What can help me fix my scar and uneven skin texture at the age of 29? (Photos)

Question

What is a proven method/treatment to get rid of the acne scars (divots/holes) & uneven skin texture, and perhaps target collagen/elasticity loss & fine lines. I'm 29 yrs old. Glycolic night repair, vitamin C oil, glycolic face mask, etc. NIR Red Light therapy I had hydra facials, and AHA/BHA skin peel and nothing helped with the scars/"holes" or smooth texture. What will help me achieve smooth skin for sure & how many treatments? Thank you!

Jason Emer, MD · Answer

For facial rejuvenation I would suggest a combination approach including:1) skin care with products and microneedling/PRP2) PDT Light Therapy a few times per month with growth factors3) laser treatments like Clear + Brilliant regularly and others (Fraxel, Viva, CO2, Erbium) a few times per year4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest
See an expert. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Microfractional laser treatments can benefit skin quality and resiliency through collagen stimulatory effects. In our office, we use combination platforms for Clear and Brilliant added to PRP, fractional RF, and filler placement in order to enhance the skin. We use Clear and Brilliant laser to improve sun spots, post-inflammatory hyperpigmentation, atrophic skin, and skin wrinkles; in addition to scars. 
Best, Dr. KaramanoukianRealself100 Surgeon

Nelson Lee Novick, MD · Answer

I am sorry that you have had no success with the topical and light treatments that you have tried. However, unfortunately, from the get-go, they were all unlikely to do anything for you except to waste time and money. Your photos show boxcar and rolling scars and although more difficult to discern in the photos provided, you likely do have ice pick scars and dilated pores. Subcision would be appropriate for the boxcar and rolling scars; TCA CROSS (which is fine for use in skin of color) for the ice pick scars, pit marks, and dilated pores; and finally professional medical microneedling to improve overall skin texture and tone and to better blend the treated areas with the surrounding skin. Make sure that you consult with acne scar specialist and not just any place selling you on the supposedly "next big thing," relatively expensive bells and whistles device that it just purchased. Best of luck to you.

Tanveer Janjua, MD · Answer

There is no 'cure' for acne scarring.It can be improved but not eliminated. The best option is laser like Resurfx and later a filler like Sculptra. RegardsDr. J

Charles M. Boyd, MD · Answer

Thank you for your question! I generally recommend laser treatment, such as CO2 fraxel, and microneedling with radio-frequency to tighten the skin, produce collagen, blend in acne scars, and help with fine lines and wrinkles. Peels and medical grade skin care in combination with these treatments can give you an extra boost as well. I would recommend scheduling a consultation with a board certified plastic surgeon or dermatologist to discuss your options. Best of luck!

Supriya Tomar, MD · Answer

It looks like you have been on an excellent skin care regimen, so be sure to continue with that to enhance the treatment you decide to go with. I would recommend a series of microneedling treatments to stimulate collagen to lift the atrophic scars and improve texture. Dermal fillers will provide you with instant results, however, they are temporary and will require maintenance every 6 months to 1 year. Due to the risk of hyperpigmentation, I would advise avoiding any aggressive lasers, however, Clear and Brilliant should be gentle enough to help with the scarring and uneven texture. Although you would need a series of them. Your best course of action would be to schedule a consultation with a dermatologist that can determine your ideal course of treatment.
Best,
Dr. Tomar

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,Your skin looks good! Consider Prp with micro needling, Clear and Brilliant, Co2 lasers.Have a consolation with a certified physician to set a treatment plan in place for you.     Best of luck..

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