Papular acne scars on nose and atrophic scars on forehead and temples. How much improvement can I get? (Photo)

Question

Hello, I was wondering what type of treatments for the most optimized results with the least potential side effects. How much of an improvement can I get? Thanks.

Jeff Rapaport, MD · Answer

Scars are treated based upon their morphology. Papular scars can be lasered with fractional devices or destructed with radiosurgery. Pretreatment with steroid or 5 FU is suggested to prevent recurrence. Atrophic scars need to be lifted. Subcision with PRP including Nokor needle and Cannula is recommended. A suction device post procedure assists in keeping the scar elevated. Find a scar expert.
Jeff Rapaport MD FAAD 
Realself Hall of Fame

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

In general, for scars over twelve weeks of age (defined as "mature" scars) even legitimate treatments, such as subcision for elevating and smoothing boxcar and rolling scars; or TCA CROSS for improving ice pick scars and dilated pores; or anti-inflammatory injections in proper concentrations and amounts+/- light electrocautery for papular acne scars can usually legitimately offer somewhere between a 60-80% overall improvement in appearance. 100% smooth skin of a five year-old is simply not possible, unfortunately, with any techniques or technologies currently available. Contrary to what you may have seen on Dr. Instagram regarding lasers, you should know, in the words of a recent 11/22 article in the peer-reviewed medical journal JDD,  "social media posts are not standardized and carry a high risk of misinformation."  The fact is that the hard science to support, expensive "bells and whistles" lasers lags woefully behind the heavy marketing and social media influencer-promoted hype. So, exercise a great deal of buyer beware when being offered these approaches. You would be wise to consult and experienced board certified cosmetic dermatologist with experience in acne scar treatment experience and especially in papular acne scar treatments. Best of luck.

Papular acne scars on nose and atrophic scars on forehead and temples. How much improvement can I get? (Photo)

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Papular acne scars on nose and atrophic scars on forehead and temples. How much improvement can I get? (Photo)

Answers (3)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.