Why have my pores and acne scars gotten worse after my 2nd Fraxel session? (Photos)

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

Thank you for the post. I am sorry your acne scarring is worsening.  You should see a dermatologist to address underlying active inflammatory acne which may be contributing to scarring.  Treatments include topical agents, oral tablets and light based treatments such as PDT.  Once the acne is under control, your atrophic scars can be addressed.  It looks like you have ice pick, rolling and box car scarring.  You have Asian skin and need a combination bespoke multimodal approach.  The best treatment may involve subcision and microneedling with PRP along with an injectable filler using a "tower technique'.  Sometimes TCA cross helps and sometimes resurfacing lasers help.  Given you are Asian, a conservative / low energy approach is needed and meticulous pre and post treatment care is needed (with strict sun protection, SPF 50 products and sometimes hydroquinone / retinoid based agents). I hope this helps.

fraxel induces local damage and stimulates microinflammation during the healing process so its not surprising to see the skin flare. Please go back to your doctor, he/she may be able to give you some medication to reduce the acne flare. Use a topical that is non allergenic. Your skin will heal eventually and will look better than before.