Treatment of Acne Scar can involve several modalities based on the type of scar from excision, subcision, injection and resurfacing. All laser type treatments provide a way of resurfacing the skin and stimulating the production of new collagen and elastin. Whether its erbium, c02 or radiofrequency energy the skin doesn't necessarily matter except for the side effects. F.A.S.T is just an intense C02 laser treatment followed by a couple fraxel treatments. CO2 laser treatments are very effective for acne scars, but they can cause pigment issues in darker skin types, either bleaching the skin or leading to hyperpigmentation. Erbium, has less risk but still can lead to pigment problems especially if it is turn up enough for a significant result. Radiofrequency devices(ematrix and infini) are much less prone to pigment issues. The problem with ematrix, is it is not able to delivery the energy deep enough, it can only go 0.4mm. The Infini uses miconeedles to inject the energy deeper, without hurting the epidermis. It has largely replaced fraxel and co2 lasers in my practice because of its safety in darker skin types and significantly less downtime.
In my opinion, patients with dark skin should be careful with lasers that compromise the surface of the skin. For this reason, patients such as yourself, who have box cars and pits, are treated with subcision and micro needle radio frequency( infini). Both of these treatments are primarily underneath the skin and will lift the scars. Ask to see pictures of patients with similar type of scars and skin color as yourself. Multiple treatments will probably be needed. Seek someone who has experience in treating acne scars. Hope this helps. Good luck.
In our office, we specialize in acne scar treatments. For darker skin, I would suggest a combination of Clear and Brilliant laser, subcision, and Ematrix RF.
I really like the INFINI RF micro needling system, not only in darker skin types, but even in lighter skin. This has less downtime than CO2 Fractional- Fraxel- Profractional, and in my opinion works better. I am transitioning most of my laser patients to Infini RF.
Infini is not a laser, so the chances of skin colour changes in YOUR situation is very slim. Remember its the method of scar revision that gives you the best result, not the machine.
All the best
Dr Davin Lim
Laser and aesthetic dermatologist
I have treated so many patients like you who exactly your skin type and acne scars. I have found that eMatrix is by far the best treatment. You will have almost no down time and no hyperpigmentation issues with lasers such as Fraxel. Please consult an expert with lasers and dark skin to best treat you. Best, Dr. Green
I am not much of a fan of lasers in the first place, finding them relatively expensive treatment options and far more manufacturer backed marketing hype than hard science. Additionally, extra caution needs to be exercised in their use in people of color, since permanent loss of pigmentation has occurred following their use, as well as prolonged episodes of postinflammatory hyperpigmentation.
In general, less expensive alternatives have been shown to yield gratifying results in persons of all backgrounds. These include subcision to elevate depressed scars (boxcar and rolling scars), the TCA CROSS for pit (ice pick) scars, and medical microneedling for blending the tone of and texture of the treated sites with the surrounding normal skin. None of these relatively inexpensive treatment modalities carries the risk of the hypopigmentation.
For more information on any of these treatments, check out the archives of RealSelf.com.
You would do well to seek consultation with a board certified aesthetic physician with experience and expertise in acne scar treatment in people of color.
There is no acne scarring treatment that will work solo, you will need a combination approach and specifically for your type of scars lasers or radiofrequency and TCA cross. Best, Dr. Emer.