TCA Cross? Lasers? What treatment(s) for treating these acne scars, texture? Cost/ location not an issue. (photos)

26 F. I have had 5 fraxel treatments (2+ years ago) and 3 dermapen treatments (~1 year ago). I apply tazorac nightly (on and off for ~9 years). About 4 months ago I had HA fillers in some of the worst rolling scars, that is the protruding lumps on the right cheek. ~6 years ago I took Accutane and it was a miracle drug - improved texture some and cleared acne. I have been to several local dermatologists for treatment and they said my scars aren't that bad, but I think in bad lighting they are.

Doctor Answers 5

Acne scarring that is still present after multiple treatments with Fraxel, Dermapen, etc.

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I see that you have undergone multiple treatments including fraxel, dermapen and multiple topical treatments. I see that your skin is not completely smooth and you have some textural irregularities as well as depressed atrophic large areas of scars. They maybe right that your scars aren't the worst, but I can see what you're talking about. You can improve your skin through general rejuvenation techniques along with treating your acne scars as well. There is a way to combine multiple treatments into one treatment that can be done in about 2 hours. This is something that we've been working on and we have created a new way to improve acne scars by treating them through multiple layers. We call it the Acne Scar Vitalizer Treatment.

Bellevue Facial Plastic Surgeon

Acne Scarring -- Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch Excision

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I suggest seeing an expert this area can be improved with lasers, fillers, microneedling/PRP.  You will need long term maintenance and if you want more substantial improvement you will want a more aggressive laser treatment to start.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Scars and Additional Improvement Wanted

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Depending on the depth of the scars I would consider additional Fraxel or eMatrix treatment.  I prefer eMatrix for your type of scars and there is less down time than with Fraxel.  You can combine this treatment with PRP for even better results.  Best, Dr. Green

Mild acne scarring needing improvement

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Up until Infini, Fraxel 1550 was my mainstay of treating acne scars. Now, all my patients get Infini and are happier. TCA is best for treating ice pick scars and you don't need it. Fillers work for deeper rolling scars which you don't have either. You have a superficial textural problem. You have to make sure you are completely volumized, which is hard to discern with your pictures. Keep in mind, your skin will never be 100% normal, better is the only thing you can hope for.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

"They said they aren't bad but I think they are"

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Sorry for you. You are not alone.A lifetime of fraxel and peels will never get the results you seek because the injury to your skin took place when your active infection led to loss of deep dermis and fat. The only way to improve that is to treat the problem where the problem exists. The deep dermis scar needs to be released by sub cision and the fat replaced with your own fat/ stem cells as a transplant from your hip fat.There is every reason to believe that you can be helped. Good luck

Richard Sadove, MD
Gainesville Plastic Surgeon
4.9 out of 5 stars 32 reviews

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