Best treatment options for Acne Scarring and Hyperpigmentation

Question

Hi, South Asian heritage, Fitzpatrick IV, mid twenties. Having had 3x sessions of Picogen FX to tackle acne scarring and hyperpigmentation (as well as oily skin and large pores) I was wondering what treatments would be most suitable to target acne scars and hyperpigmentation the most? Best regards

Nelson Lee Novick, MD · Answer

For elevating and smoothing indented boxcar and rolling scars, consider Subcision. Subcision, which I have personally been using successfully for thirty years has a proven track record for safety and efficacy, something that cannot be said, despite all the marketing hype and social media buzz, for the expensive laser and RF gizmo treatments out there, as you unfortunately have found out the hard way after three sessions of treatment with it. Sorry.  FIELD SUBCISON works well for improving large areas of depressed scars, such as those responsible for significant atrophy and sinking of the CHEEKS OR TEMPLES. 
TCA CROSS, WHICH I HAVE BEEN USING FOR TWENTY-FIVE YEARS, WORKS WELL FOR TREATING ICE PICK SCARS AND DILATED PORES. 
YOU WOULD BE WISE TO CONSULT WITH AN EXPERIENCED, BOARD CERTIFIED COSMETIC DERMATOLOGIST. HOPE THIS HELPS AND BEST OF LUCK.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. For acne scarring and hyperpigmentation, CO2 resurfacing laser and Pico laser are two of the most effective treatment options, each addressing different aspects of the skin’s healing process. CO2 resurfacing laser is a fractionated laser that works by delivering targeted beams of energy to the skin, removing damaged layers and stimulating deep collagen production. This treatment is particularly effective for textural acne scars, such as pitted or indented scars, as it helps to smooth out the skin’s surface over time. The CO2 laser also targets hyperpigmentation by resurfacing the skin and allowing healthier, more even-toned skin to emerge. While the treatment is more invasive and requires a longer recovery period, it delivers dramatic results for more severe scarring. On the other hand, the Pico laser is a non-ablative laser that works through ultra-fast pulses to break up pigment in the skin and promote collagen production. It is especially effective for hyperpigmentation associated with acne, as it targets melanin without damaging the skin’s surface. The Pico laser is gentler than CO2, with minimal downtime, and can be used to address lighter scarring and pigmentation issues, leaving the skin looking more even-toned and refreshed. Both treatments can complement each other, with Pico laser used to address surface-level discoloration and CO2 laser tackling deeper scarring and skin texture. I hope this helps and best of luck!

Best treatment options for Acne Scarring and Hyperpigmentation

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