Can I use the Infini RF and PicoSure lasers at the same time to treat acne scarring and hyperpigmentation? (photos)

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Yes, a combination approach will give the most improvement to acne scarring. For the best results, one should target the acne scar type. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision. Subcision for depressed tethered scars. Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring. Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision. All lasers are combined with microneedling and PRP to get even better results and improve healing times. The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician. It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome. Scars cannot be cured and will need life-long treatments to maintain and build on the results. Best, Dr. Emer.

You can certainly have both PicoSure and Infini RF concurrently but seek an experienced skilled practitioner.  The Pico is a nice tool for improving post inflammatory hyper pigmentation and shallower scarring, while the Infini is a more robust device for heavier and deeper scarring.  The trick, however, is to find a scar specialist who can combine the two effectively with the right parameters in the same session.  Best wishes, Shobhan.

Yes you can, however Picosure will not give you an improvement with your rolling scars. Pico is excellent for pores, and reducing pigmentation. In this situation in your skin type, I like to space your treatments 2 weeks apart. The pico can reduce the PIH you may get from Infini, and further improve textural changes. There in lies the logic. 
Acne scar revision comprises of specialised procedures. For the best results, one should target the acne scar type with ideal treatments METHODS. Using one device is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. 

As an example deep ice pick scars, and narrow box car scars are best treated with TCA CROSS. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat grafts, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combination that give you best results, and everyone is unique! It is never about the device, its about the specialist behind the equipment that will deliver the best outcomes. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.