Thank you for your question. I suggest that you consult with a board certified facial plastic surgeon and consider ablative laser skin resurfacing, which removes the most superficial layers of the skin including the acne scarring and skin spot blemishes. It also works to improve any skin pigmentation. Always consult with a board certified facial plastic surgeon.
Thank you for sharing your question and photo. The combination of color of your skin and type of scars you have can be challenging to treat. There is a risk of hyper or hypopigmentation following aggressive laser treatments. You would probably have good/safe results with alternating treatments of erbium laser and PRP with microneedling (Vampire Facelift). See an experienced doctor for evaluation in person and discussion of treatment plan.
With your skin type, my suggestion is to treat your deep scars with TCA CROSS, you will definitely get skin colour changes, but this fades over 4 months.
For you skin colour, I do prefer microneedling with energy- INFINI RF is a great solution. Co2 laser can be used, however in LOW Density but max. power. Erbium laser will give you less chances of skin colour changes.
Certainly non-ablative lasers in the 1400-1550 wavelengths - Fraxel, Fractora etc... can help, as these have less chances of skin colour changes, but you will require 5-6 sessions.
All the best
Dr Davin Lim
Laser and aesthetic dermatologist
Typically for acne scars, lasers like Profractional and Halo will help smooth those areas. We would not treat as aggressively because of your darker complexion. Halo is a hybrid laser that treats multiple layers of the skin at the same time. If you are interested in correcting discoloration and acne scars then Halo would give you the optimal results.
You would get good improvement of the acne scars from fractional CO2 laser resurfacing but it caries a risk of skin pigmentation that will have to be treated with a skin lightening cream. A test spot treatment will help to give you an idea of how your skin responds. Micro-needling, with or without radiofrequency energy, performed by a physician will also improve the scars and the risk of skin pigmentation is much lower.
Non-ablative fractional laser would serve you well and is skin colour safe. Micro-needling would also prove synergistic and helpful. Once you finished these treatments you could have any residual scarring treated with fillers to improve imperfections and provide the final result.
There are a lot of lasers out there, but most you would not want to use with your darker skin. I agree with prior remarks that a fractionated erbium, or better yet, the new Halo laser by Sciton would be a good option. If you have expectations of a nice improvement, you may be a good candidate. Realize though that nothing can completely get rid of the scarring, we can only improve it.
Andrew Campbell, M.D.
Facial Plastic Specialist
With a darker skin tone you want to stay away from both IPL and ablative lasers. You could try: non-ablative fractionated resurfacing with the Palomar 1540nm laser. Another good option is the Infini. This is micro-needling with radiofrequency. Both of these treatments help to break up the scar and stimulate new collagen growth to smooth out the skin.
For darker skin IPL and other light therapies are not as safe. Ideally profractional laser treatment would be used as it works best at targeting acne scars and is safe in darker skin types. Scion makes a great laser for that. Make sure that your surgeon uses a a test patch to make you you don't hyperpigment and also discuss skin lightening creams with them to minimize that risk.
Dr Rodger Shortt
Oakville Plastic Surgeon
Assistant Clinical Professor &
Director of Cosmetic Surgery Training Program,
Oakville, Burlington, Georgetown, Milton, Mississauga, Hamilton, and Toronto.