What else can I do to treat these acne scars? Is ablative surgery an option? (Photos)

Question

these scars were once pimples I popped as a teen of course… Ive done multiple picosure sessions, another resurfacing laser (2x) and have had 4 microneedling sessions.. it has improved in appearance but I want them gone, would I be a candidate for ablative? Saw ablative remove papules from Asian patient. Ive spent a lot and would just love to spend on what will be best. Thanks, I have oily skin btw.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

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.

Nelson Lee Novick, MD · Answer

The nose appears to have a kind of hypertrophic scarring known as papular acne scars, which typically involve the nose and often the chin. They can be flattened by the use of appropriate intralesional anti-inflammatory injections, much the way ordinary hypertrophic scars are treated. Sometimes, this needs to be combined with "Scalpel Sculpting," which essentially sculpts the elevations off so that they become flush with the surrounding normal skin. In certain circumstances, this procedure may be performed alone, without the need the intralesional treatments. Make sure that you consult with an experienced board certified cosmetic dermatologist with extensive experience in acne scar treatments. Hope this helps and best of luck.

What else can I do to treat these acne scars? Is ablative surgery an option? (Photos)

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What else can I do to treat these acne scars? Is ablative surgery an option? (Photos)

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Everything you need to know about CO2 Laser

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