Hypertrophic acne scars and keloid treatment - Dermapen vs Fraxel vs CO2? (photos)

I've been struggling with acne for a while now and recently decided to seek professional treatment. I have tried retin a, clindamycin, BP, salicylic acid, sulfacetamide and others for my active acne. I am yet to try accutane however, should I? My biggest concern though is for my hypertrophic scars. Which treatment works best for the type of scars i have. Dermapen, fraxel? im not a candidate for co2 fraction laser because of my dark skin. What do you suggest based on my pictures?

Doctor Answers 3

Acne scars and laser treatment

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Your skin and acne scars need to be treated after your acne is under control.  Once you do not have anymore severe break outs you can then have Fraxel or eMatrix therapy.  You may need to do a course of Accutane if nothing else helps get your skin under control.  I have used both Fraxel and eMatrix for severe acne scars such as yours with excellent results.  Please be certain to consult a dermatologist with a great deal of experience with cosmetic lasers for the best results.


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you still have active acne lesions on your face. the acne needs to be treated first before you can start laser treatment for scars. its true that Fractional CO2 is one of the better devices that we have to treat acne scars and its a bit challenging to use it in darker skin types but its not strictly contraindicated. I have treated all skin types

Treatment for Hypertrophic Scars

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Hi Jonny.  In your situation, we may start with steroid injections for the hypertrophic scarring.  We would likely then move to fractional laser resurfacing (Erbium vs CO2) which is perfectly ok for all skin types.  We have done many African Americans with the Sciton Profractional erbium laser for acne scar.  

We are also wondering if any of the hypertrophic scarring is related to ingrown hair and if this is the case, laser hair removal may be a good option as well.  

Your best bet is an in person consultation.  To see photos of other Los Angeles laser resurfacing patients for acne scars, check the link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.