Erbium: Will YAG laser (pinhole method) treat papular/raised/hypertrophic acne scars on nose? (photos)

Question

I have slightly dark olive skin tone and I have papular acne scars on my chin and nose. I've heard that injections can help, but recurrence or atrophy can happen. CO2 laser also seems risky in terms of permanent hyper/hypopigmentation. There is a relatively recent study which says using the "pinhole method" with the Er: YAG laser is a safe/effective procedure. Does this seem like a good treatment? Where can I find a dermatologist that has expertise/skill in this specific pinhole laser method?

Jason Emer, MD · Answer

this is fibrosis and scarring that require deep treatment -- dermabrasion, co2 or erbium. you likely will have time healing and get some hyperpigmentation that can be treated with peels.  long term fraxel or halo will be needed for maintenance.

at home peels like cosmelan, enlighten and aerify along with dermarolling (Emerageskin roller with anteage MD AERIFY ampules weekly) should be started now (see link to emeragecosmetics).

if you have post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, halo, maxi, pro fractional laser/erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we already pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Erbium: Will YAG laser (pinhole method) treat papular/raised/hypertrophic acne scars on nose? (photos)

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Erbium: Will YAG laser (pinhole method) treat papular/raised/hypertrophic acne scars on nose? (photos)

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Everything you need to know about YAG Laser

Our mission is to create a world where every investment in modern beauty is Worth It.