced scar treatment specialist, you should have been told in advance that you were unlikely to realize much benefit from just one treatment. So, again, no surprises. Finally, when considering expensive "bells and whistles" gizmo treatments, such as fraxel lasers and RF devices, keep in mind that the hard science to back up the use of these devices lags well behind the heavy marketing hype and social media buzz to promote them. You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist scar specialist and best of luck going forward.

Would do anything if it will help with my acne scars - is there any solution? (Photo)

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Would do anything if it will help with my acne scars - is there any solution? (Photo)

Answers (2)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.