Do you agree 3 ProFractional treatments, one microneedling PRP session and hydrafacials will improve my skin? (Photos)

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. Generally speaking, 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, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, 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.
For darker skin types, it is important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation. Instead, scars in darker skin types can be improved with a combination of microneedling RF (Fractora, Intensif, Infini), Aerolase or Laser Genesis, microneedling with PRP, skin lightening, peels like Cosmelan, and a proper skin care protocol (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol). Sun protection is essential. I recommend getting a formal evaluation with a board-certified cosmetic dermatologist and acne scarring expert. Best, Dr. Emer

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. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

I have been cautioning readers for years now that relatively expensive fraxels, radiofrequency devices and ultrasound machines are far more backed by device manufacturer supported marketing hype than hard science. Moreover, extra caution is needed to avoid long-standing or even permanent postinflammatory hyperpigmentation is needed whenever light-based therapies are used in skin of color.  Regarding PRP, I have also oft quoted a relatively recent November, 2018 JAMA Dermatology study of PRP for improving skin tone and texture that concluded, "Both raters and participants found PRP to be nominally, but not significantly superior to normal saline,"  (i.e. no better than placebo salt water injections). You appear to have a mixture of acne scars, which from the photos are rolling, boxcar and ice pick scars. A customized treatment program consisting of subcision for indented craters and TCA CROSS for ice pick scars would be a reasonable treatment approach. Professional microneedling can then be helpful for better blending of the color and texture of the treated scars with the surrounding normal skin. You would be wise to consult with a board certified aesthetic physician with experience and expertise in the treatment of acne scars. Please do your due diligence before signing up for any treatments with any of the supposedly "next big thing" bells and whistles devices. Not everything that flashes or buzzes is worth your time and hard earned money. Best of luck.