What procedures should I consider for these scars? I already had fractional CO2 and normal microneedling (Photo)

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. 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

I am not at all surprised that fractional lasers did not work. I have been cautioning my regular followers for years to exercise more than just a healthy dose of "buyer beware" when considering these expensive 'bells and whistles" gizmos, since the hard science to support their use lags woefully behind the heavy marketing and social media hype to promote them. Sorry. Microneedlinig (no need for the additional expense and risk of adverse reactions from combining with RF), whcch I have been performing for twenty-three years is best reserved as a final "polishing" step for blending treated scars with the surrounding normal skin after other more appropriate treatments, like subcision, are first performed to elevate and smooth the boxcar and rolling scars. The reason that subcision can yield long-lasting to permanent results is because it stimulates the production of new, native (one's own) collagen and elastic fiber synthesis and does not rely on a filler for a temporary lift. So, no need to despair. You would be wise to consult with a board certified cosmetic dermatologist and best of luck.