What would be best for these acne scars and skin texture? (Photo)

Question

Hello, what would be best for these acne scars and skin texture. Don't want to do CO2 because of long downtime. What would give me good results? Thank you.

Anna Chacon, MD, FAAD · Answer

When considering treatments for acne scars and improving skin texture with minimal downtime, there are several options available that can provide effective results:

Microneedling: This procedure involves using fine needles to create micro-injuries in the skin, stimulating collagen production and improving the appearance of scars and texture. It typically has a shorter recovery time compared to more invasive treatments.

Chemical Peels: Light to medium chemical peels can help improve skin texture and reduce the appearance of acne scars by exfoliating the top layers of skin and promoting new cell growth. The downtime is generally less than that of CO2 laser treatments.

Laser Resurfacing (Non-ablative): Non-ablative lasers, such as fractional lasers, can target deeper layers of the skin to promote collagen production without damaging the surface, resulting in less downtime.

Radiofrequency Microneedling: This combines microneedling with radiofrequency energy to enhance collagen production and improve skin texture and scarring. It typically involves minimal downtime.

Dermal Fillers: For deeper scars, dermal fillers can be used to raise the depressed areas, providing immediate improvement in skin texture.

Topical Treatments: Retinoids and other topical agents can be part of a long-term strategy to improve skin texture and reduce the appearance of scars.

Consult with a board-certified dermatologist to evaluate your specific skin type and condition. They can recommend the most suitable treatment plan tailored to your needs and lifestyle preferences, ensuring you achieve optimal results with minimal disruption.

Christopher T. Maloney Jr., MD · Answer

The Sciton TRIBRID laser, it is one of the more advanced resurfacing options on the market and is designed to combine multiple laser technologies in a single platform. We LOVE it in our practice especially because it can be particularly useful for acne scars, uneven skin texture, wrinkles, sun damage, and overall skin rejuvenation.

The TRIBRID platform combines 3 different technologies in one. The non-ablative and ablative fractional treatment to improve texture, pores, fine lines, and superficial scarring. The ProFractional which creates deeper microchannels to stimulate collagen and improves acne scars. And finally, the Contour TRL, the deeper erbium ablative resurfacing for more advanced wrinkles, severe texture irregularities, and deeper acne scarring.

For acne scars and skin texture, TRIBRID is attractive because it allows the technician to customize the treatment.

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic skin in Chicago. Since you don’t want CO₂ downtime, here is a realistic approach: Start with RF microneedling (maybe 3 sessions spaced ~4–6 weeks) to build collagen and improve texture, and combine it with subcision if you have tethered/rolling scars. Then add in a session of a non-ablative fractional laser (or Er:YAG moderate) every few months for further refinement of texture and tone. Maintain home skincare with retinoids/peptides + daily broad-spectrum SPF + gentle barrier support so that your skin is in good condition. Have realistic goal: Something like 50-70% improvement (depending on scar severity) rather than “erase all scars.”

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Viva Eve Dermatology - New York · Answer

Hi there!
This is a great question! First and foremost, CO2 laser is a highly customizable treatment that can result in very little downtime (about 3 days) if settings are selected properly, so those extremely intense photos you have probably seen online can be misleading! Don't get me wrong, there are surely extreme settings that can result in 3+ weeks of social downtime, but there are also much milder settings that can be chosen. It is really a customizable treatment, with tons of setting selections.
From your photos, I see some acne scarring and overall uneven tone. Just from these photos, I would suggest a combination treatment of microneedling with a light pass of CO2 laser on top. This gets your collagen stimulated and treats acne scarring both deeply within the skin with the microneedling, and very superficially with the CO2 laser. This is one of our most highly sought after treatments, and one which patients benefit greatly from.
As always, an in-depth, in person assessment of your skin and anatomy is required for safest treatment selection and most accurate treatment plan. 
Have a great day!Eleni SgantzosBoard-Certified Dermatology PA

Keera Kang, MD · Answer

Hi olga_daniel!The acne scars and skin texture that I see from your pictures do not seem to be severe and I am assuming you want a procedure with a short downtime. I have quite a few patients coming to the hospital for the same concerns. There are several options you can choose from. 1. Skinboosters (PDLLA, PN, PDRN, PRP injections) 2. Microneedle radiofrequency or both combined (combining fractionated RF with a skinbooster is an excellent combination since it helps the small holes from the needleRF heal more nicely).In my opinion I would probably start with a polynucleotide injection first bc it will not only help you with the scars but also the roughness of your skin texture, redness and also enhances the skin barrier.I recommend you to visit a physician and get a consultation in person. I hope this helped. Good luck :))

What would be best for these acne scars and skin texture? (Photo)

Answers (6)

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