Acne scar treatment plan for ice-pick and rolling scars. (Photos)

Question

I have severe acne previous, have taken a accutane treatment. Right now, i have visible acne scar on my right cheek. I have review lots of online forum and medical journal. I believe tca cross and microneedling should be the treatment for my acne type. I have done 3 times of pro fractional laser (300 micros 22% density) and 1 time co2 laser (30mj) and 3 time subcision. I found no much improvement after the laser treatment, and some improvement after subcision.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne 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 acne 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 acne scars and indented acne 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 acne 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

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. ​"

Steven Costalas, DO · Answer

I suggest Microneedling at least 3-4 treatments. This therapy has been proven to help with visible scarring. I'm sorry laser did not work. A cosmetic dermatologist can help since they deal with acne and treatments of scars. Good luck.

Justin Harper, MD - Account Suspended · Answer

Hello rui, based on your pictures, I believe a Microneedling treatment followed by a chemical treatment would give you the best results. Microneedling is a fantastic, minimally invasive skin-rejuvenation procedure that involves the use of a device that contains fine needles. We use state of the art physician grade technology called Skin Pen II. The fine needles  of the device are used to minimally puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin.
Your physician would have to determine the best peel for you at the time of treatment, but the two services complement each other greatly. I would suggest multiple treatments for the amount of scarring present, but I'm very confident you would see amazing results the first treatment.
I have extensive experience in both Microneedling and Chemical Peels. Our rate for Microneedling is currently $250 and our Peels range from $109-$180. See our RealSelf profile for examples of these treatments
Have a great day!

Acne scar treatment plan for ice-pick and rolling scars. (Photos)

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Acne scar treatment plan for ice-pick and rolling scars. (Photos)

Answers (4)

Answer: Acne Scar Recommendation

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