I'm half korean & struggle to find the 'best' solution to pitted acne scars.I had cystic acne as a teenager (now 24 yrs old) and it has left numerous pitted scarring. My history:light chemical peels (helped discoloration only), creams, microdermabrasion, silicone injections and DOT laser. Needless to say, little to no improvements. Olive skin tone doesn't allow strong laser settings; the DOT actually left more scarring. I'm scared any tx besides topical creams will do damage. Any suggestions?
I've Had Numerous Treatments for Pitted Acne Scars, Are There Any Solutions to my Problem? I'm Desperate.
Doctor Answers 5
Treatment for pitted acne scars
My treatment of choice for pitted/ice pick scars is CROSS using 100% TCA. I recommend 5-6 treatment sessions. The TCA is applied down to the depth of the scars and stimulates healing with new collagen. It is a strong treatment for the scars but avoids injury to the rest of the skin.
Fraxel Skin Resurfacing
You should look into the option of Fraxel DUAL. The Erbium fiber laser component penetrates deeper layers of the skin (1,550 nanometer). The Thulium fiber laser component is more superficial (1,927 nanometer). Fraxel DUAL may be used on all skin tones and on the entire body. It’s also non-ablative since you had previous issues with treatments scarring. Some pitted scars would call for surgical intervention, such as punch extractions.
I would suggest a mix of CO2 fractional laser and fraxel laser to treta the scarring you describe. Fraxel is safe in all skin . There will be 3-5 days of downtime with each procedure, generally less with the Fraxel. You will get the best resurfacing from these treatment options as they help to restore colalge and resurface pitted scars to even out skin tone. The FAST program would be the best suggestion for what you describe- Focal Acne Scar Treatment.
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Fractional Laser Resurfacing
Hi Jennis. We would use fractional laser resurfacing to treat your scars. Even with deep scars, profractional laser resurfacing with dental blocks can go do to 600-800 microns, deep enough to get to the bottom of the dermis where the fibrous acne scar tissue lies. Although you have had DOT laser resurfacing, unless the recovery was 7 days, the procedure was done 3 times and it was done with dental blocks, you have not had a good resurfacing procedure and need to research other resurfacing options.
We would not consider punch excision as you will just be trading one scar for another.
Pitted acne scars on darker skin types
Pitted acne scarring, if they are icepick like, can be treated with the TCA CROSS technique. I utilize 100% TCA to spot treat these areas and reboost healing, results are seen in 3-6 months. Other options include small punch excisions (removals with a tiny circle cookie cutter) with suturing to trade these scars for flat small line scars. If the scars are more shallow, laser treatments can improve it. However, multiple sessions are needed. Lasers such as Fraxel can be used on even darker skin types.