If I no longer see improvement with chemical peels, should I try laser therapy instead for acne scars?

Question

I had cystic acne as a teenager and young adult. I started chemical peels in 2010 (age 23) and initially saw improvement with 18%TCA + Jessner peels and IPL, but it wasn't long before I plateaued. Now peels only help maintain earlier results. Does this mean I should move on to laser therapy or stronger peels, or is it possible I've reached the maximum improvement one could hope to get for acne scars and I'd be wasting my time and money to keep trying for perfect skin?

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. The skin resurfacing techniques include laser refinishing, chemical peel and dermabrasion. These techniques vary in strength and they can be adjusted depending on your specific needs. That is to say that, I suggest that you move forward and consult with a board certified facial plastic surgeon because the consultation will allow the surgeon to recommend a few techniques that are specifically combined and tailored for your specific needs.
Best wishes,

Lee B. Daniel, MD · Answer

Without a photo, it’s difficult to tell which treatment option or combination of treatments might be the best for your situation. That said, if you’re no longer seeing any improvements in the appearance of your acne scars, then you may want to talk with your plastic surgeon or other trained professional about the possibility of using a stronger chemical peel or laser skin resurfacing. In some cases, using a combination of treatment methods, spaced appropriately apart, can be very effective.

Sheryl D. Clark, MD, FAAD · Answer

Dear 6431:
The best improvements in acne scarring I have seen have been with Microneedling with PRP, especially when PRP is injected directly into each scar as well as microneedled into the skin surface.  The response to chemical peels of any type are limited in true acne scarring, i.e. depressions of various types in the skin. Sometimes when people complain of acne scarring they are actually talking about brown or red marks.,This type of discoloration will respond to Micro needling with PRP or lLaserGenesis.
All the best, Dr. Clark

Pablo Prichard, MD · Answer

Thank you for your question. Acne Scaring is difficult to treat with peels if it is deeper. You might want to try resurfacing lasers or even dermabrasion (not microdermabrasion). Speak with your skin care provider for assessment to see if you would be a good candidate for either of these treatments. Best Wishes, Pablo Prichard, MD

If I no longer see improvement with chemical peels, should I try laser therapy instead for acne scars?

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Answer: Acne scars no longer responding to chemical peels

Answer: Acne scars no longer responding to chemical peels

Answer: Acne Scars

Answer: Acne Scars

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If I no longer see improvement with chemical peels, should I try laser therapy instead for acne scars?

Answers (6)

Answer: Acne scars no longer responding to chemical peels

Answer: Acne scars no longer responding to chemical peels

Answer: Acne Scars

Answer: Acne Scars

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Recommended reading

Everything you need to know about Chemical Peel

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