Will chemical peels help with this scarring? (Photo)

Question

I'm 40 and have these acne scars from years ago. I have Indian skin so I know I must be careful with chemical peels. Might jessner and tca peels help with this scarring and hyperpigmentation?

Raffy Karamanoukian, MD, FACS · Answer

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

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

Superficial peels, like Jessner's Solution, high concentrations of glycolic and salicylic acid, and low concentrations of TCA can work well, even in skin of color for improving very superficial textural and color abnormalities, but would be of little value for the deeper boxcar and rolling scars. For the latter, subcision, which I have been performing since 1995, can be used in all skin types for elevating and smoothing them. Once this is done, either the aforementioned superficial peels may be used for improving the color or professionally performed microneedling. You would be wise to consult with a board certified cosmetic dermatologist scar specialist and best of luck.

Diyanah Bani Hani, MD · Answer

Hi there! This is such a great question. There is often confusion between scarring and pigmentation, because sometimes a person can break out from acne, and when it heals, there is a dark mark left behind which they call a scar. This is actually post inflammatory hyperpigmentation (PIH), and chemical peels work well for this.
From what I can tell in your pictures, it seems that you actually have a mixture of PIH and true scarring, though your scars appear to be mild. Chemical peels can help with the pigmentation and skin texture, but expect to require 3-6 to get good results. For the scarring, I would consider radiofrequency microneedling, which is safe for darker skin types. Hope that helps!

Will chemical peels help with this scarring? (Photo)

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Will chemical peels help with this scarring? (Photo)

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