Acne on cheeks and foreheads which left shallow red scars: Fraxel or IPL?

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

Since you are Asian, you run the risk of hyperpigmentation from both Fraxel and IPL. Red marks can be reduced with a vascular laser (such as Vbeam). Even then there is a chance of increased pigmentation so your doctor may prescribe a pigment suppressing agent too.Lasers per se are a bit of a challenge with ethnic skins because there is such potential for post treatment pigmentation caused by the laser passing through the melanin producing cells.Beyond the Vbeam for your red marks, you might look into eMatrix as this is a fractional resurfacing device that uses radio frequency instead of laser. The RF energy bypasses the melanin cells and this reduces the risks of discoloration.If you do decide to have Fraxel for the scars, your doctor will likely pretreat your skin for a period of time to try to prevent the pigment problems.

Fraxel is a fabulous laser for acne scars.  If the redness of the scar is your predominant concern than I would definitely recommend the V-Beam laser to you.  I have too many patients whom I have consulted on after IPL with your pigmentation and were hyper-pigmented after treatment.  For the best results please consult a board certified dermatologist with experience in Asian skin and laser treatments.

IPL might
help improve your red scars, however I would not advise you do IPL because it
is not appropriate for your skin type as there is a high possibility of
hyperpigmentation from this treatment. My best recommendation for your red
scars isVbeam Perfecta. Vbeam is a pulsed dye laser that is gold standard for
removing red on the skin and is safe on Asian skin. It is excellent for red
acne scars, broken capillaries, rosacea, port wine stains and many other conditions.
Typically you would need a series of treatments anywhere from 3-5 to see best
results.

Fraxel would
help improve your depressed scars but again there is a high possibility for
hyperpigmentation for your skin type. I would recommend Ematrix, the Ematrix system uses Sublative RF-
fractioned bi-polar radio frequency technology to effectively place heat energy
into the dermis with less possibility of hyperpigmentation. Though I have done
Fraxel treatments on Asian skin, I now prefer the Ematrix. Best results come
with a series of treatments and Ematrix can be combined with the Vbeam to
improve both your concerns.If you still choose to go forward with either IPL or
Fraxel it would be best for you to use a bleaching type cream to help minimize
the risk of hyperpigmentation and make sure to use SPF 50 daily.

Consult with a Board
Certified Dermatologist to see which treatments are best for your skin type.

Fraxel laser is the leading
treatment for acne scarring and hyperpigmentation of the face. It is safe on
most skin types. It will definitely help with the "red marks" but will take a
series of treatments to see optimal results. Additionally we would recommend a
regimen of Retin-A with a sunscreen in the morning.

A pulsed dye laser would be preferable in my opinion to remove/reduce the red marks. I often use this at the same time as a fractional laser for optimal results. IPL can be used too but you have an increased risk of pigmentary alterations. I find the pulsed dye laser far more effective and safe.  Good luck