Acne scars and discoloration on my cheeks - would dermabrasion be the best option? (Photos)

Good Morning! For the acne scarring, subcision with a needle to release any deep tethering may be a good start. Sometimes, I'll add micro and nanofat to provide stem cells and growth factors to promote healing. Dermabrasion can work but it's often better for raised, not depressed, scars. CO2 resurfacing is an option but paying attention to pigment is important. If all else fails, excision of the deep and large scars can be done to create a "better" appearing scar. Hope this is useful!

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

Unfortunately, no surprises regarding the failure of the fancy-named, relatively expensive "bells and whistles" device treatment. I have been cautioning my readers to exercise a very healthjy dose of "buyer beware" when vetting so-called light and energy-based devices, since the hard science to support them lags well behind the heavy marketing hype to promote them. Let other readers of this answer take note and exercise the appropriate caution when being offered these 'here-today-gone-tomorrow" devices. Now to what can work and have proven track records for safety and efficacy in all skin types.. From the photos, there seems to be a great deal of acne atrophy-related volume loss in the cheeks, which is accentuating the depths of the individual overly scars. So, first step would be a "Field Subcision," which can then be followed, as needed, by individual subcisions to elevate and smooth the scars. I have been performing subcisions regularly for boxcar and rolling scars since 1994 with very gratifying results. Once all subcisions have been performed, professionally performed manual microneedling (no need for additional RF) can be performed to treat any residual superficial, surface skin color and textural irregularities. You would be wise to consult with a subcision-experienced, board certified cosmetic dermatologist who can also help with the current active outbreak also visible in the photos.. Hope this helps and best of luck.