Need advice for my acne scar treatment. What are the best options for my case? (Photo)

Question

I have finally decided to give my acne scars some good treatments. But before going for lasers, I did some research and found out that lasers are not always the best option depending on each individual and one needs a combination of different kinds of treatment to deal with different scar types. So I am uploading my acne scar photos and really hope I can get some good advice. Thanks a lot!

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

"​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

It is particularly wise to be cautious, especially with ablative lasers, and especially in skin of color, which carries the risk of long-term or permanent, disfiguring dyspigmentation--either hyperpigmentation or hypopigmentation. And fraxel lasers to date are much more heavily backed by marketing hype rather than hard science. At least from the photos, ice pick scars predominate. And TCA CROSS, which I have been using for treating ice pick scars for twenty-three years, was develiped in South Korea, and has a proven record of safety and efficacy in all skin types. Subcision would be appropriate for elevating and smoothing the few individual boxcar/rolling scars seen in the photos. An in-person examination would be needed to determine whether a Field Subcision would a first step for both the cheeks and temples prior to the above. You would be wise to consult with a board certified cosmetic dermatologist with extensive acne scar treatment experience. Best of luck.

Need advice for my acne scar treatment. What are the best options for my case? (Photo)

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Need advice for my acne scar treatment. What are the best options for my case? (Photo)

Answers (3)

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Everything you need to know about CO2 Laser

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