Recommended acne scar procedure? (Photo)

Question

Hello.doctors. Just want to ask your opinion about my acne scars and what would you recommend for my type of scars. I'm 27, Male.

Chet Mays, MD · Answer

Thank you for your inquiry! Lasers such as Microneedling can be performed to minimize appearance of scars. We would love to see you in person or virtually to discuss treatment options or schedule a consult with a licensed aesthetician to make a plan for you!

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

Nelson Lee Novick, MD · Answer

There are some simple rules to follow for treating acne scars: keep the treatments simple, relatively inexpensive, and look for those that have proven their value in decades of real-world use for both safety and efficacy. The following treatments meet those criteria.
For treating ice pick scars, consider TCA CROSS, a technique that I have been using for nearly a quarter of a century, with a proven track record for safety and efficacy in all skin types.
For acne related generalized atrophy-related volume loss in the cheeks, as is evident particularly in the photo of the right cheek, a Field Subcision can be very helpful. This will not only help to restore volume and decrease the sunken appearance, but by elevating the skin will help to smooth the overlying scars.
For individual indented scars, such as rolling scars and boxcar scars, consider individual subcisions, an approach that I have been using for coming up on thirty years, for elevating and smoothing them. It, too, has a proven record for safety and efficacy in all skin types.
And for superficial, surface, texture and/or pigmentary irregularities, consider professionally performed, manual microneedling (no need for the added expense and risks of RF micro needling) accompanied by the application of the appropriate Rx topicals. I personally have nearly 25 years of gratifying experience using this approach for these kinds of issues in all skin types. 
Finally, I would suggest exercising a great deal of "buyer beware" caution when considering the use of so many of the expensive, so-called, "next big thing," often here-today-gone-tomorrow, light and energy-based devices being advertised out there, as the hard science to back of their use lags well behind the heavy marketing hype and social media buzz that promotes them. 
You would be wise to consult with an experienced, board certified certified cosmetic dermatologist acne scar treatment specialist. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Hello, and thank you for your question. Based on your description and understanding that you are seeking advice for acne scars, a few treatment options are commonly recommended, depending on the type and severity of the scars. It's important to consult with a dermatologist for a personalized assessment, but here are some general approaches:

Laser Therapy: Fractional laser treatments, such as CO2 or Erbium lasers, can be effective for various types of acne scars. They work by removing layers of skin to promote new skin growth and improve texture.

Microneedling: This procedure involves using fine needles to create micro-injuries in the skin, stimulating collagen production and improving the appearance of scars.

Chemical Peels: Medium to deep chemical peels can help reduce the appearance of acne scars by exfoliating the top layers of skin and promoting new skin growth.

Dermal Fillers: For certain types of atrophic scars, dermal fillers can be used to raise the depressed areas to the level of the surrounding skin.

Subcision: This is a minor surgical procedure that involves inserting a needle under the skin to break up fibrous bands that tether the scar down, allowing the skin to lift.

Topical Treatments: Retinoids and other topical treatments can help improve skin texture and reduce hyperpigmentation, but they are generally less effective for deep scars.

Each treatment has its own benefits and potential side effects, so it's important to have a thorough discussion with a dermatologist to determine the best course of action for your specific needs. Wishing you the best on your journey to improved skin health!

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