40, male - What treatments will help with acne scarring? (Photos)

Question

Hi, I’m a 40 year old white male. I have a bit of acne scarring on my nose and deeps pores. I also have a scar on my cheek from my dermatologist cutting too deep into my skin. I’ve had roughly 30 blue peel chemical peels, 2 Aqua Gold treatments, A glicolic chemical peel and I’ve done at-home micro needling. Nothing seems to heal these scars. Any recommendations or suggestions for permanent healing?

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

Nick Slenkovich, MD · Answer

Hi, I’m Lauren, the aesthetic injector here at Colorado Plastic Surgery Center.
Based on what you’ve shared, it looks like you’d be a great candidate for CO2 laser treatment. This advanced technology is highly effective for targeting acne scarring by resurfacing the skin and stimulating collagen production.

I’ve attached a link to our website with more detailed information about this amazing treatment — feel free to take a look.

Nelson Lee Novick, MD · Answer

Oh gosh. I'm so sorry for all the time and money wasted on the previous treatments. Superficial peels, no matter how fancy-sounding the names, were extremely unlikely to do much for the the kinds of ice pick scars you circled in the photos and home microneedling had little chance of success, as well. 
At least from the photos, the several, narrow-based ice pick type scars would likely respond to TCA CROSS treatments, and the broader-based, depressed scar would likely respond to subcision to elevate and smooth it more. 
You would be wise to seek consultation and treatment from an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

Stefan Weiss, MD · Answer

CO2 Laser Resurfacing can improve deep pores and acne scars by stimulating collagen and resurfacing damaged skin.

40, male - What treatments will help with acne scarring? (Photos)

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