Which procedure would help minimize redness and indentations from acne scars? (photos)

Question

Hello, My question is twofold: First, I am looking to reduced the redness associated with my acne scars. You can see in my photos I have boxcar, ice pick and rolling scars that still have redness/hyperpigmentation. Next, I would like advice on which treatments to pursue to help with my indented scarring. Thank you very much!

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented  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 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

I have been treating acne scars for decades. In my experience, it would be wise to first use simple, relatively inexpensive, subcision, which I have been performing routinely since 1995 for elevating and smoothing boxcar and rolling scars and has a proven track record for safety and efficacy in all skin types. Once optimal improvement has been achieved and there is so to speak a more even playing field, then professionally performed manual microneedling (no need for the added expense and risks of RF microneedling) accompanied by the application of prescription anti-redness agents, such as topical tranexamic acid and  brimonidine, can be used to tackle the redness issue. You would be wise to consult a board certified cosmetic dermatologist with extensive acne scar treatment experience. Best of luck.

Which procedure would help minimize redness and indentations from acne scars? (photos)

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Which procedure would help minimize redness and indentations from acne scars? (photos)

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