Which treatment option would be best for my acne scars? (Photo)

Question

I’ve recently been to a couple consultations to treat my acne scarring and have been recommended different options by every doctor. I really need advice on what would be best. 1) sciton profractional laser (2-3 rounds) 2) Resurfx laser (at least 3 times) 3) CO2 laser (1 time) 4) pixel laser (6 rounds) 5) TCA cross (two times) I know my ice pick scars are prob hard to treat so I’m at a complete loss of what would be best as I do not want to waste money on something that won’t work.

Raffy Karamanoukian, MD, FACS · Answer

We love the results of these microfractional lasers. We use either fractional RF, fractional erbium, fractional c02, or fractional thulium to help redefine the texture and contour of the skin.

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

So, here's the story. Subcision, which I have personally been performing for over a quarter of a century, is a safe, effective, and relatively inexpensive technique for elevating and smoothing indented boxcar and rolling scars in all skin types that engenders little to no significant downtime. TCA CROSS, which I have personally been performing for over two decades is likewise a relatively inexpensive approach used for treating ice pick scars and dilated pores that also has a proven track record for safety and efficacy and little to no significant downtime. Now, compare that with the whole list of relatively expensive, "bells and whistles," Johnny-come- lately fraxel laser and RF devices, etc. that were rattled off in the question all of whose hard science to back up their use unfortunately lags woefully behind the heavy device manufacturer marketing to hawk them. So, do your due diligence and keep in mind the simple rule: Keep it safe, simple and effective. Best of luck.

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