What can be done to minimize the appearance of acne scars and 11 lines? (photo)

Question

I have what started out as acne scars in the area where the 11's lines form and as I've gotten older I have deep lines even while my face is at rest. How could a scar/11's line be treated? Thank you!

Anna Chacon, MD, FAAD · Answer

Minimizing the appearance of acne scars and deep lines, such as the "11 lines" (the vertical lines that form between the eyebrows), can be challenging but there are several effective treatments available. Here’s a comprehensive approach:

### Topical Treatments
1. **Retinoids**: These can help with both acne scars and fine lines by promoting cell turnover and collagen production. Examples include tretinoin or adapalene.
2. **Alpha Hydroxy Acids (AHAs) and Beta Hydroxy Acids (BHAs)**: These exfoliants can help improve skin texture and reduce the appearance of scars and fine lines.
3. **Vitamin C**: This antioxidant can help lighten hyperpigmentation and improve collagen synthesis.
4. **Silicone Gel or Sheets**: These can be effective for raised scars and can help flatten and smooth the scar over time.

### In-Office Procedures
1. **Microneedling**: This procedure involves using fine needles to create micro-injuries in the skin, stimulating collagen production and improving the appearance of scars and wrinkles.
2. **Chemical Peels**: These can help exfoliate the skin and improve texture. Medium to deep peels are often more effective for scars.
3. **Laser Therapy**: Fractional laser treatments can target both scars and wrinkles by promoting collagen remodeling. Examples include CO2 laser and erbium laser.
4. **Dermal Fillers**: Hyaluronic acid fillers can be used to fill in deep lines and atrophic scars, providing immediate improvement in appearance.
5. **Botox**: For dynamic wrinkles like the "11 lines," Botox can relax the muscles that contribute to wrinkle formation, making the lines less prominent.
6. **Subcision**: This minor surgical procedure involves breaking up the fibrous bands beneath a scar, allowing it to lift and smooth out.

### Lifestyle and Home Care
1. **Sun Protection**: Use sunscreen daily to prevent further damage and pigmentation changes.
2. **Healthy Diet and Hydration**: Maintain a balanced diet rich in antioxidants and stay hydrated to support skin health.
3. **Consistent Skin Care Routine**: Follow a regimen that includes cleansing, moisturizing, and targeted treatments for your specific concerns.

### Combination Therapy
Often, a combination of treatments yields the best results. For example, using topical retinoids alongside in-office procedures like microneedling or laser therapy can enhance overall outcomes.

### Consultation with a Specialist
Given the specific nature of your concerns, it's advisable to consult with a dermatologist or a plastic surgeon. They can assess your skin and recommend a personalized treatment plan tailored to your needs.

Minimizing acne scars and deep "11 lines" can be achieved through a variety of treatments ranging from topical agents to in-office procedures. A combination approach tailored to your specific skin type and concerns is often the most effective. Regular consultation with a skincare specialist will ensure the best outcomes.

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.  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

What can be done to minimize the appearance of acne scars and 11 lines? (photo)

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What can be done to minimize the appearance of acne scars and 11 lines? (photo)

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