What is recommended to treat my acne scarring? Please help (Photo)

Question

Hello, I wanted to know what is recommended to treat the type of acne scars I have. I think they are mostly ice pick and box scar acne scars. I’m from Indian ethnicity so I’m not sure what lasers work, would TCA cross be a better option. I’ve been on accutane twice in the past so there isn’t any active acne, just the leftover scarring. I live in Dallas TX and haven’t really found a doctor that does specializes or helps treating acne scars. I really would like some advice as I am very lost.

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

Jason Emer, MD · Answer

​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​

Nelson Lee Novick, MD · Answer

Even if the fraxel lasers were truly backed by hard science and as effective as their marketing hype, there would still be the legitimate concern about post-treatment dyspigmentation problems (prolonged hyperpigmentation or even permanent loss of pigmentation). On the other hand, subcision to elevate and smooth boxcar and rolling scars and TCA CROSS for ice pick scars and dilated pores, each has a greater than a two decade track record of safety and efficacy in all skin typies, including skin of color. Make sure to consult with a board certified cosmetic dermatologist with expertise in acne scar treatments and continue to be cautious in evaluating offers for this or that latest fad laser to come along.. Hope this helps.

Anshul Gambhir, MD · Answer

Thank you for your question! With your Indian ethnicity I would recommend starting with microneedling treatments. You can do PRP at the same time to boost your results and speed up your healing time. It will take several microneedling sessions to really resurface the scarring. To be on the safe side with your ethnicity you should pre-treat your skin with lytera for two weeks prior to any microneedling treatment. Hope this helps!

What is recommended to treat my acne scarring? Please help (Photo)

Answers (4)

Answer: Acne Scarring

Answer: Acne Scarring

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What is recommended to treat my acne scarring? Please help (Photo)

Answers (4)

Answer: Acne Scarring

Answer: Acne Scarring

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Recommended reading

Everything you need to know about CO2 Laser

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