Acne Scar Reduction - Would pearl fractional or profractional laser work on my scars? (Photos)

Question

Hello, Would pearl fractional or profractional laser work on my scars? Ive had 1 session of TCA CROSS, and I feel that laser resurfacing can already target the reduced icepick scars, big pores and the general area of my face

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

I suggest seeing a certified dermatologist for a formal consultation. 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. 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, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, 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. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​

Nelson Lee Novick, MD · Answer

TCFA, which can be used safely and effective in all skin types is best reserved for ice pick scars and dilated pores. It is important to keep in mind, however, that this technique typically requires between two to six treatment sessions (average about three to four) in order to achieve maximal improvement in appearance. Except for a lucky "lottery winner," one treatment session is not likely going to give sufficient visual improvement. The photo also shows several boxcar scars. Subcision would be more appropriate for those. Make sure that you consult with a board certified cosmetic dermatologist and not simply some venue hawking the latest laser device it has just purchased. Hope this helps. Best of luck.

Acne Scar Reduction - Would pearl fractional or profractional laser work on my scars? (Photos)

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