What is the most effective treatment for my acne scars? (Photo)

Question

I use to have severe acne for the most part it’s cleared up but now I have atrophic scar that really bother me bc despite not having acne anymore I still have bad scars so it’s a constant reminder…I’m hoping to get procedure sometime soon but I’m not sure what type I’ve been told that micro needling wouldn’t be effective with type of scare

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

Forget what you have seen about the supposedly "next big thing" (usually here-today-gone-tomorrow fraxel laser or RF device) on Dr. Google or Dr. Instagram. Ignore the marketing hype and social media buzz for expensive fraxel lasers or RF gizmos. There are a few relatively expensive techniques that have stood the test of time for safety and efficacy in all skin types. For ice pick acne scars and dilated pores, consider TCA CROSS, and for extensive cheek and temple acne atrophy, consider Field Subcision, and for boxcar and rolling scars, consider individual subcisions. And finally, for a final skin "polishing" step to better blend the aforementioned treated areas with the surrounding normal skin, consider professionally performed, manual microneedling (no need for the added expense and risks of RF microneedling). You would be wise to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and saves you a whole lot of needless waste of money and time, and a whole lot of needless frustration and disappointment. Best of luck

John L. Burns Jr., MD · Answer

In my opinion, a full ablative laser offers the best outcomes for acne scars. At these scars are very difficult to treat. An improvement is hard to achieve without an aggressive approach. I prefer ablative, Erbium laser resurfacing using the Sciton joule platform.

What is the most effective treatment for my acne scars? (Photo)

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What is the most effective treatment for my acne scars? (Photo)

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