Using Epiduo after Deep FX?

Question

My esthetician treated me with Deep Fx about 2 months ago. Would it be okay to begin using Epiduo again, or will that inhibit my skin's healing? I used Epiduo in the past to control my comedonal acne. After getting Deep Fx, my esthetician sold me onto his Environ vitamin serums, but they have been ineffective in preventing my acne. I'd like to swap out the vitamin/retinoid serum for Epiduo. Or could I use both in conjunction? I'm 18 if that matters. Thanks!

Hooman Khorasani, MD · Answer

Great question! I would recommend that you speak with the treating Board Certified Dermatologist or Plastic Surgeon as they may have a particular post Co2 regimen they prefer.  I have not heard or know of any issue with treating the area after initial 1-2 weeks of healing.  I recommend using bland emollients for the initial phase then can switch back to Epiduo.  This may be irritating on the new skin so work it in slowly.  I appreciate the question and wish you the best with future treatments.

Davin Lim, MBBS, FACD - Account Suspended · Answer

New papers on Adapalene for acne scars. Recommence 4-5 weeks after ablative laser. If possible try to use the 0.3% concentration.The ideal treatment for acne scars will depend on the morphology of individual scars. For example, rolling scars are best treated with subcision, atrophic scars with fillers, pick-ice pick scars with TCA or Phenol CROSS/ Paint, box-scar scars with fractional laser/ modified TCA/ phenol chemical peels, hypertrophic scars with steroid injections/modulated fractional delivery. 
Energy devices such as lasers, microneedling RF and bipolar radiofrequency are other methods to treat ‘general’ scar types. For example devices can improve rolling-tethered scars as well as ‘deep - superficial scars’ such as broad ice-pick scars and broad box-car scars. Devices should be viewed as a method of scar revision, and rarely as a sole modality. Exceptions do apply- for example in patients with predominantly shallow/broad box-car scars and or superficial pits. 
Another factor that will determine the ideal combination of treatment is the skin type of patients. Skin typing used to determine the ‘skin colour’ of patients. Darker skin patients will require modifications to treatment parameters. This includes a lower percentage of chemical peels, conservative protocols for lasers and energy devices and in some cases pre and post treatment of skin to reduce but not eliminate the chances of PIH- post inflammatory hyperpigmentation- skin darkening. 
The very first step in scar revision is to accurately determine the subset of scars you have. This is best done with a real time examination. Factors such as animation (rather than static photographs) are frequently used to determine the amount of ‘deep scarring’ /anchored scars or tethering. Palpation or touch is also extremely important to determine the presence of dermal and subdermal fibrosis. Scars that have altered ‘texture’ either hard or soft (atrophy) are more challenging to treat compared to scars with ‘normal’ texture. In some cases the use of angled lighting can be employed to accurately map scar types. 
My answers given in the context of this question is a general plan given the limited information. For an accurate guide, one has to take into consideration factors such as animation, touch, feel, real time examination and most importantly subjective measures, namely patient expectations. A real time consult with a procedural dermatologist or plastic surgeon is required for the best accuracy- diagnosis. 
All the best, Dr Davin S. Lim, Dermatologist. Brisbane. Australia.

Using Epiduo after Deep FX?

Answers (2)