Severely dehydrated crepey skin! What procedure can be done to take that away and produce new healthy non crepey skin? (Photo)

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Fraxel Re:Pair and Re:Store are two of my top modalilties for resurfacing aging skin and stimulating the production of new collagen and elastin. Re:Pair is a CO2, ablative laser that will leave your skin looking reddened for a couple of weeks. You only need one treatment per year. Re:Store is gentler, but will take more than one session. Boosting your skincare regimen with antioxidants and creams like SkinMedica’s HA5 with hyaluronic acid will help you maintain your results. You also need to take extra precautions in the sun and always wear sunscreen. Consulting with a board-certified dermatologist will help you find the best treatments to repair and maintain your skin.

Although hydration is part of the puzzle, the bigger part is loss of collagen as we age. This is greatly accelerated by sun damage (wear your zinc or titanium containing sunscreen every single day!). IPL/BBL will even out the color and slow down the rate of skin aging while building collagen. If you are looking for faster or more dramatic results, combine this with fractional lasers (I like Halo best), PDO threads for support and additional collagen, and PRP. Start managing this delicate chest skin early - in our office over 70% of our patients opt to treat their chest in addition to their face.

Dear Nadiagrace88:
There is more than one modality that would be effective for your issues, including Fraxel, LaserGenesis and microneedling with PRP.  I think you would see the most benefit at a reasonable cost with a few LaserGenesis treatments. Whatever you do, you will want to begin a regimen of high-quality topical agents to promote and maintain the results. Glycolic acid will immediately smooth the skin and, over time, increase proteins that bind water maybe the skin less dry, as well as correct wrinkling and sun damage. A retinol product, one with growth factors, and Alastin will also remodel the skin over time.
All the best,   Dr. Clark