Can I use both Smoothbeam and V Beam at the same time to treat acne and scarring?

Question

I was originally interested in only Smoothbeam to treat my overactive sebaceous glands and active acne, but while researching I noticed some people reccomending VBeam for acne hyperpigmentation. Can I do both at the same time or do I alternate between them? I’ve been on Accutane and relapsed, had fraxel, microneedling, took antibiotics, tried homeopathic remeadies, tried IPL facials, etc. Would SmoothBeam and/or VBeam be a good investment or another failed attempt to cure my acne and scars?

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

Harold J. Kaplan, MD · Answer

Hello - You have good questions, and we can understand that the options may be overwhelming.
Unfortunately, there is no "cure" for acne and scarring which is why it's so frustrating and disheartening.  However, there are very good options, and much has to do with what kind of acne you have, how you have responded to other treatments, and what your end goals are.  Here is a summary of what we would like to share with you:
*Accutane is a good option if there are no better options.  Given that you relapsed, not sure if you were returning to this or had too  many negative side effects to return.  
*Lasers are not appropriate until you have been off Accutane for several months.  This is a general guideline but mostly for the more aggressive lasers.
*We have used our Aramis (similar to a Smoothbeam) with good and predictable outcomes but would need 6 to 8 treatments once monthly
*We use our VBEAM for red based acne scarring and inflammatory pigmentation (red only)
*We have always incorporated our QYAGV laser for acne/scarring for the collagen stimulation, reduction of inflammation, brown pigment, and overall rejuv. benefits
*We believe that a good option to Accutane and lasers for acne is Aminolevulinic Acid with Photodynamic Therapy.  "ALA/PDT"  We have used this more frequently than lasers since 2006.  This has a direct and predictable effect on sebaceous glands and seems to be more effective than the Smoothbeam.  However, there is downtime of approx. 1-2 weeks - social downtime.
*For textural scarring, we prefer the Erbium MicroLaserPeel (sciton laser)

We do not hold much faith in microneedling, facials, etc.

When doing your research, ask for before/after photos, realistic expectations, short and long-term benefits.

Take care

Dennis Gross, MD · Answer

Great question, in my practice I recommend Vbeam and Smoothbeam for patients. I usually have them alternate between the two from appointment to appointment.

Deborah H. Atkin, MD · Answer

Smoothbeam / VBeam combination or "dynamic duo" is a fantastic way to treat both active acne and acne scarring, at the same time. Scars improve, redness fades, oil glands shrink and acne improves!

Can I use both Smoothbeam and V Beam at the same time to treat acne and scarring?

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