What procedure would be best for me? Laser? Microneedling? (Photo)

Question

Considering laser. Would like ablative. Or should I go for microneedling? I’m 47. The older I get the worse my skin looks. No acne problems now just the pin holes and severe scarring. It’s so embarrassing. I want to see a professional who knows what they are doing. Not these fly by facial places. Please advise me what to do.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

R. Brannon Claytor, MD, FACS · Answer

Hello,

Microneedling is one of the top procedures known for helping with acne scars. This treatment promotes new collagen to produce, revealing newer, healthier looking skin.  This will reduce the appearance of the acne scars.   Typically a series of 3 treatments are needed, spaced one month apart for optimal results.

William Groff, DO · Answer

Scarring like yours can be challenging to treat and often requires a combination of treatments to produce the best results. I might recommend a CO2 laser combined with RF microneedling to address the enlarged pores and shallow scarring, while rejuvenating the skin. I encourage you to schedule a consultation with a board-certified dermatologist with laser expertise. Through an in-person evaluation, your doctor can create a customized treatment plan designed to produce the best possible results for you.

Jacob Sedgh, MD · Answer

Thank you for your question! We have seen dramatic results in our patients with acne scarring after a couple of treatments of FRAXIS Duo, a combination of CO2 and micro-needling with RF. The treatments help to treat scarring, reduce pore size, among other benefits. Please meet with an experienced, licensed practitioner who can speak with you about your options. We wish you the best!

Jason Emer, MD · Answer

CO2 is the best laser for scars, but Erbium is a great alternative. It may take a series of treatments to see improvements and to maintain. Keep in mind that a tailored combination approach will give you the most improvement with acne scars. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and helpful photos.  I would suggest in-person consultation with an experienced board certified cosmetic dermatologist who has a variety of procedure options.  Fractional CO2 laser is excellent for improving acne scars, but does have a few days to a week of downtime.  Something with less downtime that you could do in series is RF Microneedling.  There are a number of devices with this technology, and they are showing great promise for scar and skin irregularity improvement.  Combined with excellent skin care and sun protection, you will probably have wonderful results with either of these treatments.  Please see an expert and best of luck!

Susan Fox, DO, RPVI · Answer

Hello, we've seen amazing results minimizing acne scarring with Vivace.  Vivace is fractional microneedling with the added benefit of radio frequency.  This allows for better results with less downtime.