Is Halo laser treatment effective on my boxcar scars? (Photos)

Question

Mine are a little deep and I'm hispanic (fitzpatrick scale 4), my dermatologist consider them ''moderate''. She recommended Halo laser treatment instead of microneedling (because laser goes deeper into the skin), what do you think? Thank you very much.

Jason Emer, MD · Answer

Unfortunately a single treatment won't give you the outcome you're looking for. 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. Generally speaking, we use injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars; subcision for depressed, tethered scars; and TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.For darker skin types, it's important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation. Instead, scars in darker skin types can be improved with a combination of microneedling RF (Fractora, Intensif, Infini), Aerolase or Laser Genesis, microneedling with PRP, skin lightening, peels like Cosmelan, and a proper skin care protocol (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol). Sun protection is essential. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

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

Jeff Rapaport, MD · Answer

Lasers alone do not lift scars. Preparing your scars with subcision with PRP, microneedle radio frequency, and possibly TCA cross will improve the results of your Halo laser treatment. Preparing your skin with bleaching agents to decrease post inflammatory hyperpigmentation is suggested. Find a scar expert. Good luck!
Jeff Rapaport MD FAAD
Realself All-star

Richard Ort, MD · Answer

You might want to consider subcision and/or filler treatment under the scars to break up the scar tissue and adhesions and lift the scars.  I often do subcision using a blunt cannula and inject filler at the same time. This treatment in my hands would be appropriate for all skin types.Regards,Dr. Ort

Thomas D. Griffin Jr., MD · Answer

I love halo. In general it is a very quality laser treatment. However, in acne scarring like yours i suggest combining a number of treatments. I like RF microneedling the backbone to treatment. as compared to regular microneedling, it goes deeper than laser can penetrate, it has rf energy which serves to tighten collagen. Then based on the depth and nature of certain spots usually some subscision, fillers and maybe surgical improvement of the deepest lesions. I will usually then halo as a last step to improve the skin overall. It’s  a process but it works.

Is Halo laser treatment effective on my boxcar scars? (Photos)

Answers (5)

Answer: Boxcar scars on cheeks

Answer: Boxcar scars on cheeks

Answer: Need more than one treatment option for best results

Answer: Need more than one treatment option for best results

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Is Halo laser treatment effective on my boxcar scars? (Photos)

Answers (5)

Answer: Boxcar scars on cheeks

Answer: Boxcar scars on cheeks

Answer: Need more than one treatment option for best results

Answer: Need more than one treatment option for best results

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Recommended reading

Everything you need to know about Halo Laser

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