Solutions to remove pitted scars?

Question

I am a 22 Asian girl. I have several pitted acne scar on both of my cheeks, and I also have oily skin with enlarged pores and broken capilaries around my nose. I have to wear foundation everyday to cover them. I am getting married next year, so I want to have a good skin condition on the big day. (At least go without those pitted scars which is not able be covered by foundation) What kind of laser or treatment should I have? And What is the price range I am going to spend on these? Thank you.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Sanusi Umar, MD · Answer

Fraxel Dual is a laser system that offers a very reliable
way to improve the appearance of acne scars. Additionally it can safely be used
for all ethnic skin types. Many laser treatments use rather short wavelengths
which can easily scatter beneath the skin’s surface and cause over heating.
Scars can develop from this. Melanin is a pigment that creates different shades
of skin color. And it easily absorbs laser energy. Therefore, it is best to use
wavelengths that only treat the target areas instead of being absorbed by
general melanin in the skin.

By deliberately applying laser heat, Fraxel Dual triggers
wound healing processes in the dermis layer which leads to the formation of new
collagen fibers. This collagen fills in the acne scar recesses to create a
smoother and more even looking texture. Fraxel Dual can also shrink pores.
Broken capillaries can be removed by the vBeam laser which uses a specialized
wavelength for clearing unwanted blood vessels.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question. Photos would be helpful.Deep pitted acne scars are usually best treated with direct excision and closure if there aren't too many.Also, little vessels around the nose can be treated with intense light therapy, such as BroadBand Light or a vascular laser.An added benefit is that BroadBand Light, or Forever Young BBL, also improves the appearance of pores.To be sure what is right for you, see a board certified plastic surgeon or board certified dermatologist who has several lasers and who is highly skilled at laser skin correction. Here is a link and a video.  I hope this helps.

Misbah Khan MD, FAAD, FACMS · Answer

acne scars require a combination of procedures including but not limited to laser resurfacing. best would be for you to be evaluated in person and then determine the short and long-term plan to treat your scars. I use a combination of lasers, sometimes combined with surgeries along with either fat grafting or other filler injections. you can look at the pics below

John J. Martin, Jr., MD · Answer

One of the best lasers for acne scarring is the 1540nm non-ablative fractionated resurfacing laser.  I use the one made by Palomar.  I usually recommend 3-4 sessions with this laser, which delivers heat into the skin to help reconfigure the scar and help promote collagen production.  you will be red for about a day or two.  With the last session, I do the 1540 first, and then use a 2940nm fractionated Yag laser.  With this you will have about 5 days of downtime - pretty red at first.  If your scar are very deep, the laser can be done with subcision where a small blade is put under the skin to but some of the deep scar bands.  A small amount of fat can also be placed under the scars to help fill them in.  Unfortunately acne scars take a lot of work to improve, and it will cost you a few thousand to really make a good improvement.

Todd C. Becker, MD, PhD · Answer

Some fractionated CO2 lasers, including Syneron's CO2RE, can be used safely in Asian skin. These remove scar tissue while leaving a reservoir of normal skin to heal. The results can be dramatic with minimal risk of pigment problems. An alternative approach is sublative fractionated radio frequency which stimulates collagen and improves even pitted scars with several treatments.