What is the best type of laser resurfacing for Indian male skin?

Question

What is the best type of laser resurfacing for Indian male skin? I mainly have acne scars / really big pores that I want to improve. Also, what's the cost typically per treatment for Manhattan? I should mention that I was recommended the PicoSure by my dermatologist and the cost was ~$1k/treatment (he recommended doing 4-6 treatments). I'm trying to obviously maximize value and minimize cost (and given the cost for this option, I just want to make sure I'm investing in the best treatment).

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

John J. Martin, Jr., MD · Answer

You might look into doing an Infini treatment.  This is microneedling with radiofrequency.  The needles and the heat help to soften the deep scar tissue, and promote new collagen production.  Results have been very good for acne scars.  And since there is no laser light involved, it can be used on all skin tones.

Renuka Diwan, MD · Answer

Thanks for your question. The best treatment is determined not just by skin type but also the nature of the scars. Treating darker skin with lasers is always challenging compared to lighter skin types. Without the knowing the type of acne scars you have, it is impossible to make a treatment recommendation. The best way to make an assessment is not only by inspection of the skin but also testing for pliability of the scars. I presume you do not have any tunnel scars but this is also something that needs to be evaluated.

If you have pliable depressed scars that improve / flatten out by stretching the skin, one consideration is treating the scars with injectable hyaluronic fillers. Hyaluronic acid is a normal component of the skin and injecting the filler to lift depressed scars carries little risk of skin darkening or lightening and provides immediate results, with no recovery time. A bruise is possible at any injection site but usually clears in a week and can covered with a concealer in the meantime, if it occurs at all. A radiofrequency (RF) treatment can also help with these scars, and requires multiple ( think 10) treatments at weekly intervals followed by improvement of the scars which can take another 4-6 months to become evident as collagen regeneration can take that long. This also carries a negligible risk of discoloration from the treatment. Between the two I think fillers will give you better results for the right kind of scars. Results from fillers and RF need to be maintained with periodic touch ups.

If the scars do not improve significantly with stretching the skin, consider a non-ablative fractional laser resurfacing eg Fraxel. It requires multiple treatments (4-6). The risk of pigmentary alteration is low but you could request a test spot to assess the response of your skin. Microneedling is another (non-laser) fractional treatment that carries a lower risk of discoloration and can improve acne scars with multiple treatments.

You will find a range of prices for Manhattan. To optimize for value, it's best to see a board-certified dermatologist / dermatologist surgeon with specific experience in treatment of acne scars. Expertise and finesse will cost more but it's the best way to go. Cheap deals often correlate with lack of experience or services provided by  non-dermatologists or non-physicians. I would recommend checking out specialists at NYU / Columbia / Cornell University academic centers. Or you can check with one of the dermatologists at The Laser and Skin Surgery Center of New York.  You'll know if you're investing in the best treatment by consulting an experienced board-certified dermatologist / dermatologic surgeon, and possibly getting a second opinion. Hope this helps.

Davin Lim, MBBS, FACD - Account Suspended · Answer

You do have a few choices (depending on the size of skin pores), in your situation I too would use the Picosure Focus 6 mm spot. Yes, agreed, 5-6 sessions. The other option you have is micro needling RF insulated needle with PRP. I often do this treatment first, then the Pico 2 weeks later. The results with this combination is predictable, and you will get at least 50% reduction in pore sizing, providing the correct settings are used. Cheers, Dr Davin Lim. Brisbane. Australia.

What is the best type of laser resurfacing for Indian male skin?

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