24 Year-old with a History of Acne and Moderate Acne Scarring - Richmond, VA

I will be having the first of several CO2 laser...

I will be having the first of several CO2 laser treatments this Friday with Dr. Travis Shaw of the Stony Point Surgery Center.

I've suffered from acne since I was just 8 years old. For years I visited a rather mediocre dermatologist who was unable to diagnose the cause of my problem and as I grew older the acne only worsened. By the time I was in college, I was deep in the throes of cystic acne and beginning to get scars.

It wasn't until this fall that I visited Dr. Hayri Sangiray of the Dermatology Center of Richmond, and I only wish I had done so sooner - turns out that my acne was caused by a hormonal imbalance, and after ~6 weeks of Spirolactone, my acne is basically cured!

However, I'm still deeply unhappy with my acne scars. I have both boxcar and rolling scars. I've tried to treat them with multiple Cynosure laser treatments at a local medspa, but it was to no avail.

Dr. Travis Shaw came highly recommended to me by Dr. Sangiray, so I had a consultation with him ~2 months ago and scheduled a treatment for 12/19/2014. I have the fortune to be able to work from home for my job, so the downtime for this won't be too inconvenient for me. I just hope this treatment works.

I plan on keeping this page updated with daily updates for the first week, followed by bi-weekly updates for a couple of montsh. After that, I'll update it sporadically if I notice any new changes or after I repeat this treatment.

More pre-laser/day 0 pictures

Here are some more recent pictures of my acne scarring. Now that my acne is mostly cleared up, the scars don't look quite as severe but are still in need of improvement.

Day 1: 4 Hours Post-procedure (12/19/2014)

It's been 4 hours since I finished my CO2 treatment, and overall I feel pretty good!

I arrived for my 1pm appointment at 12:15 to make sure I came in early enough for the numbing cream to take effect. My mom opted to be my driver for this visit , since I'd be too drugged up to drive myself home. Before we started the procedure, I had to fill out a waiver that just clarified what to expect, how the procedure works and potential side effects.

After that, they brought both my mom and myself to the procedure room. The nurse removed my makeup for me and applied a numbing cream, as well as some strips of saran wrap to help the cream soak in more fully. She also gave me 2 Percocet pills and a bit of Valium.

She then went over my post-care instructions, which they also sent home with me. I opted to buy their post care kit, which totaled $120. Then she rubbed off my numbing cream.

The procedure itself was fairly short, and there were 3 phases of the laser treatment. I couldn't tell you exactly what each phase was for or recall it very well, as I was a bit loopy on the Percocet, but my mom described it as this:

* The first stage was much like my laser medspa experience - bursts of lasers on my problem area (cheeks).
* The second phase was were it felt he was burning the surface of my problem skin.
* After that, the nurse was instructed to wipe down my face. Then he did the second stage again.

And just like that, I was done! They gave me some ice bags to hold on my cheeks and applied Aquaphor to my skin to moisturize it. I was then instructed not to wash my face for 24 hours, but then after that I'd have to alternate between vinegar soaks and my moisturizing kit.

They sent me home with nice, very detailed instructions about what to expect and what to do as my recovery progresses. I didn't notice until this packet of instructions that I won't be able to strenuous exercise for 1 week or do heavy lifts for 3(!!) , which stinks but I'll deal. I'll have to call and see if I can do bodyweight stuff after 1 week is okay.

They also sent me home with a 4% hydroquinone prescription, my post-care kit ("Eau Thermale Avene") and Regenica. I was told where to get Aquaphor, though Vaseline was acceptable too.

Immediately after the treatment, I felt no pain, just a little heat on my face. The biggest side effect so far was the nausea caused by the Percocet. Next time, I definitely need to ask for only one pill.

In the following couple of hours after the treatment, my nausea worsened and my face began feeling much hotter, but not painfully so. It was very much like a sunburn. The nausea became the worst part of the procedure, and I ended up sleeping away the next couple of hours since I couldn't sit up without feeling sick to my stomach.

Now, 4 hours later and after a lot of Ginger Ale, Peptobismol, and a peanut butter sandwich, my nausea has subsided and I feel good enough to drive again. The sunburnt feeling is also completely gone at this point.

So far, so good! I'm actually glad Dr. Shaw only treated my cheeks and not my entire face like I was expecting, as I don't yet have a problem with wrinkles and I'd probably be a lot more miserable if my whole face felt like it had a horrible burn/was covered in Aquaphor.

Day 1, part 2: Side effects of percocset

My mom tried to serve me macaroni and cheese for dinner. Mistake. It was too greasy, and combined with my percocset nausea, I threw up immediately.

Looks like I'll just be on bread and peanut butter for a bit.

Day 1, part 3: 5 hours post-procedure

I'm surprised to be making such an update so soon after my last, but I thought I should note that my swelling is already down *significantly*. After the procedure, I looked quite puffy and liked I gained a couple of pounds in my face. Now, I'm almost back to normal.

I now only have some very localized "hot" and tight feeling spots. For the most part, my face feels fine and my head is finally clear of the percocet.

I noted this in an earlier comment, but it's worth mentioning again - Dr. Shaw used a newer CO2 laser on me called "UltraPulse", and it appears that he used it's ability to target very tiny spots to really localize the intense burn spots to only my scars and pores on my nose. The skin in between these zones seem to be pretty intact. Color me impressed! I think that's why I appear to have very different CO2 post-procedure redness than most others on here.

Day 2: 22 hours post-procedure

I woke up in the morning to a little dryness and tightness. Re-applying my Aquaphor did the trick in relieving it.

No real pain so far today, just an occasional bit of stinging on my temples and cheeks. My swelling seems to be a bit worse today than it was last night.

Day 2, part 2: 30 hours post-procedure

I've started the vinegar soaks and using the various cleansers and moisturizers that I was sent home with. The peeling has begun, and so has the battle against dryness/scabbing.

Day 3, morning: less redness, more crusting

This morning I had a bit of crust on my skin, despite my diligence with Aquaphor and my other creams.

I'm going to keep going through my cleanses every 3 hours and hope that the crusts go away.

Day 3, evening: crusting and peeling

Nothing terribly new to report, just more crusting and peeling. I've been keeping up with my vinegar soaks and my cream regimen, and have been staying out of the sun.

I should note that I've had a persistent headache these last few days, and I have no idea what exactly is causing it. I don't usually have them, and I wonder if somehow the laser or Percocet caused it?

Day 4, morning: redness down, peeling up

Nothing too terribly new to report, just more peeling and my redness seems to be going down.

I *am* happy to report that my headache is almost gone today, which is great! That so far has been the worst part of my recovery.

One more thing I'll note is that I've been consistently sleeping 10 hours nights during my recovery. I can't do anything strenuous during the day per the doctor's orders, so I don't quite get why my body feels it needs *that* much sleep, but I'll roll with it. Maybe rebuilding skin is harder on my body than I expected?

Day 5: new skin reveals itself

Up until today, I've had very little peeling really - just the crust slowing coming off. But this morning - holy cow! My beautiful new skin is showing in patches between the crust!! Yes!!!

Will continue my routine in the hopes of easing the rest of the crust off.

Day 6: Almost all crusting gone

I'm very excited by how much crust has come off over the past day! My new skin is very visible on my right cheek, where most of the crust has fallen off! It's gorgeous, just a little pink - no pores, almost no trace of my old acne scars.

Very excited to see how this comes along.

Day 7: almost all residual flaking gone

Today is the first day where I felt decent-looking enough to go outside. I went on a run, and it went well (no weird swelling or anything).

I still have some flakiness to my skin, but for the most part I think I'm done peeling! No signs of hyperpigmentation yet, but I still have a lot of pinkness so let's wait and see how it goes.

It may be too early to do a true before/after and "was it worth it?" rating, but I attached a picture to this post to at least make it clear that I have seen some improvement in my more shallow scars and in the depth of my deeper scars. When the pinkness and flakiness clears up some more, I think the changes will probably be more apparent.

Day 8: No flakiness, smooth skin

I didn't have any flakiness this morning, but I *did* have delightfully smooth skin. It's hard to show the detail because of the resolution of the pictures allowed here, but I only have darker pink marks where my scars used to be. If I run my hand across my cheeks, I don't feel any craters like I used to.

My one super-deep scar on my right cheek now just looks a tiny bit dented, which I can live with.

During my peeling process, I did break out a tiny bit - one zit near my mouth and one on my right cheekbone - but they're tiny and will probably be gone soon enough.

Overall so far, I'm very pleased with how this has turned out. I'll go ahead and rate this as "worth it", but I'll still keep updating as I notice changes.

Day 20: Persisting pinkness and hyperpigmentation in scars, but overall skin quality improved

I'm being messaged a ton by everyone wanting to know my progress so far, so here's another update!

I seem to have some small spots of hyperpigmentation in my scars, but I've been on 4% hydroquinone since my last update so I hope that will help in the long run. I wear that 4% at night, and wear a 2% hydroquinone/AHA cream called "Ambi" that I've been using since before the procedure. The AHA in it helped me get over my post-laser acne quickly, and it smells MUCH nicer than the 4% hydro, so it's more appropriate for daytime wear.

I have a lot of pinkness on my lasered areas which is difficult to hide with my makeup (Yves Saint Laurent's Fusion Ink foundation). I've somewhat accepted that I'm going to look a little flushed for many months to come, and it's not that unsightly so I don't mind that much.

My large scar is still indented, so no change there.

My shallow scars are actually still there as well. They were hidden by the swelling in the first few weeks, but now I can see that they're still indented. I would have liked my scar improvement to be more dramatic for sure, but I knew going in that this was going to be multi-procedure deal. I'm not sure if they're really improved in depth that much, since I don't have great before/afters on me of just my scarring. My doctor does though, so I'll wait for my post-procedure checkup to see for sure. I will say that in dramatic light with heavy shadow, I can still see the scarring, but it doesn't seem to look as bad as it once did.

Overall, the main difference I've seen was due to a great, unexpected benefit from the laser - the overall quality of my skin where I was lasered has become! I have poreless baby skin on my cheeks, so although I still have some scarring, I still do look better overall. A friend whom hadn't seen me since before my procedure even remarked that I look like I'm "glowing" now. :)

The attached pictures are both before and afters with my makeup on, but unfortunately image quality on realself.com seems to be not too great so I don't know how much you'll be able to see.

I have a follow up with my doc scheduled for next week Friday, so I may have better before/after pictures to post then.

Day 20: one more note

I wanted to attach some more upclose pictures of my skin since realself shrunk my latest pictures down a ton, and add one more note.

I already mentioned that I am permanently flushed, but I should also add that it gets significantly worse after any kind of exercise. If I go hiking or running, I come back looking like I'm super sunburned, no matter how much makeup and sunscreen I wear. Not a huge deal, but definitely something to know. I wouldn't recommend doing this procedure right before a major event, like a wedding or reunion, because you will look like you developed rosacea.

5 months post treatment: lasting improvement in skin quality and some improvement in scar depth

It has been 5 months since my first laser treatment, and here are the results.

It's clear to me that the initial drastic reduction of the scars is attributable to the swelling caused by the laser, however I have seen some lasting reduction in the depth of my scars and a definite improvement of the overall quality of the treated skin. The redness from the treatment faded fully after the 3rd month.

My scars still bother me and are still very noticeable in dramatically lighted settings. In softer light, they are not noticeable and don't photograph, which is great. I've included some sample photos from the same wedding to show exactly this.

I was scheduled to do a follow up this month, but due to the demands of my job and a house hunt, I'll be post-poning it to September instead. In the meantime, I may try the Dermapen + some kind of filler (?) treatment that Dr. Shaw suggested to me.

Round 2 of the CO2 laser

Had a new round of CO2 laser surgery yesterday, but here are my doctor's before/after shots from my first round.

I'm not going to document the second round quite as thoroughly given my goal with the first was to give people considering the procedure a day-by-day play of what to expect.

I'll post more about my second experience in the coming days as I recover.

Photos from session 1's before/after

The last post "failed to upload my photos" and didn't tell me until I had submitted the text post, so here are the pictures.

Unfortunately the "afters" are not as well photographed as the befores, making me look jaundiced and not really capturing the overall improvement in the quality of my skin, but ah well. Hopefully you can still see how the laser made most of the scars more shallow.
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