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

Question

I have really large areas of hyperpigmentation and deep scars on my cheeks. I had 3 treatments (about $2,000 wasted) of Morpheus8 and I don’t think it did anything (and possibly made my scars and discoloration worse). Would dermabrasion be the best option?

David M. Kowalczyk, MD, MBA, FACS · Answer

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!

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

Nelson Lee Novick, MD · Answer

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.

Libby Copeland-Halperin, MD · Answer

Thank you for your question and for sharing your photos! Microdermabrasion in combination with non-ablative lasers can help improve acne scarring and the overall quality of your skin by stimulating collagen growth and improving areas of hyperpigmentation. Based on your photos, you may also benefit from MicroRF needling to treat your deeper scars and this could be combined with the laser treatments or PRP. I also recommend a comprehensive skin care program to help improve your areas of hyperpigmentation, acne, and overall skin quality. I recommend you meet with a fully-trained plastic surgeon who is experienced in treating scarring and hyperpigmentation to discuss the best approach for you.

Michelle Copeland, MD, DMD · Answer

Thank you for your question and for sharing your photos. Microdermabrasion in combination with non-ablative lasers can help to move you in the right direction by stimulating collagen growth deeper into the second layer (dermis) of the skin and improving areas of hyperpigmentation. This non-surgical process involves a stacking method using microdermabrasion, NdYag laser, Intense Pulsed Light (IPL), and Light Emitting Diode (LED) that work together to effectively smooth and tighten skin. It is a quick procedure without associated flaking or downtime; you can even have it done on your lunch hour. Based on your photos, you may also benefit from MicroRF needling to treat your deeper scars and this could be combined with the laser treatments. I also recommend a comprehensive skin care program to help improve your areas of hyperpigmentation, acne, and overall skin quality. I am passionate about skin health and created a skincare line (Skin Care Products | Anti-Aging | Dr. Michelle Copeland Skincare – drcopelandskincare.com) to help my patients improve the quality of their skin. I take a hands-on and individualized approach and recommend you meet with a board-certified plastic surgeon who is experienced in treating scarring and hyperpigmentation to discuss the best approach for you.

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

Answers (5)

Answer: Acne scarring

Answer: Acne scarring

Answer: Acne Scar Treatments

Answer: Acne Scar Treatments

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

Answers (5)

Answer: Acne scarring

Answer: Acne scarring

Answer: Acne Scar Treatments

Answer: Acne Scar Treatments

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Recommended reading

Everything you need to know about Dermabrasion

Our mission is to create a world where every investment in modern beauty is Worth It.