What are some options for removing papular scars on dark skin? (photos)

Question

Hello, I have problems with papular scars on my chin and I have a hard time to find a doctor that can help me to remove this. It is not alot of doctors that know how to work with dark skin in Sweden. I do not know what to do. Can I do something at home? I use vitamin a and sillicongel but I need something more effective. I want to do of laser/ injection but cant find a clinic that can work with my skin color. What can I do?

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

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. Generally speaking, 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, PiXel8, Morpheus, Skinfinity, 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.

For darker skin types, it is important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation. Instead, scars in darker skin types can be improved with a combination of microneedling RF (Fractora, Intensif, Infini), Aerolase or Laser Genesis, microneedling with PRP, skin lightening, peels like Cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, and a proper skin care protocol (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol)​. Sun protection is essential. I recommend getting a formal evaluation with a board-certified cosmetic dermatologist and acne scarring expert. Best, Dr. Emer​

What are some options for removing papular scars on dark skin? (photos)

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