Ice Pick Scarring and Big Pores

Question

Thanks for your time doctors. I have some very ugly icepick scarring on both cheeks and my dermatolagist recommended I come in for Cynergy Multiplex. Is Cynergy Multiplex the same as Affirm Multiplex? I don't mind spending the money if I will see results. I understand my scarring will never 100% go away but it would be great to hide them if I can. Also will accutane shrink the appearance of my pores permanently? I have very big pores on my cheek that makes it looks like I have more Icepicks.

William Ting, MD · Answer

While there is no magic bullet for patients with ice pick acne scars to achieve porcelain smooth skin, there are plenty of good options including punch excision of ice pick scars, fractional co2 laser resurfacing, Nd:Yag based lasers such as Spectra laser, Cutera GenesisPlus or Cynergy Multiplex. It is important that the treatment protocol be customized for your skin type and priorities and be supervised by a board-certified dermatologist.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 been 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 laser 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 acne 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

Benjamin Barankin, MD, FRCPC · Answer

There are various ways to reduce scars or the appearance of scars. For ice pick scars and large pores, I would first try having trichloroacetic acid inserted in the large pore or ice pick scar, something called CROSS therapy which can work quite well. It may need 2-3 treatments. Also, fractionated laser resurfacing can be helpful, or in some cases punch excision. Isotretinoin can reduce remaining pore size, sometimes with long term results.

Ice Pick Scarring and Big Pores

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Ice Pick Scarring and Big Pores

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