What treatment would be best for my cystic acne scars? (photo)

Question

My skin is getting really bad to the point where I'm crying. My cystic acne is currently flaring up- one of the nodules busted and I noticed a indentation about the size of a dime. I also have some boxcar scars and ice pick scars; it varies. At this point I'm willing to work with a doctor in my area to start accutane and then the best possible treatment. I don't want to be hit with discouraging prices. I want to take my time and do one treamtent at a time from subscision to fillers, etc...

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

​Acne requires a combination approach to get long-term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling with PRP, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with an expert. Best, Dr. Emer​

Peter J. Jenkin, MD, FAAD · Answer

You're on the right track.  You need to do the accutane treatment first to stop your acne.  3-6 months later you can start Infini treatments which I find to be the best treatment for all kinds of acne scars.  Fillers and subscision can be used as adjunctive treatment along with but not instead of Infini.  Best.

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