I’ve been pouring over scar research for days now. It is pretty endless, but I’m making progress. I’ve read through the latest summaries of research as well as a bunch of your comments on the scar treatment ratings pages. I have a couple of initial strong feelings:

1. Prevention is key! Scar treatment is hardcore–bleeding, oozing, bruizing, pain, long recovery time, permanent change in pigmentation at times, and major expense. It is far easier to prevent acne than it is to attend to scars. I happen to not be prone to scarring, but if I were, I would be diligent on the regimen and I would also be serious about creating anti-inflammatory action in my body. I’d be all about fish oil, zinc, eating well, exercising, and if I was healing from a pretty hardcore zit, I’d take an advil or two during recovery to prevent over-inflammation in my body and the scar response (this is only theorized and not proven to work, but I’d try it). I’d also refuse to pick at my skin, knowing that picking can cause as much scarring as the acne itself.

2. Scar revision is more of an art than a science. I’ve researched 19 different procedures so far. These 19 different procedures often need to be combined for best results. If I were looking for a doctor to take care of my scarring, I would look specifically for a plastic surgeon who specializes in acne scarring. Furthermore, I would not just take their word for it. Lots of people seem to “specialize” in whatever you’re paying $4000 for. Rather, I’d feel more comfortable if they themselves had scar revision treatment performed and if this is what got them into plastic surgery to begin with. I’d also make sure they had lots of before and after pictures for me to look at of their own previous clients. To give you an idea of what I mean regarding combination of treatments, if you have some ice pick scars, some narrow and some wide boxcar scars, and several rolling scars here and there, your treatment might consist of one or two punch excisions, one or two punch elevations, a bunch of subcisions, and perhaps some 75% TCA applied directly to a few scars. Then, 6 weeks would pass and you might get CO2 laser revision, followed by Er:YAG, or alternately, 5 medium depth TCA peels, with a little needling should it be required. I think you catch my drift.

I’m angered and motivated from some of the reviews you guys have written about doctors with a laser just sitting you down in the chair with no prep work and just lasering away, taking your $3500 and being done with it, leaving you with less than desirable results. Let’s help educate one another so those of us who need scar revision can be better advocates for themselves and others. I’ll post what I’ve got on the updated scars pages soon.