Help me. How do I get better skin overall? (Photo)

Question

My skin is textured, bumpy, discoloured, lifeless, losing elasticity, dull and just full of pimples. Not the mention the one pit of pus permanently stuck on my face. I can't go out in public without feeling absolutely hideous. I was on accutane (80mg) and my cystic acne is now gone. This is what remains. I've tried the following; -Microneedling -Microdermabrasion (8 sessions) -Chemical peels -and over the counter exfoliation products I was looking into fraxel or pico way laser, Thoughts?

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

Jason Emer, MD · Answer

For now that you are at home a peel with derma rolling would be great. then lasers and a long term plan is needed.
Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we alreayd pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Dmitriy Schwarzburg, MD · Answer

Fraxel is a non-ablative fractional laser treatment that treats signs of skin aging such as fine lines, wrinkles, scarring, sun damage/age spots, brown spots, laxity, crepiness, pore size. It creates focal zones of thermal injury which causes intense collagen stimulation and growth of new cells. Please contact a qualified provider or a board-certified physician with extensive experience in these procedures.

Help me. How do I get better skin overall? (Photo)

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Help me. How do I get better skin overall? (Photo)

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Everything you need to know about Fraxel Laser

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