1 month post Fraxel. Do I have ice pick scars or large pores? How can I treat this? (photo)

Question

I believe I have ice pick scarring or large pores I am not to sure. I have been to doctors and spa. I did get a Fraxel treatment 1 month ago but it didn’t make a difference at all. Also it ledt to much downtime was almost 3 days. I heard about chemical peels would be good for my scars to? I do also get breakouts so I might go on minocycline. Please look at my photos and let me know what would be best.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

William Groff, DO · Answer

Hello and thank you for your question. Unfortunately, it is difficult to make recommendations from the photos you provided. There are different types of acne scarring and I can’t tell what type you have from your images alone. I can tell you that there are different laser treatments to address acne scarring and many patients will benefit from a combination of these procedures when they are customized to the precise needs, scarring and skin tone of the individual patient. If you undergo fractional treatments for this type of scarring, the depth required for the treatment will require some downtime afterward. More than one session may also be required to achieve an optimal outcome.

Kimberly Butterwick, MD · Answer

These photos do not give me enough information to make a recommendation, unfortunately. I encourage you to schedule an in-person consultation with a board-certified dermatologist who can diagnose the type of acne scarring you have and create a customized treatment plan designed just for you. There are many different laser options for scar revision and the right device should be able to produce very satisfying results for you.

Ron Shelton, MD · Answer

It is very difficult to evaluate scars from a 2-D photograph. It may be that there is a combination of craterform acne scars and dilated (widened) pores but not many icepick scars. One laser treatment does not improve the scars to a high percent except in some cases the fractional carbon dioxide laser (Fraxel Repair) can do that but the scars will still be there and there is a good week and a half to two weeks of down time.  A series of Fraxel Restore, Fraxel Dual, or Halo,  treatments can help reduce the severity of scarring but there is still downtime, at least 5 - 7 days of downtime of redness and some swelling but not the wound as in Fraxel Repair.  Profractional laser produces a downtime somewhere in the middle of these two groups of lasers.There are risks with all laser treatments so please seek a consultation of a laser expert.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist. I recommend lasers, microneedling/prp, Cosmelan, peels and skin care. See an expert. Best, Dr. Emer

1 month post Fraxel. Do I have ice pick scars or large pores? How can I treat this? (photo)

Answers (5)

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