Order of acne scar revision treatments? How long should one wait between treatments?

Question

Is there a particular order of treatments that one should follow in order to achieve maximum benefit/results? If one is treating ice pick, boxcar and rolling scars, what would the recommended order be for treatments, and how long should one wait in between each treatment? Treatments I’m considering include punch excision, punch extraction, subcision, TCA cross, microneedling & laser.

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. ​"

Raffy Karamanoukian, MD, FACS · Answer

Combination treatments are ideal for acne scars. Using RF and microfractional RF with resurfacing is a good start, followed by TCA Cross, subcision, scar modulation, Vbeam laser, and resurfacing.

Best, 
DR. Karamanoukian
Realself100 Surgeon

Order of acne scar revision treatments? How long should one wait between treatments?

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Order of acne scar revision treatments? How long should one wait between treatments?

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