Male, age 27, South Asian, I have keloid scars on my face - should I go ahead with acne scar treatment?

Question

I am thinking about having acne scar treatment on my face. Age- 27 Gender- Male Ethnicity- South asian I have had very severe cystic acne in past for that I took accutane at 70 mg per day. Recently I have noticed keloid scars after acne especially on sides of the face in the beard area but not on cheeks and I wish to have scar treatment on the cheeks

Raffy Karamanoukian, MD, FACS · Answer

The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! If you're done with Accutane for at least 6-12 months and your acne is largely gone, it would be a safe time to proceed with treatment. Subcision helps to release the underlying scar tissue if there is tethering. We use a needle to do this. If the scars are raised / keloids, steroid injections with Kenalog would be a good starting point to soften them. Pending how dark your skin tone is, certain interventions like CO2 or Morpheus RF microneedling can be trialed. Excision of the scarring which is large to create a smaller, more favorable scar is an option. But, there's always a risk of creating a keloid again if you're prone to them. Hope this helps you out!

Male, age 27, South Asian, I have keloid scars on my face - should I go ahead with acne scar treatment?

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