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 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. If you are a darker skin type, have pigmentation, or post-laser scarring with brow discoloration, it is important to be on the right lightening skin care (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol) along with peels such as cosmelan or lightening peels. Addtiionally, 1064 nm lasers such as Aerolase or laser genesis can help improve the discoloration and scarring. For darker skin types it is important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation in ethnic or darker skin types (latin, black, hispanic, mixed). Microneedling RF is the most safe in darker skin types along with lightening peels and skin care. Overall, scars in darker skin types can be improved with a combination of microneedling RF like Fractora/Intensif/Infini, Aerolase or laser genesis, microneedling/prp, skin lightening, peels like Cosmelan, and proper skin care. Sun protection is essential. I recommend getting a formal evaluation with an acne scarring expert. CAUTION: With your skin type, it's best to start on a protocol with skin care such as retinols and skin lightening peels such as Cosmelan first before doing agressive resurfacing procedures like CO2 and Fractora RF to reduce the risk of hyperpigmentation. Also, check out my new line of Emerage Cosmetics, it has at home kits that you can do from the comfort of your own home. Best, Dr. Emer
