Always treat the scar type, and never go for a 'laser' treatment. Sure, if you have rolling and atrophic scars, than lasers such as Fraxel 1550, Erbium or Co2 can work, however if you have ice pick scars - procedures such as TCA CROSS works better than laser.
If you have dark skin, I would use an energy device. eMatrix is great for early scars, but for established scars energy RF Microneedling works best.
See the video in the web reference for more information.
All the best
Dr Davin Lim
Countless patients present to my clinic
with acne scars, and fortunately, I have had a lot of success with treating
this difficult condition. Although you cannot completely erase a scar,
there are several available options to make scars much less noticeable. There
are 4 important conditions associated with scars: 1.) Depth of the scar (whether it is elevated or depressed); depressed
scars create shadowing which makes the scar more noticeable. 2.) Width
(wide vs narrow), facial scars are ideally less than 1mm. 3.) Color of the scar (lighter vs darker)
compared to surrounding skin. 4.) Direction
or position of the scar (ideally within or parallel to a natural skin crease or
fold). For depressed scars (such as chicken pox scars or some acne scars),
there are surgical and nonsurgical options. A combination of excision/repair
and then a resurfacing procedure to blend the area is ideal. When surgically
removing a scar it is important to ensure proper skin alignment. About 6 weeks
later, a resurfacing procedure is most commonly performed in my practice.
Fractional laser resurfacing purposely injures the skin’s surface in and around
the scar, and helps with blending. Lasers also stimulate collagen formation and
improve the scar’s surface and texture. Fractional laser resurfacing may be
used alone to lower the “shoulders” or elevated portions of a scar. Although
individuals with darker skin can develop hyperpigmentation after laser
resurfacing, this is never permanent, and easily treated with topical creams at
our clinic. Another option is subcision using a needle to undermine or break
apart the tether of the scar. Subcision results are variable and better when
used in combination with fillers or laser resurfacing. Nonsurgical options
include soft tissue fillers such as the hyaluronic acid fillers (Restylane,
Restylane Lyft, Belotero) for temporary (usually about 1 year) improvement in
scars. Prior to any intervention, however, a proper physical exam is necessary
by a board certified facial plastic surgeon
It does work but you have to know how to use it. Dark skin is riskier because your skin is made lighter and there can be some hyperpigmentation or hypopigmentation that can happen that is just part of the risk. Most of the time this doesn't happen but the mild changes in pigmentation can be something that you won't like. Most all people would rather have less scars though. Things can be done about the different pigmentation but there are limitations. I have treated many dark skin patients and patients with all types of skin tones with great success, but you have to be realistic.
Laser treatments for scars with patients with dark skin works very well. However, without photos it is not possible to say how many treatments or what other treatments such as injections may be needed. In general the EMatrix is the best laser for acne scars with patients with dark skin. Please consult an expert. Best, Dr. Green
In my opinion, acne scars are treated based upon the type of Scar. Without a picture it is difficult for me to assess whether a laser would work. Typically lasers work for moderately deep and superficial scars. Both ablative and non-ablative Lasers are successful in treating acne scars. Dark skin is typically treated with a bleaching cream before and after the procedure. You should see an acne scar expert. Ask to see photos. Good luck.