15 replies to this topic

[DRaGZ]

Not sure if you guys know about Dr. Garcia, but he's a doctor in Las Vegas that answers questions about plastic surgery procedures. I asked him some questions about laser resurfacing, and this is what he replied:

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I think any benefit with lasers for acne scarring will be even less long lasting than for wrinkles as the problem is much deeper. All the best.

I replied thusly:

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Hey Dr. Garcia, Thank for answering my questions so quickly. Why are lasers only temporary? If the point is to make new collagen, why doesn`t this collagen last?

And he replied:

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be cause the body`s aging process, environmental causes, personal habits such as smoking or sun exposure are constantly breaking down collagen. Usually the amount of collagen formed form laser, especially fractional lasers is minimal and it is quickly gone.

So far, this is the third person, and the second doctor, I've heard from that said the process is not permanent. The first person was a random doctor comment on RealSelf.com, who also claimed that no laser procedure is permanent. The second person was a nurse who worked at a dermatologist's office I was scoping out, and she said that it was not permanent either. Nobody elaborated on timeframe.

This is strange to me because I've heard a lot of evidence to the contrary.

My personal dermatologist claimed that collagen does, indeed, break down over time, but that it breaks down the same way collagen would break down as you get older and thus skin sags and scars do not return in the same form as before, if at all. He said I should not worry about it until I'm, say, seventy. Many other dermatologists have also said the process is permanent, though they did not elaborate into as much detail as my own dermatologist did.

I've also spoken to people who've had laser resurfacing procedures, their last treatment having been done over a year ago, and they still have their same results, meaning it seems to last.

From the trend I've seen, it seems plastic surgeons don't think laser resurfacing works while most dermatologists believe they do. I'm not entirely sure what that means.

Anyway, if you'd like to see the actual thread and questions I asked, here's the link: http://www.lvcosmeti...m/QandAPost.asp

I am not saying this to discourage people from taking laser resurfacing (I'm currently doing it myself). It's just kind of startling information to hear when there didn't seem to be much evidence to the contrary.

EDIT: More correspondence.

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Hello again Dr. Garcia, If you do not think laser resurfacing is a good option for acne scarring, what do you think is a suitable option, other than fillers? Especially for texture, because that is what I am concerned with most. I am less annoyed by the random pits as I am by the texture of my skin due to some of the more superficial scars.

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well, I do think lasers are OK for acne scarring in pale skinned patients, but not in fair skinned Latinos, Asians or African Americans.

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EDIT: Even more correspondence.

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Dear Dr. Garcia, Again, thank you for taking this time to answer my questions. I am Asian with acne scars, and since you don`t believe laser resurfacing is a good option for Asians with acne scars, what do you think would be a good option? I personally don`t like the idea of fillers, and I can`t really think of any other methods that do not cause permanent hyperpigmentation.

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well, the honest answer is that there is not much that will help, doing a skin only facelift was an option in the old days, the acne scars do look better with the tension on the skin, but over time, the skin relaxes and the textural differences come back. Along with that, you will have the scars from the cheek or facelift.

Edited by DRaGZ, 09 January 2012 - 07:25 PM.

[lianghaochen]

I've heard quit a bit of testimonies on this forum that laser is not permanent.

[DRaGZ]

lianghaochen, on 09 January 2012 - 04:12 PM, said:

I've heard quit a bit of testimonies on this forum that laser is not permanent.

As far as I can tell, all of those testimonies referred to micro-swelling, which can last up to two weeks after the last treatment depending on the laser. I don't think anyone, including dermatologists and the people pushing the machines, are claiming that the swelling is an actual result.

[californiaEstie]

This only pertains to scarring not PIH right?

[DRaGZ]

californiaEstie, on 09 January 2012 - 05:33 PM, said:

This only pertains to scarring not PIH right?

Yes, PIH is not scarring.

Has anyone heard from other doctors? What are their opinions?

Edited by DRaGZ, 09 January 2012 - 05:35 PM.

[californiaEstie]

I know it's not, thanks.

[DRaGZ]

I'm still continuing to correspond with him, I will continue to post up what he says.

Also, I have relayed the issue to my dermatologist as well, and asked him for his opinion again, especially in light of how other doctors have been responding.

[tricia]

It probably depends on the type of scarring as well as how deep the laser goes. If you get fraxel repair it goes considerably deeper than fraxel restore so you are changing your skin on a deeper and likely more permanent manner. If your scarring was super shallow to begin with perhaps the restore can eventually obliterate all the scar tissue making your results more permanent. If you have deep scarring and there are edges that are thicker and the laser only somewhat softens those edges and builds some collagen in the middle, then over time you may see the same scar shapes reappear as you get sun damage or age and the collagen is depleted. There is also the sagging of the skin that will make a shallow scar look worse over time, and lasers while touting to firm the skin, have actually been known to stretch the skin in some people. The heat could do all kinds of things to your skin, especially if it is ematrix or anything with an rf wave, thermage was known to shrink fat cells which left some people with saggy skin. I would only spot treat if I had laser, very nervous about long term side effects and all the horror stories I have read about.

[lianghaochen]

DRaGZ, on 09 January 2012 - 04:53 PM, said:

lianghaochen, on 09 January 2012 - 04:12 PM, said:

I've heard quit a bit of testimonies on this forum that laser is not permanent.

As far as I can tell, all of those testimonies referred to micro-swelling, which can last up to two weeks after the last treatment depending on the laser. I don't think anyone, including dermatologists and the people pushing the machines, are claiming that the swelling is an actual result.

I read from a bunch of people seeing no improvement after a year.
Based on what I have read so far, subcision seems to be a MUCH better option, more effective with a smaller price tag. Check out greg's post, he had HUGE improvements.

[DRaGZ]

lianghaochen, on 09 January 2012 - 07:17 PM, said:

DRaGZ, on 09 January 2012 - 04:53 PM, said:

lianghaochen, on 09 January 2012 - 04:12 PM, said:

I've heard quit a bit of testimonies on this forum that laser is not permanent.

As far as I can tell, all of those testimonies referred to micro-swelling, which can last up to two weeks after the last treatment depending on the laser. I don't think anyone, including dermatologists and the people pushing the machines, are claiming that the swelling is an actual result.

I read from a bunch of people seeing no improvement after a year.
Based on what I have read so far, subcision seems to be a MUCH better option, more effective with a smaller price tag. Check out greg's post, he had HUGE improvements.

I've spoken with people who've had results lasting beyond a year, so it does work for some people.

I've seen Greg's thread, I've actually posted in it. Subcision primarily works best with rolling scars and really deep scars, if I am remembering corectly. Also, Greg had fairly deep scars, so of course a subcision would work better for that.

My initial surprise was with doctors claiming that laser treatments aren't permanent in the first place.

tricia, on 09 January 2012 - 06:44 PM, said:

It probably depends on the type of scarring as well as how deep the laser goes. If you get fraxel repair it goes considerably deeper than fraxel restore so you are changing your skin on a deeper and likely more permanent manner. If your scarring was super shallow to begin with perhaps the restore can eventually obliterate all the scar tissue making your results more permanent. If you have deep scarring and there are edges that are thicker and the laser only somewhat softens those edges and builds some collagen in the middle, then over time you may see the same scar shapes reappear as you get sun damage or age and the collagen is depleted. There is also the sagging of the skin that will make a shallow scar look worse over time, and lasers while touting to firm the skin, have actually been known to stretch the skin in some people. The heat could do all kinds of things to your skin, especially if it is ematrix or anything with an rf wave, thermage was known to shrink fat cells which left some people with saggy skin. I would only spot treat if I had laser, very nervous about long term side effects and all the horror stories I have read about.

Yes, I think it's always important to consider that results are different from person to person.

Also, I was surprised to learn that the laser I was being treated with, Lux 1540, is actually partially ablative, despite it being advertised as a non-ablative laser, and that this is very different from other lasers of the same wavelength of laser.

Edited by DRaGZ, 09 January 2012 - 07:23 PM.

[DRaGZ]

Having spoken to more doctors, my previously noticed trend seems more prominent: plastic surgeons don't think lasers work, dermatologists and dermatological surgeons do. Not sure what's behind this trend.

[DudleyDoRight]

http://www.realself....xel-repair-last

My theory, and it is only worth what you will pay for it, is that the more intense the laser the more likely it will last. If a lower powered laser creates less sweling and less improvement as the swelling reduces the more noticible the returning scars will be and people will say the procedure does not work.

[maggie07]

I was one of those silly people who was fooled by lasers. Lasers do not work for deep acne scarring. Well, at least the one I wasted a grand on didn't. It helped surface scarring -- i.e. red spots. And in the specific places I have had the laser, I don't get acne anymore. But my scars look the same. I was supposed to see the maximum results of the laser treatment by November...and sad to say don't see any.

I did have one scar on my chin that was more shallow than the others. And for a few months it did look about 80 percent better. But, over the past 2 months, I've noticed it has sunken in and gone back to its original state. I'm not sure if it is possible that it had been swollen for months or if the effects of the laser wore off or something.

When I was first introduced to lasers, I was so optimistic about them. And a lot of people on this board basically told me to save my money. I wish I would have listened to them. You really go through hell for a week, between the peeling, the swelling, the redness, and it is all for nothing.

[DRaGZ]

DudleyDoRight, on 12 January 2012 - 06:36 AM, said:

http://www.realself....xel-repair-last

My theory, and it is only worth what you will pay for it, is that the more intense the laser the more likely it will last. If a lower powered laser creates less sweling and less improvement as the swelling reduces the more noticible the returning scars will be and people will say the procedure does not work.

Yeah, I'd read that, but what I noticed was that it didn't specifically refer to acne scars. Since Fraxel Re:pair is very often used on wrinkles, it's hard to tell what type of results they are talking about. Obviously, wrinkles will return with age, since they are a natural product of aging, but if the underlying mechanism is to be believed, then there's no reason to believe that acne scars should return, at least not in their original forms.

Here's my own topic that I put up on Realself, and it was a lot more specific in referring to acne scars. I got two responses, which were interesting:

http://www.realself....scars-permanent

Dr. Kaplan's response is a good amalgamation of all the opinions I've been getting.

My personal opinion...is that there is no consensus! Haha, it's probably why acne scars are still such a problem.

Edited by DRaGZ, 12 January 2012 - 06:43 PM.

[Smra]

Please help! 5 months ago I had CO2RE laser resurfacing done for acne scars and some mild existing acne. I was told that 1 visit would be all I would need and I would see marked improvement in the scaring and that I should not have any future outbreaks that my acne would actually be reduced! I should add that It was NOT painful AT ALL , few blood spec and mild pink & blotchy...(healing time was MUCH quicker than I expected 3 or 4 days instead of 10 that I expected and I NEVER peeled) I actually questioned if he had gone strong enough? I was fine for the first 3 weeks after the procedure BUT ....Now I have been struggling with horrible acne have needed several cortisone shots that have literally collapsed areas of my skin, constant out breaks of peri oral dermatitis, my face looks dull wrinkly and old! Texture is horrendous and full of inflamed acne. My scarring is more noticeable than ever! I was on 100 mg of spirolactone before and after proceedure and have recently weened off of it( not helping and felt it was to dehydrating) and just take cephalexin. The Dr. Said that skin can take up to a year for full results. My results are worsening as time goes by! Has anyone else had a similar experience with a favorable end result?

Edited by Smra, 10 March 2012 - 08:23 PM.

[DudleyDoRight]

Excellent thread DRagZ! As you can tell by my signature I have had many procedures, and the effects seem to be cumulative. I now go for yearly tuneups of Fraxel Re:pair, and at $800 a pop they are well worth it. After the last one I was out in public in 3 days.