Facial skin thinning due to steroid use, what options or laser would restore my skin?

Question

Which laser would be best (fractional CO2 laser or any other) to treat thin and wrinkled skin and stretch marks like appearance caused by prolonged (2.5years) use of bet novate. what are other treatment options? esp. there are no red spider veins.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented  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 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 lasers 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 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

Jason Emer, MD · Answer

all lasers , microneedling, peels, and skincare help rebuild collagen. you need a treatment plan. 
need to consult and start peels aand at home dermarolling now (see link) then in office lasers.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Michael A. Persky, MD · Answer

HI Isha,
I would treat you with fractionated CO2 laser combined with an automated injection system (Medi-Inject) that "boosts" the skin by placing a cocktail of hyaluronic acid filler, botox, vit C, and platelet rich plasma (PRP) at the precise depth and dosage to maximize your skin rejuvenation.  Depending on your physical exam you may benefit from Profound RF which builds elastin.  Please call our office to schedule your in person or virtual consultation.  We look forward to meeting with you as well as the privilege of helping you achieve and maintain your aesthetic goals for many years.  Good luck and be well,

Michael Persky, MD
Encino, CA

Robert T. Buchanan, MD (retired) · Answer

This, crinkly skin occurs naturally over time after about 25-30 years of age when the body stops making collagen and elastin in the skin naturally. The steroid just sped this process. Treatment is basic skin care with the addition of tretinoin (Retin-A) to stimulate collagen production and Obagi's ELASTIderm to stimulate elastin. To speed the process you can add fractional laser or micro-needling. If you have definite wrinkles, you can inject them with a filler like Juvederm Volbella and place it just under the dermis at 90 degrees to the wrinkle. The red spider veins are due to the sun, that also contributed to the above. They are best treated with an IPL (Intense Pulsed LIght, a laser like machine that uses a spectrum of light instead of a single wavelength).

Facial skin thinning due to steroid use, what options or laser would restore my skin?

Answers (4)

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