Ice Pick Acne Scars - EMatrix Vs Profractional Laser?

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

Thank you for your question and for the pic.Your acne scars are ideal for eMatrix treatments.BestDr. Karamanoukian

my preference is to treat this type of scar with a fractionated CO2 laser system. I think this allows a certain depth of injury which helps improve these scars. Because you have ethnic skin ( pigment) we have to be more careful with your skin and often decrease our settings ( less aggressive). This means you will likely require more treatments to accomplish the same goal. Very deep acne scars are best treated with simple excision and closure( trading an acne scar for a better controlled scar).

Fractional resurfacing improves ice pick acne scars, however, even though micro laser peel is an excellent treatment for shallow surface irregularities, I would be concerned about pigmentation changes after this treatment, particularly now that we are heading into the sunnier time of the year.

I would recommend waiting until the fall to have the fractional resurfacing, using a broad specrum sunscreen during the summer and using a bleaching cream for a month before and a month after each fractional treatment for acne scars.

Ice pick scars... though deep, they are super easy to treat- a process called TCA cross can give excellent results. If one lasers ice pick scars, you have to get to the base of the scar to completely remove it. Ice pick scars, as the name suggests are very deep. RF or radiofrequency can work, the resistance of collagen bundles in ice pick scars, causes heating, and hence remodelling. This may work for some, but not others. My method of acne treatment is to treat the scar type, and skin type using a combination of techniques, Hope this helps. Dr Davin S. Lim Laser Dermatologist