22, Indian with wheatish skin tone. I have acne, ice pick scars, some box scars & open pores on my both the cheeks (Photo)

Question

1. I was advised to go for Co2 laser for my scar and with retinol peel for post hyperpigmentation 2. She said the laser and peel will b done on same day. Is that fine if we done the treatment on same day ? 3. I was on accutane for a period of one month in Jan 2017 and I am going to start by Co2 laser n peel by 20th April. Can this cause side effects.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Philip Solomon, MD, FRCS · Answer

Acne scars such as your are best managed with multimodality treatment including Laser resurfacing, Bellafill filler,  hyaluronic acid filler, PRP,  subcision, punch excision of ice pick scars.  You must have stopped accutane prior to treatment.  I also advise patients with darker skin to use pre laser treatment with  retinA and hydroquinone.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question raashmi10. Fractional
CO2 laser resurfacing is an outstanding treatment that can address multiple
aspects of aging in a single treatment. I often combine the treatment with a laser peel (not chemical peel) on the same day. I recommend that my patients wait 6-12 months after discontinuing Accutane prior to such treatments as it can delay wound healing. Fractional CO2 laser treatment works well for acne scars. A series of treatments is required and results are seen slowly over time. For my patients with darker skin I pre-treat them with products containing hydroquinone, kojic acid, retinoic acid, salicylic acid, vitamin C, vitamin E, hyaluronic acid, and sunscreen for 1-2 months prior to the treatment. Please
consult with a doctor for specific recommendations. Good luck!

Sameer Bashey, MD · Answer

I agree with the other opinions that a combination of treatments is necessary including laser resurfacing, extensive pre and post procedure topical therapy but you also have some active acne still that needs to get under control before I would embark on such a procedure. You must also go to someone familiar with dealing with Indian skin which is very complex in its response to procedures and hyperpigmentation.

22, Indian with wheatish skin tone. I have acne, ice pick scars, some box scars & open pores on my both the cheeks (Photo)

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