Acne Scar treatment - what would be the best options? (Photos)

Question

Hello, i was hoping to get some advice on what treatment for my severe acne scars. I have done 8 rounds of RF microneedling and two Morpheus 8 treatments, which i think Morpheus made it worse. Im really deseperate at this point, i dont leave my house and feel i wasted my life in hiding. But enough of the sob story, any advice would be great. I attached pics. Also would you clasify the scars as rolling or boxcar?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 acne 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

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Nelson Lee Novick, MD · Answer

Unfotunately, I am hardly surprised by the disappointment and frustration with the lack of results from the expensive "bells and whistles" RF devices with the alluring names. I have been cautioning my regular followers for years that these supposedly "next big thing" devices are backed far more by social media hype and heavy advertising and unfortunately by little hard science. Sorry.  The same can be said for fraxel lasers. On the other hand ,some relatively inexpensive, but time tested techniques, such as Field Subcision for generalized, acne-related cheek atrophy and individual subcisions for boxcar and rolling scars (all of which I have been performing since 1995) and TCA CROSS for ice pick scars and dilated pores (which I have been routinely using for over twenty-three years) have proven records for both safety and efficacy in all skin types. You would be wise to seek consultation with an experienced, board certified cosmetic dermatologist acne scar specialist. Hope this helps and best of luck.

Acne Scar treatment - what would be the best options? (Photos)

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Acne Scar treatment - what would be the best options? (Photos)

Answers (3)

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