C02 didn't make much of a difference - what procedures should I get to treat my scarring? (photos)

Question

I had CO2 laser in late February for my scarring but I do not know if that’s the only treatment I should opt for as it doesn’t seem to have made much of a difference to some of my scarring. If someone could please advise me on what other procedure I should get - as this has really affected my confidence - I’d be very grateful.

Nelson Lee Novick, MD · Answer

I have been cautioning my followers for years to exercise a very healthy dose of "buyer beware" when being confronted with marketing hype for this or that expensive, "next big thing" bells and whistles laser, RF or ultrasound device for acne scars. Unfortunately, the had science to back up their use lags well behind the heavy marketing and advertising to promote them. Simple, relatively inexpensive and tried and true (for decades) treatments that have stood the test of decades of time for safety and efficacy include subcision for elevating and smoothing boxcar and rolling scars and TCA CROSS for improving ice pick scars and dilated pores. Make sure that you consult a board certified cosmetic dermatologist with experience and expertise in scar treatments and be leary of other venues simply hawling their latest device purchase. Hope this helps and best of luck.

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. ​"

Bilgen Katipoglu Erenoglu, MD · Answer

Hi, SofiaHFernando ! Thank you for your question and photos. CO2 laser combined with Needle Radiofrequency (RF) and mesotherapy to give the best results. Raising the level of the treatment may be necessary and this treatment must be done in 3 sessions with 3 weeks intervals to achieve a much smoother skin surface.

C02 didn't make much of a difference - what procedures should I get to treat my scarring? (photos)

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