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  1. Hey guys, I wanted to share what I consider to be really positive results after just a single session of Fraxel (I've purchased a total of three). I hope it helps anyone who might be considering this treatment. I have a mix of scar types, as you'll see in the before photo; I'm really pleased with the improvement so far and hope for more in subsequent sessions. I had the first treatment two days ago. I'd appreciate any feedback or advice you guys may have. P (before and after)
  2. Hey guys - I am new to this community and hopefully will find some help here. After battling with acne for a few years, I finally got it cleared and went it for fraxel to clear a few scars. Worst mistake ever. Infact the day I was going for my fraxel my niece even commented my skin was glowing. Anyways, the fraxel has now left white spots on several places on my skin and I have to idea how to treat it. Its devastating because now I have no acne but a horrible new problem. I would take back that acne anytime because I knew what to do , right now I am so depressed and desperate. If abybody has any suggestions, please please help. Thanks, Mia
  3. I need some help. I know the scarring is not terrible, but a few months ago I had no scarring and smooth skin. I went through, and still have some adult acne. However they never scarred until i used benzoyl peroxide. Big mistake. Anyways, I did one treatment of dermapen three months ago, but i think the esthetician did not do it correctly as her pen would stop mid treatment and get stuck!!! This probably made the scars worse. I feel like the texture of my chin is terrible. Please see the pictures below. Scarri
  4. Holes from fraxel

    Hi, I'm after 3 treatments fraxel and rf. 3 months after. I have big holes and my skin broken on its very forehead. Please help !!! who help me :(:(:( Please
  5. I had a few Fraxel and PRP treatments to repair my acne scarring and ended up with really bad skin quality that looks worse than an orange peel. (To be precise 3 Fraxel treatments and two PRP treatments -- all of them one month apart) I have wrinkles and inflammation all over my face and it has made even looking into the mirror really difficult. I have no clue how to fix this and now all I do is keep looking for solutions online or dermatologists or at beauty clinics. Dermatologists and beauty clinics keep dumping more treatment packages. The spa where I got the treatments refuses to even acknowledge my condition (How can someone be so cruel) Based on what I have read about skin that looks like mine, I might have burned the skin barrier and destroyed the facial fat (But this is just my assumption because my skin matches the appearance of lost barrier and fat lost texture) I have read a lot of articles mentioning what these harsh treatments can do to your skin. Wish I had read those before doing something so drastic. I read an article on how emu oil and honey helped a lady who had similar skin texture but she got that orange peel like texture from using too much Vitamin A on her face. I keep reading on forums that thermal damage is irreversible and skin can never recover from it. It pains me emotionally so much every time I read something like that. Now I seem to be stuck in a dark zone with little hope for light, a way to fix my skin. I wouldn't wish this on my worst enemy but does anyone have any experience with this kind of situation or know any treatments that can help my situation. I would really appreciate some help on this.
  6. Hello all! I'm new to the forums but I've been a bit of a lurker for a few months now. I am a 27 year old Aussie girl who, like many here, suffered terrible acne as a teenager and well into my twenties. In the beginning I was left with moderate to severe rolling scars and an uneven texture to my entire face. I was depressed, angry and constantly dodging any reflecting surface. In 2008 I decided I could live like that no more, so I got off my butt and did something about it. Fraxel I have had 5 sessions of the Fraxel Re:Store laser. I had my first session in 2008, I then had a further three (spaced three months apart) in 2010 and my last session in January this year. I have many things to say about Fraxel, but the first is that I rushed into it a little in that I did not do my research properly. I should have gone with Fraxel Re:Pair or a fully ablative laser instead of the Re:Store. Too late for that now, and I haven't ruled out the Re:Pair for the future yet. Pain: I have a really high threshold for pain so the first few sessions were okay. A little tender after them making multiple passes but in all it wasn't too bad. For some reason though, the last treatment I had was horrific. I don't know if they didn't use the same numbing cream or if they dialled the settings up dramatically or what it was, but I was practically convulsing on the table. Was not nice at all. Downtime: 2 full weeks each time. Even after the 2 weeks was up I was left with micro swelling here and there and an acne flare up to die for. Add in house-bound and sun sensitive and you've got a miserable 2 weeks. Results: Slow, like all good things. I'm ashamed to say that I didn't take before/after pictures whilst going through Fraxel. I felt too hideous. However, I think in all I would have seen around a 30% improvement in my scarring and a bigger improvement in my pore size and general skin texture. So it wasn't a complete waste of money, but i would like to go back and do it all again knowing what I know now. Cost: $1700 each time... so that's a whopping $8500. Eek! Other: The doctor. Curses to the doctor that I saw! He has no bedside manner, no care factor and is clearly out for the money. I am not a sceptic when it comes to the wonders of lasers. I know they work and I know in the right hands they can result in outstanding improvements. I'm not saying my doctor was useless, but I am saying that I will not pay him a cent more. 5 days to return an urgent phone call is unacceptable in my books, especially when I have paid so much. Not only that, but the clinic is poorly designed. In order to get to the treatment rooms you have to walk past the people waiting to be seen! That means walking past gawking patients while your face is smothered in crap and then walking back past them once your face has been attacked by a laser. Talk about awkward. End rant. Dermaroller So, after my last Fraxel session in January 2012 I decided to look for alternatives. I scoured the Internet looking for information on the Dermaroller. I think I found every medical paper, every website, every before/after picture. Months of research. When I finally decided that I was going to give it a shot I then went through the same process to find someone skilled enough to do the procedure. Firstly I really want to make it clear that I would never treat myself with a skin needling device. I've read things about people purchasing cheap rollers on eBay and on other sites and I am horrified! If you want to go out and chance further scarring your skin or causing infection by doing this procedure yourself then that's your risk. I pay someone to do the procedure using the genuine Dermaoller, the one made in Germany. 192 needles, medical grade material, 1.5mm needle length. I have had three sessions so far. The first was in July, then again in September and the third last Friday. Between each session I have waited 7 weeks to allow for proper collagen formation. Pain: Almost none. A little tender on the bony parts of my face and on my nose but nothing compared to laser treatments. Downtime: Around 4-5 days of redness and swelling all up, but I can go back to work on day 3 with a little bit of makeup and nobody's been scared to look at me! I do have a small acne flare up after each session but it's mild and might be more from the products I'm using (which are new and my skin is not used to them yet). Results: Colour me impressed! In my deepest rolling scars (on my left cheek) I can honestly say I've had around 40% improvement. This is over two sessions with my gauging results six weeks after the second session so no chance of me seeing micro swelling. My scars are slowing filling in. I didn't see much change after the first session and was a bit downhearted by that but I am sticking to my treatment plan of 5-6 sessions! Cost: $800 a session. Compared to Fraxel that's nothing, but till expensive I know. I pay for it because I know I'm getting the best treatment money can buy. Plus the person who is treating me with the Dermaroller is fantastic. She cares deeply about what she's doing for me. It's her passion and that makes me excited! Other: Just wanted to add a further blab on Dermarolling. I chose to go with the original Dermaroller as it is the only one listed on the TGA (Therapeutic Goods Administration) here in Australia. Every single copy of the original dermaroller is not listed and never will be unless they apply for it and are thoroughly tested. I didn't take the brochure's word for it, looked it up myself. It's there, all other rollers are not. Copies that claim that they are "TGA approved" etc mean absolutely nothing! There is no such thing as TGA approved. You're either listed, or you're not. Simple. Needles shorter than 1.5mm do nothing for scarring. They don't reach deep enough into the problem layers of your skin. Shorter needles are for product penetration only and are safe to use at home (although I'd still only ever touch the original Dermaroller brand). Needles longer than 1.5mm are a very unwise choice as they are too long and may cause damage to the deeper layers of skin. 2mm needles and longer are reserved for burn scar victims as their scarring goes deeper and into the layer of fat; unless this is your problem don't use them! When your skin is treated using the 1.5mm needles you want to see blood, and lots of it. Your blood contains fibroblasts and collagen fibres. More blood in each session means that your circulation is getting better, which is a really good thing. In my first session I hardly bled at all, but last Friday my face was an awesome mess! More is not better! Rollers with more than 192 needles are extremely dangerous. With more needles more pressure is required to puncture your skin and there is a huge risk of tearing your skin to shreds (think of is as a bed of nails, the more nails, the easier it is for you to lie on it without being impaled). I also have a blab I could get into regarding skin care lotions and vitamins but I'll save that for a rainy day, hehe. Sorry for the damn story... I just wanted to share my experiences and hopefully give a little, learn a little from others here! I have taken a few half-arsed before/after pictures on my phone but I'm still deciding on whether to put them up. All of this stuff I have posted is from my personal research and experiences. I tend to ask a million questions these days and am glad I do; I am not taking any chances on my skin. I may come across as a Dermaroller infiltrator who is out to brainwash you to go do the procedure. I'm not. I am just so freaking excited about find a treatment that has worked for me that I wanted to share. Not seeking perfection, just happiness.
  7. Skin condition

    Hello everyone, that's my first thread on this forum. Found it somewhere in the Internet cause I was looking for help and here's my story. As I started puberty, I got acne. It wasn't as bad as in some cases but it left me with scars - especially on the temples. Anyway - when I was 18 I've started taking isotretinoin for about a year and I got rid of acne. About a year after my isotretinoin therapy had ended I underwent a sieries of fraxel laser treatment (for the scars) - the last one was 2 weekes ago so the skin doesn't look healthy yet (redness and the peeling). I'm describing this so that you knew my situtation. I'd like you to assess condition of my skin. Especially the center of the forehead - don't you think there's something weird going on - I've got a problem with those dark little dots, what are they, are they scars? How can I get rid of them? Sorry if I made any mistakes writing this - English is not my first language .
  8. I had cystic acne on my chin in high school, I went to an asthetician who extracted the big pimples with a needle, yes BIG mistake, but I didn't know any better. Finally my acne had cleared up but I have been left with ice pick scars that I have tried to get rid of over the years (I am 28 years old now) and I have tried Maderma scar cream but that doesn't do anything for old scars. I have tried a session on microneedling two months ago (found a Groupon that had great reviews for this asthetician who does the treaments in New York where i live). She told me that it will take 8 sessions to see improvement but told me they will never completely go away, which I know, but I just need improvement. She also told me I had to get a facial to clean my skin prior to th first treatment, so I did, I paid $120 for that plus the microneedling session, well after one microneedling session of course you cannot see any improvement but I did notice my skin otherwise being smoother and less tired. I went to my derma doctor for another issue and he told me that microneeding is a waste of time for my scars and that I should do non-ablative fraxel in his office(I paid $65 for the consult on this that will go towards the first session of the fraxel plus I have to get a facial to clean my skin prior to the session ($100, not much money but still I am tired of paying for this service when I don't need it as I do not have active acne and my skin is fine otherwise). I did consider Fraxel before doing microneedling but am so scared of any bad side effects. He told me that the nonabalative fraxel will only help 40% which is fine, I want to improve my skin, I know it will never be perfect. He also told me to consider excision of each scar and then fraxel after, which I am certainly not considering. Can someone tell me what is best for my skin? I have posted my scars on my blog, link here. Any help will be appreciated asI really am lost and would like to stop paying money for something that will not give me results. Thank you! http://thedrasticallyblog.blogspot.com/2016/12/acne-scars.html
  9. I had fraxel restore on multiple scars on my face just several hours ago (pics were just taken with phone). The pics I have posted shows fraxel restore being done to a part of my face that didn't even have scars (totally unnecessary) and you can see two rolling scars that was not treated with the fraxel restore (technician missed it). My problem is the vertical fraxel restore treated area (3 inches vertical) is now indented, towards the bottom you can see a quarter size indentation and with broken skin and still oozing....it was perfectly fine before, smooth and scar free....help??? What should I do?...the office I had this done are closed. I'm afraid of ending up with more scars then I came in with. damn... Settings were 60 mj, level 7, and 8 passes.
  10. Hi Everyone, Long time lurker, and I finally bit the bullet to create an account and post. I need some advice for my pitted scars on my left cheek with active acne. For some reason my cystic acne loves my left cheek and crops up every 4 months or so for the past 2 years. I've had cystic acne all my life, and after different treatments it slowed down for the most part. Just my left cheek is active. My wedding is next July and I'm trying to lessen the severity of the pit appearances. My dermatologist recommended me RF - Radial Frequency? Microneedling or Faxel treatement. They recommend Microneedling for me. It costs $3,600 USD for 3 treatments. This seems very high priced based on what I've seen, however I really trust and like my dermatologist and she's never been one to push me to do things I didn't like. Based on the comments I've seen , RF microneedling hasn't really worked for a lot of people, in fact ive seen it damage people ? What about Fraxel? Should I just go ahead with Inifini or fraxel - even if it helps a little? I feel stuck with little options. Are there any other recommendations that are not aggressive like skin punching/surgery (both NOT recommended by dermatologist due to skin type) or subsicion or even dermarolling? I don't want to do any DIY stuff since I scar very easily - I'm prone to have keloids and raised scars. (If it's basic name brand creams - I'm all for it. Just nothing like aggressive such as 80% TCA peels at home) I'm also tempted to consult with other dermatologist, but it is time consuming and costly for several consultations. I just want advice on what has worked for people who have had not-too-aggressive treatments. Anything that has helped slightly improved appearance(10-20% improvement) would be good with me, I'm feeling desperate. Provided below is my skin background alongisde the duration or year completed: Skin background: -Cystic Acne (all my life, I am 25 yo) -3 Keloids scars from cystic acne on shoulders and shoulder blade (10 years old) -raised white back acne scars ( 10 years old) Treatments: -regular monthly "light" chemical TCA peels on face and back , 10 - 30% depending on face or back ( 2015 - 2016 current dr) -Steroid injections for keloids and cystic acne (2015-2016 current dr) -Laser treatment, Genesis - Did not work ( 2014, at skin spa) -Obagi Kit - Effective for forehead cystic acne , got rid of 80% of acne (2010, done at different skin spa) -Birth Control, got rid of 5-10% of acne - stopped working after 6 months (2010 PC physician) -Tetracycline, worked for 6 months (2008/2009 PC physician) Provided below is a pic of my lower half of my face, apologies as i have makeup on, but you can still see my pitted scars.
  11. What is the difference between fraxel repair laser, restore, pixel and pearl? I want to repair some individual atrophic scars. What kind of down time is there?
  12. i am a 41 yr old male and over the last few years have gotten a number sebaceous hyperplasia on the face. I have tried the following with results: -topical retin-a micro (tretinoin gel) 40% decrease in size of papule -topical tazorac 50% decrease " -topical epionce lite lytic lotion 50% decrease " -topical cp serum 10% decrease " -topical cellex-c 5% decreases " -benzoyl peroxide 20% decrease " -light electrocaughtery-not recommeded since approximately 1 out of 4 result in a noticable hole in skin due to unpredictable results. -levulan-decreases papules 75%-100% but result is temporary.lasts couple months.not worth the money and time you spend red and peeling to get final result. -fraxel-reduces papules by 60% but result is temporary not worth money spent -oral isotretinoin aka Accutane at 10mg per day 99%-100% decrease in papule within 14 days**this is the best solution i have found** switch to 10mg once every 2- 3 days. the only frustration is getting a dermatolgists to prescribe isotretinoin. none will suggest isotretinoin unless you ask and beg for it. this is due to the big scare with accutane and risk of suicide. the new mandate in the u.s. by the fda and ipledge does not allow a dermatologist to write a isotretinoin prescription for sebaceous hyperplasia. it is not a covered prescription on health insurance for sebaceous hyperplasia either. my dermatologist told me isotretinoin works great and nothing works better, and that no topical lotion will resolve sebaceous hyperplasia. but he was bound by the rules of ipledge. i had to persuade my derm docter to agree to give me a prescription, then go over the internet and order it myself from a canadian pharmacy. thus paying for it out of my own pocket. isotretinoin miraculously relieved me of sebaceous hyperplasia completely within 14 days. you are supposed to limit your alcohol intake to little or nothing per day due to the taxing affect alcohol has on your liver and the potential toxic vitamin a affect in isotretinoin. i have not been able to find any studies that indicate any negative affects of low dosage 10mg per day of isotretinoin. although with equal success, i changed to 10mg once every 3 days, after the first 2 weeks of daily dosage. i know with higher dosages for severe acne such as 80mg to 150 mg per day can pose some additional risks. in any case no matter what dose, it is suggested to get liver function tests periodically to check if your triglycerides are at the proper level.
  13. July 2016 Davin Lim on Energy Devices and Scar Treatment Interesting Infini (goes 3.5mm, laser only 1.5mm) is his favorite when he is the Fraxel Spokesman, he gets the machines for free and is paid to talk at conferences. Fraxel he said "is the most overrated treatments out there", good for minor scars but not many things. CO2RE is more powerful than the Fraxel device, even Re:pair. His number one recommendation seems to be Subcision & Filler depressed scars, & TCA Cross Icepics. As I have been saying in the FAQ for out Sub Forum... lasers are for surface texture and filler, subcision, microneedling, tca cross / spot tca peels, are great for scars before you go the laser route. Start with non energy treatments first and move to energy devices if you are ready ;-P He said to only do a derminator not a dermaroller they are not effective microneedles and often tear. https://www.youtube.com/watch?v=38Wty2Rpj7U Dr. Davin Lim covers Lasers and Radio Frequency Micorneedling in the Video with Pluses of Each New Technology for Acne Scaring, wrinkles, and large pores. Syneron Candela Core / Co2re laser (good for acne scars "laser of choice acne scars" as it is customizable up to 80mj setting and can do hybrid mode like Total FX or shallow settings like Re:Store ETC All-in-one) Fraxel re:pair (tightens, refreshes skin, acne scars) Cynosure Picosure focus laser (great for large pores, no down time, ethnic skin, hyperpigmentation) Lutronic Infini Radio Frequency Microneedling (tightens & plumps, fractionated skin refreshing, goes deeper than laser, low down time) Ematrix (active acne pustules ablates top surface of skin) Scition erbium laser (great for ethnic skin or stacking with CO2 laser) Video Overview / Fractional laser resurfacing- dermatologist Review of All New Laser Technologies and Radio Frequency and Pluses of Each: Syneron Candela Core / Co2re laser with deep acne scars: Results of Laser Acne Scar Procedures: Subscision is Still the Best Cheap Non Laser Treatment for Rolling Acne Scars: Tethered / Anchored / Puckered: TCA Cross for icepicks Procedure:
  14. ACNE SCAR Q&A / FAQ; LIBRARY of POPULAR THREADS <If You Have Updates / Hints/ Tips for This Thread, or Questions, Please PM Me> Special Thanks for Contributors : Robertitoo, DeLovely, PCT14, somethingsomethingagain, QuanHenry, Hope01, Dan Owner of Acne.org Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor, Dermatologist, or Plastic Surgeon provides you. Please keep in mind that this is for general information only and results will vary for each individual. TABLE OF CONTENTS: 1. SUCCESSFUL TREATMENT THREADS 2. WHAT IS ACNE & PREVENTING SCARS 3. DIFFERENT TYPES OF SCARING 4. TREATING SCARS AT HOME 5. SKIN: TEXTURE, DRYNESS, RED, BROWN, WHITE MARKS, & COVERING UP SCARS 6. PUNCH GRAFTING & EXCISION 7. HYPERTROPHIC / KELOID (RAISED SCARS) 8. SUBCISION 9. FILLER FOR SCARS 10. LASER 11. MICRONEEDLING 12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS 13. LIST OF ACNE SCAR TREATMENT DOCTORS 14. ANATOMY PICTURES ___________________________________________________________ 1. SUCCESSFUL TREATMENT THREADS Scar Treatment Success > PCT14 Suction and Subcision Success with Suction http://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/ > MR. Matt Subcision Success http://www.acne.org/messageboard/topic/232731-man-in-the-mirror-pre-and-post-subcision-photos/ > Boxcar scars improved significantly through subcison http://www.acne.org/messageboard/topic/323172-my-total-fx-diary-procedure-scheduled-for-120412-updates-to-follow/ > DC Girl TCA improvement http://www.acne.org/messageboard/topic/337794-scar-success/ > Success Recell UVB Lamp + Melgain (Decapeptide - Basic Fibroblast Growth Factor) Fixing Vitiligo, Lightened Scar Hypopigmentation, Loss of Pigment Skin Discoloration http://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/ > Infini RF and Laser Didn't Fix It Filler and Subcision Did http://www.acne.org/messageboard/topic/322562-my-infini-treatment-for-my-acne-scarring/#entry3301228 > Scared pores/ice picks improvement of as well as a few boxcar scars http://www.acne.org/messageboard/topic/316133-just-had-ablative-fraxelrepair-and-ultrapulse-co2-with-photos/ > Good results to a guy doing Mixto CO2 Laser to boxcar scars http://www.acne.org/messageboard/topic/315693-asian-doing-mixto-for-acne-scars-on-cheeks/ > Total Fx good results boxcar scars http://www.acne.org/messageboard/topic/323172-my-total-fx-diary-procedure-scheduled-for-120412-updates-to-follow/ ___________________________________________________________ EMOTIONAL / PSYCHOLOGICAL EFFECTS OF ACNE / SCARS (YOUR NOT ALONE) Many Acne scar suffers live a life of pain from their outward appearance. This often manifests itself with low self esteem or hiding away in the house from anyone seeing them. It can effect ones life in many ways that are not healthy both physically, mentally, and spiritually. When the acne scar suffer finds treatment they often are overly critical of themselves and think everyone else sees them the same way, this is a sub form of BDD - Body Dysmorphic Disorder called Acne Dysmorphic Disorder. This can lead to a obsession for perfect skin and finding small faults in them and others. A roller coaster of unrealistic expectations of treatment outcomes and something to save them becomes not realistic. Part of healing from Acne Scars is realizing you will get a small percentage of improvement at a time with each treatment that can take many years in some cases. Glass perfect smooth skin is a goal but often not a reality of severe scarring. Therapy can help get that remaining percentage to live happy and healthy lives. Colleges offer low cost therapy to everyone and now there is a smart phone app even if you cannot leave the house where you can get therapy called Talkspace which has helped many. Acne.org also has a psychological challenges sub forum linked below. > Emotional/Psychological Effects of Acne Scarring (Individual stories) http://www.acne.org/messageboard/topic/360711-emotionalpsychological-effects-of-scarring/ > Emotional/Psychological Effects of General Acne - Sub Fourm for Acne.org http://www.acne.org/messageboard/forum/10-emotional-and-psychological-effects-of-acne/ ___________________________________________________________ 2. WHAT IS ACNE & PREVENTING SCARS Q: How Does Acne Occur? A: Sebum overproduction, hyperkeratotic obstruction of sebaceous follicles, and microbial colonization that promote perifollicular inflammation. When the content of a comedone, the mixture of keratin, cell debris, sebum and bacteria, is exposed to tissue due to the breakdown of the follicular wall, inflammatory cells aggregate and counteract these foreign bodies. That is why painful papules, pustules, nodules and cystic acne form. Inflammation in acne is typically a destructive process, reaching deep into the subcutaneous tissue where the follicular structures are situated. It is more destructive for the deeper structures than the superficial. The more manipulation through squeezing, pushing, and pricking, and picking the greater the chance follicles will rupture, and the more severely the acne will inflame. The longer the inflammation persists, the more tissue that will be destroyed and scar. Scarring tends to be genetically linked to an individual's unique inflammation response. Those people with a "secondary inflammatory response" to trauma tend to scar, while those with a "single inflammatory response" to trauma tend not to scar. This explains why some people will scar easily and others maintain a smooth complexion even through moderately severe battles with acne. Prevention is always better than cure Q: How can I prevent my acne from scarring? A: The best way to prevent scarring is to prevent the acne that causes it. See http://www.acne.org/regimen.html Sulfur cream, or Benzoyl peroxide on pimples, and Retin A cream nightly have helped many. ** The newest treatment is called Photodynamic therapy (PDT) which uses a medication which is absorbed by the bacteria and oil glands in the skin, and a light source (blue led) to activate the medication closing the pore after several treatments. Intense pulsed light that is used for photofacials can also be used to do a PDL type treatment by activating these medications. For extremely severe, widespread acne, you may choose to see a dermatologist to inquire about Accutane medication which does have side effects. Many dermatologists contend that scars are really more from picking than from the acne itself. Occasional popping can often be performed quickly and safely. It is the picking afterward that often leads to the worst scarring. Scarring tissue theoretically has no regenerative capacity, and will not grow unless it is hypertrophic or a keloid. Meaning you can improve the cosmetic "look" of the scarred skin but the underlying skin structure is scared tissue. If you have pimples specifically underneath the nose region or in the chin / goatee region, or they could be just near your ears and on the cheeks. These pimples or cysts maybe keep appearing in the same spot(s). This could be due to Staphylococcus Aureus bacteria, do not pop these, ask your dermatologist to swab and send to the lab to culture, antibiotics will be needed. Pimples tend to be all over the face, staph can be more cystic or in a contained region. Q: What happens to my scars as I age? A: In ageing skin, progressive tissue laxity worsens the problem of unevenness around scar tissue. Aged skin loses its elasticity and descends under gravity, the scarred tissue and the normal ageing skin behave differently. This difference makes the skin appear more uneven. More Fat loss naturally makes the scars appear much worse, this is why we use fat and hyaluronic acid fillers for ageing augmentation. Q: What is my Fitzpatrick Scale of Skin Darkness & Type (This Determines Treatment) Please note non-white skin can hyper pigment with energy devices source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 ___________________________________________________________ 3. DIFFERENT TYPES OF SCARING Q: Can you describe the different types of scarring? scar types: source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 Icepick: Looks like an ice pick has been pressed into the skin. It is generally small in diameter, but can be shallow or deep. Boxcar: Looks somewhat like a chicken pox scar with more rounded edges. It can be small or large in diameter and is fairly deep, though not usually as deep as icepick scars. Rolling: Looks like a smooth indentation in the skin. These scars can be deep or shallow, but are generally shallower. Macules: Pigmented scars, These are most common on the back, chest and arms. They are small areas of hairless scar tissue that will initially be red but will usually fade to pale ivory within 1-2 years. They can be raised (hypertrophic) or indented (atrophic). There are two basic types of Raised scar types: Hypertrophic scars - are scars that are raised above the skin surface but remain within the boundaries of the original injury. Scarring and can be treated with silicone sheets , liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam / QuadroStar Pro Yellow Laser. The treatment options include laser ablation, electrodessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful. Keloid scars - which are raised scars that extend BEYOND the boundaries of the original sore, blemish or injury. It is scar tissue gone wild. It can continue to grow. Some people are genetically prone to keloid scarring. (Treatments are the same as Hypertrophic Scars above, with steroid injection & cryosurgery being the number one treatment for the raised texture). Q: How can lighting effect the appearance of acne scarring? A: Lighting can have a tremendous effect on the appearance of acne scarring. Some women use silicone primers to fill the scar / pore before makeup or blurring creams, serums, and primers you can get from a makeup store. Your scars will look worse with fluorescent lighting and when not moisturized and plump. Night light and harsh lighting can look worse for many, this is why they put HD makeup (which is thick) on at night. Guys can grow facial hair to cover it, put lots of sunscreen, or avoid sports where they get red and it shows the scars. Pure higher weight serum has bigger molecules,... hyaluronic acid makes your skin moist, low weight HA inflames and plumps the skin hiding the scarring. Use a gel moisturizer over a cream, less break out potential though often the thicker moisturizers plump the cells. Indirect lighting - shows the true scars (scars make shadows, turn out the lights and use a flashlight) . ___________________________________________________________ 4. TREATING SCARS AT HOME Q: Is it okay for me to treat my scars while I am on Accutane? A: No, it is suggested that you wait at least 6 months to a year to treat your scars after taking Accutane. Some individuals have reported that they seem to scar more easily while taking Accutane. If you have completed a course of Accutane and only use it occasionally or in low dose form your probably ok to do acne scar treatments (you can stop 2 weeks before major treatment). Q: What is the Lemon & Vinegar Method? A: This is a method that may improve the appearance of shallow, rolling scars. Drink either Robinson, Lemon Barley Water or plain water with half a teaspoon of lemon juice to a full glass of water throughout the day. It is best to use fresh lemons if possible. Use any diluted vinegar (organic apple cider if possible, malt or white are also acceptable) in warm water to splash onto the face day and night. You may have to experiment to find the right combination of water to vinegar. Try diluting it 1 part vinegar to 4 parts water to start with. First wash your face with your normal cleanser, and then apply the vinegar (dab the solution on with cotton balls and leave on) before other topicals / moisturizers (apply topicals 20 minutes later). You should see an improvement within a week or two. Q: What can I do NOW (at HOME) to improve my scars without going to the doctor? A: Retin A topical from ebay turns over skin quicker. Microneedle the scars we recommend you buy the Derminator (see link below) and use at 1.5mm once per month. When that heals alternate with a Acid Peel (like TCA - Can be bought at "Makeup Artist Choice"). TCA Cross is the best treatment for icepicks, see below for more info on these treatments. Makeup will help guys and girls spot treat their scars and even out color (all the stars and people on TV wear it) Dermablend at Macys and Nordstrom was made for surgical scars and tattoos (Unisex). http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ A: As mentioned, most people with moderate scarring do not find that topical solutions have a significant effect on their scarring. However, they can help lessen scars if used in the healing stage. Topicals typically do nothing for scarring. They are a preventative, but Retin A Gel and Vitamin C Serum can help the skin heal and create new collagen. Many combine these with their other treatments like microneedling. Q: Will Microdermabrasion reduce the appearance of scarring? A: It is generally thought that Microdermabrasion cannot penetrate the skin deeply enough to affect the appearance of moderate to deep scarring. It is a great method of exfoliation at home using a microfiber cloth or spin brush. Be careful of bacteria. Q: What treatments offer the biggest change? A: Subcision can help smooth out the skin for those with tethered scars. Filler with subcision to avoid tethering down again if you have atrophy (missing fat under scars), be sure to see a specialist who has done acne scars before, you can always ask for pics. If they don't do subcision to create a pocket under the scar the tethering will not lift with filler. For ice picks, TCA Cross to make the ice pick raise and widen. Microneedling for all types of scars makes the skin heal and renew itself, it's a slow process (also breaks up scar tissue). TCA peels renew the skin and cause it to refresh what's under the controlled chemical peel (similar to laser without the cost). -- See below detailed subcision section. Q: Is there anything I can do to optimize my healing responses following invasive scar procedures? A: Yes. Through a healthy diet (no sugar, carbs, highly processed foods, lots of fruit, veggies, and greens, lean fat meats, low salt). Supplementation: collagen, vitamin c, vitamin K, Bromelain, pure HA serum. Topicals: Vaseline - keep it moist until scabs fall off, don't pick it, vinegar soaks with diluted vinegar water, Arnica Montana for the bruising and red, sunscreen all the time, hydroquinone for bleaching and hyperpigmentation issues. Do not take blood thinning products (i.e. Ibuprofen / Motrin...take Tylenol instead, vitamin E). Spices that thin the blood: cayenne pepper, onion, ginger, paprika, peppermint, thyme, cinnamon, dill, oregano, turmeric, garlic, chocolate, fish oil. ginkgo biloba, ginseng, magnesium, taurine energy drinks. You may take these once your body has healed from the initial surgery (a few days , to a week). Using makeup can cause infection if the skin is not healed fully. Drinking and smoking hinder healing. Make sure to get plenty of rest during recovery, & drink lots of water. Q: How do I get multiple doctors opinions for treatment "FREE"? A: Post a few pictures of your scars using indirect lighting (scars make shadows) like below on http://www.realself.com . Some doctors will give you their opinion. Be aware sometimes their treatment recommendation is a canned response (the "laser" they own or are sponsored by). Post treatment recommendations for a second opinion on the forum here. Start with Non- Energy treatments first. source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 ___________________________________________________________ 5. SKIN: PIH, PIE, Erythema (red), Hyperpigmentation (brown or other colors), Hypopigmentation (white), TEXTURE, DRYNESS, & COVERING UP SCARS DEALING WITH SPOTS OF ALL COLORS AT HOMEQ: Where do I start?A: Hyperpigmentation takes a long time to heal. You can try to simply wait it out...but it never hurts to try and heal your spots naturally:-Aloe vera gel + honey and vitamin K (gets rid of bruises and red) keeps the spots moist creating quicker healing.OR You can use triple antibiotic cream or Vaseline at night to keep your wounds moist (Note: this breaks out some people so please spot test). In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. -Fresh lemon has helped some people fade their spots and also topical green tea. -Topical Vitamin C serum can help some fade their reds and browns and in others it has irritated their skin. Always wear sunscreen. In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. These spots can take months to heal being irritated wounds, the remnants of acne or other skin issues. If this doesn't work stronger treatments are below>> ___________________________________________________________ DIET NEEDED FOR HEALINGQ: What can I do diet-wise to deal with my spots (red, brown, white)?A: Eliminate: sugar, dairy, gluten, start eating fermented foods and bone broths, take your probiotics, and antioxidants such as green tea, vitamin C, and niacinamide. Smoking stops healing as does too little rest. You need animal foods in your diet, especially healthy fats, so don't be afraid to eat fatty meats! If you are a vegetarian eat nuts, hummus, coconut & olive oils, Many with these spot flare-ups mixed with red hyperpigmentation have candida (yeast) and gut health issues. This might need addressing. After antibiotics, this common yeast can cause issues in the body.___________________________________________________________ WHAT IS: POST INFLAMMATORY ERYTHEMA (PIE) - red spots that turn white after being pressed on Q: What Is Post Inflammatory Erythema (PIE)? A: Post Inflammatory Erythema (PIE) describes pink to red discoloration after an inflammatory acne lesion. Patients with lighter skin types (I-III) the post-inflammatory dyspigmentation is often not hyperpigmentation, but instead discrete erythematous macules (PIE). Acne may not be the only cause of post inflammatory erythema, as any resolving cutaneous inflammatory process may have residual erythema. Treatments (ranked most effective to least): V-beam or QuadroStar Pro Yellow Laser (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), steroid creams from the derm, Retin-A Cream, Bactroban cream, Silicone Sheets and topicals (known as scar gels), 2.5% hydrocortisone twice per day (only for a weeks time - it thins the skin), triple antibiotic. How to care for Erythema First, get your skin completely clear from active acne. This way you are preventing any future Erythema. Once you are clear, you can try a Erythema treatment above to reduce the marks you might have. Topical treatments are the first choice for treating Erythema. The treatments most commonly prescribed by dermatologists are Steroids.Erythema is common among people of Caucasian descent. Erythema can also occur in darker skin, albeit less frequently. UV light – the light from the rays of the sun – can make Erythema worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of Erythema and allow any Erythema you currently have to heal as fast as possible. How to prevent Erythema Picking at acne lesions is the worst culprit when it comes to creating Erythema. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping Erythema skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.1,5,9 The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any Erythema that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option. ___________________________________________________________ WHAT IS: POST INFLAMMATORY HYPERPIGMENTATION (PIH) - brown spots or red that stay after being pressed on Q: What Is Post Inflammatory Hyperpigmentation (PIH)? A: Post Inflammatory Hyperpigmentation (PIH) is related to brown spots, and permanent red spots. The discolorations are caused by an excess production of melanin. Vitamin C, Glycolic, Hydroquinone (skin bleaching cream) are all great tools for inhibiting melanin which will fade the discoloration. PIH is more common in darker skin types (Fitzpatrick IV-VI), although it is not limited to any skin type. Treatments ( ranked most effective to least): IPL Intense Pulsed Light or Photo facials act on certain colors, Alpha Hydroxy Acid peels: glycolic * good also for smaller pores, TCA, Mandelic (Acne.org has an excellent one in the store), Skin bleaching creams (aka hydroquinone or Kojic cid w/ Arbutin), Retin-A Cream for cell turnover, Vita-K cream for Blotchy Skin . How to care for hyperpigmentation First, get your skin completely clear from active acne. This way you are preventing any future hyperpigmentation. Once you are clear, you can try a hyperpigmentation treatment from above to reduce the marks you might have. Topical treatments are the first choice for treating hyperpigmentation. The treatments most commonly prescribed by dermatologists are hydroquinone (HQ) and retinoids.11Hyperpigmentation is common among people of African, Asian, and Latino descent, as well as other forms of non-Caucasian skin.1-5 Hyperpigmentation can also occur in Caucasian skin, albeit less frequently. UV light – the light from the rays of the sun – can make hyperpigmentation worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of hyperpigmentation and allow any hyperpigmentation you currently have to heal as fast as possible. How to prevent hyperpigmentation Picking at acne lesions is the worst culprit when it comes to creating hyperpigmentation. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping hyperpigmented skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.1,5,9 The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any hyperpigmentation that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option. Hydroquinone: (Bleach Eze®) Hydroquinone is the first choice of treatment for hyperpigmentation.12 It is normally used at a concentration of 4%. In higher concentrations it can cause "spotted halos," which appear as lighter colored ring around marks. Hydroquinone treatment results in a marked improvement or complete clearing of PIH in 63% of the patients.4 The efficacy of hydroquinone may be increased by the addition of a retinoid and a low potency corticosteroid, such as hydrocortisone.13 Side effects of hydroquinone include burning, redness, and itching in 30% of the patients.12 The addition of ascorbic acid (Vitamin C) to a topical hydroquinone treatment may help minimize side effects.2-3 Hyperpigmentation starts to subside after 4 weeks of hydroquinone treatment, but maximum results usually require 8 to 12 weeks of treatment. Be certain to work closely with your physician or dermatologist if you decide to use hydroquinone to ensure proper dosage and reduction of side effects. Read Reviews No Reviews Retinoids Tretinoin (Retin-A®), Adapalene (Differin®), or Tazarotene (Tazorac®). Retinoids are vitamin A analogues that are typically used together with hydroquinone. Retinoids are topical treatments that can help fade marks and treat acne at the same time. According to the Journal of the American Academy of Dermatology, “Of particular significance to skin of color patients is the ability of retinoids to treat both acne and PIH. By increasing epidermal turnover, these agents facilitate melanin dispersion and removal.”8 A study published in The New England Journal of Medicine on people with skin that was darkened by hyperpigmentation showed that daily retinoid treatment resulted in “much lighter” skin in 53% of participants and in “somewhat lighter” skin in an additional 33% of patients.14 If retinoids are used alone and not in combination with hydroquinone, dermatologists often prescribe a topical corticosteroid in order to reduce the irritation and potential worsening of PIH that retinoids can cause when they are used alone. An expert opinion in Skin Therapy Letters sums it up: “The use of retinoids as monotherapy is not recommended as an irritant reaction may cause inflammation that induces paradoxical hyperpigmentation; a similar concern exists over the use of HQ as monotherapy at very high concentrations (i.e., 8-20%).”12 Retinoids typically take 8 to 12 weeks to produce maximum results. The frequency and concentration of retinoid therapy depends on the severity of hyperpigmentation and should be determined by a dermatologist. Tretinoin Read Reviews 3.54/5 - 1396 reviews Adapalene Read Reviews 3.3/5 - 1305 reviews Tazarotene Read Reviews 3.51/5 - 615 reviews Niacinamide, also known as Nicotinamide. Niacinamide is a B vitamin that can be administered topically, and is currently being investigated as a potential therapy for hyperpigmentation. A study published in the journal Cutis in 2015 showed that a topical cream containing 4% niacinamide in combination with the other pigment-lightening and anti-inflammatory compounds arbutin, bisabolol, and retinaldehyde reduced hyperpigmentation due to melasma by 34% over a period of two months. Melasma is a common skin problem where brown marks appear on the face due to pregnancy or sun exposure.15 To date, there exists no published research that has investigated whether niacinamide is also effective in treating PIH, but studies are currently in progress. Read Reviews 4.5/5 - 3 reviews Azelaic acid Azelaic acid is another topical acne prescription that is sometimes used for PIH that works by slowing down the production of melanin. It is a gel that doctors normally prescribe in 20% concentration for PIH, applied twice a day. Azelaic acid is safe and effective for the treatment of both acne and PIH conditions in darker skin types. Common side effects include mild redness, scaling, and burning.16 Due to the mechanism of action of azelaic acid, results are not seen for the first few months of azelaic acid treatment, but results are eventually seen after six months. Read Reviews 3.89/5 - 218 reviews Gentle Chemical Exfoliation Over-the-counter glycolic acid products are available in strengths up to 10% and can provide gentler chemical “peeling,” which is better described as gentle chemical exfoliation. At lower percentages in over-the-counter products, glycolic acid does not cause the skin to visibly peel off in sheets like professionally administered chemical peels do, and instead provides exfoliation of only the surface cells of the skin. This is a slower and safer way to achieve the skin turnover required to reduce hyperpigmentation and can be used on a more frequent basis when compared to chemical peels. Most people find that they can tolerate over-the-counter 10% glycolic acid products every two or three nights, or every night when mixed ½ and ½ with moisturizer. Acne.org AHA+ Read Reviews 4.41/5 - 332 reviews Alpha Hydrox Enhanced Lotion Read Reviews 4.11/5 - 58 reviews ___________________________________________________________ WHAT IS: HYPOPIGMENTATION - white spots (loss of pigment) Q: What Is Hypopigmentation? A: Hypopigmentation is: Vitiligo, pigment loss due to burns, scars, skin discoloration. Treatments: XTRAC Excimer Laser at 308nm or Light Box phototherapy treatments UV-B lamp, Melgain (Decapeptide - Basic Fibroblast Growth Factor), and microneedling at home. Clinics use costly Recell which only has a small percentage of working on scars. A new spot treatment is LATISSE (bimatoprost ophthalmic solution) to darken the hypopigmentation and and cause "some" pigment to slowly return. Checkout the link below for how a member fixed his hypopigmentation. If nothing works there is medical tattooing http://basmahameed.com/paramedical/surgical-scars.php Read More here: http://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/?page=5 ___________________________________________________________ TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, Large / Scared Pores Q: How do I improve my large pores, and orange peel texture? -- Please See the Filler and Subcision Section below for a detailed description for scars. A: At Home Retin-A - Increases Skin turnover production. BHA (Glycolic acid peels) like you find from Acne.org store above. Paula's Choice 10% niamincide booster. Niamincide has been proven to thicken skin and shrink pores. There is a cream called Benefit Cosmetics "Pore"fessional that blurs these spots, used as a primer under makeup or by itself. TCA Cross using 50%, you need a very tiny way to either get into the pore and not hit the walls doing a little at a time until they heal. Some have used a broom bristle, shaved down toothpick, and tiny needle to fit inside pores or ice picks. For a larger area you can spot treat with TCA full peels (spot treatment on your scars 35% and under, start at 15% and move up, do a test spot to see how your skin reacts before going crazy). Always degrease with acetone or rubbing alcohol and a pre-peel jesner / glycolic peel before. You can do a few at a time, so you can cover with makeup. Doctors treatments: -PDT using led blue light and medication to shrink pores -Infini shrinks pores -CO2 laser is great for surface texture (long down time) -Laser Genesis Shrinks pores and small acne scars -Sublative is good for surface texture takes many treatments, results are subtle like laser genesis -Microneedle .05mm followed by botox to the pores superficially shrinks them. Q: Can Guys Do Anything to Cover Their spots and Help with Self Esteem?A: Guys you can be as manly as you want and wear makeup (the ladies have had this tool for some time). Hear me out. Movie stars, news anchors, models, musicians, Youtubers, and even politicians wear makeup. Buy a concealer for just your acne scars and spots (spot treat them). You want it to match exactly your skin color and not be shiny ("matte"). My favorite is sold at Sephora (they color match you) Makeup Forever Camouflage Concealer, this looks extremely natural on the spots. Dermablend is sold at Macy's and Nordstrom. This is used for medical scars and to cover tattoos (they match your color) and it's very thickly pigmented. Ben Nye Cover All Wheel and Bill Nye Concealer Wheel sold on Amazon and Ebay (it has various shades), this is used in the theater. Q: What can I do for extreme dryness, bumpy or bad texture, small wrinkles, or marks? -- Please See the Filler and Subcision Section below for a detailed description for scars. A: Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation or ... Skin boosters (very popular in Europe and Asia) like Restylane Vital, Juvederm Hydrate or other HA products are not crosslinked like what is used in filler and much more superficial (just under the epidermis). Filler provides lift; but boosters are different making a bunch of small injections to provide intense hydration, minor skin correction, and small textural improvements.http://www.acne.org/messageboard/topic/357406-skin-boosters-restylane-vital-hyaluronic-acid/ ___________________________________________________________ 6. PUNCH GRAFTING & EXCISION Q: What is Punch Excision & Dermal Grafting? A: Punch Excision is a procedure whereby a doctor will use a tool to punch out the scar and then sew the remaining skin together. Dermal grafting is a procedure whereby a doctor removes skin from a different part of your body (usually from behind the ear) and places it into the scar. Ice picks are often treated this way. Dermal Grafting has lost favor with dermatologists because the fat does not last and we have fillers now. Acne Scar suffers heal poorly, so there is a high outcome of poor results using this method. ___________________________________________________________ 7. HYPERTROPHIC / KELOID RAISED SCARS Q: My scars are raised (hypertrophic), not indented (atrophic). How can it be treated? A: This is called hypertrophic (aka keloid) scarring and can be treated with silicone sheets (OTC - Walmart, Walgreen's, CVS, Boots), liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam / QuadroStar Pro Yellow Laserlaser. The treatment options include laser ablation, electrodessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful. Keloid scars, different from hypertrophic, are scars with tendencies to invade the peripheral tissue, expanding in size, and growing persistently. Keloid scars should not be treated by way of surface destruction. ___________________________________________________________ 8. SUBCISION Q: What is subcision? Will it improve my scars? Should I use filler? A: Subcision is a method whereby a doctor uses a "Nokor" needle to break up the scar tissue underneath the surface of the skin. It is said to be best for rolling scars that are bound down. If your bound-down scar tissue looks smoother when the skin on the sides of the scar is pulled tighter apart you're a good candidate. Some people's scarring has improved by this method, others have had minimal or no improvement, and others have had their scarring deepen (though this seems to be more rare). Please see your dermatologist for further information on this procedure. UPDATE: Filler and Subcision is now the GOLD standard for acne scar revision for rolling and box scar scars that are sunken (fat deficient). Fillers typically used are Perlane also known as LYFT, Ultra, Belotero, and permanent solutions you should only try if satisfied from filler are Aretefill / Bellafill, Fat. Note, if your doctor does not subcise the scar to make pockets for the filler and release the scarring, it will doughnut around the bound-down area and do nothing. Fat Grafting or Fat Transfer is used for those with large acne scars where it would take several syringes to fill one scar. Q: What is Vacuuming / Cupping / Suctioning After Subcision (Prevents Re-Tethering)? The role of suctioning is to prevent re-tethering, induce repeated hemorrhage, delay healing. You should begin suctioning 24 - to 48 hrs after your procedure. Depending on how you heal you will want the wounds to be closed enough that you don't break them open when Suctioning. You will continue this 8 times a day for 4 seconds for 2 to 4 weeks after your subcision, you can also do it 3 times a day (3 sets a time of 15 seconds, or however long you can stand it). This will enhance the results of your subcision. We recommend doing filler after subcision for consistent and instant outcomes... It's not as cost effective (filler is expensive) and vacuuming / cupping / suctioning with a acupuncture cupping set from Amazon or ebay. You will get possible bruising after subcision because of the hemorrhage creating filler under the scar and in the pocket wear make-up over this. > Success PCT14 Suction and Subcision Protocol http://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/ source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 https://www.youtube.com/watch?v=ansKjWAw_G0 https://youtu.be/SrtA44lPO_c ___________________________________________________________ 9. FILLER FOR SCARS In Depth Thread on Subject: http://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/ Q: What are injectable fillers and how can they reduce the appearance of scarring? A: There are many types of injectables used for augmentation. It has been shown that once they are injected into the skin, they can raise the surface of the scar. Unfortunately, most of the injectables widely available are not considered permanent. In addition, some are not available in all countries. Always try non-permanent fillers before you go the permanent route. Here is a list of some of them to get you started in your research: Juvederm Ultra or Perlane / LYFT HA Filler: <12 Month (If you're lucky) Filler / Cheaper / Lots of Lift: http://restylanelyft.com/ Volbella by Juevederm: Softer filler, can be used near the surface in the upper Dermis with subcision, great for under eye area. Beletero: HA filler, softer dermal filler, shorter lasting period great for thinned-skinned areas, no water hydration from surrounding tissue http://www.belotero.com/ Restalyne: Shorter lasting period: HA, cheapest Semi-Permanent / Permanent Fat (harvested from your own body - only some survives, may be lumpy and need a few surgeries, some is longer lasting). This is used for scars that are large (over 10mm) and would take several syringes of filler costing more than the fat grafting surgery itself which is a few thousand dollars - See your doctor for further info. Not Recommended but some users have success with these (our skin ages and changes, fat is lost, so long-term use outcomes are unknown - yet they are permanent). We heal poorly as acne scar sufferers or we would not have scars so it's a gamble... ArteFill / Bellafill, FDA approved - Microspere beads that are permanent, can migrate or cause grandulomas or fibrosis around the material. This is the number-one recommended permanent filler for acne scars right now. Silicone Microinjections, Not FDA approved - off label usage (Must be an experienced doctor who has done thousands of these), can migrate or cause grandulomas or fibrosis around the material. Here is a thread on various types of fillers: http://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/ ___________________________________________________________ 10. LASER In Depth Thread on Subject: http://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/ Q: My doctor says to get laser, will this fix my scarring quickly {NO IT WONT!}? A: Run, the doctor wants you to pay for his or her $110,000 new toy. They tell everyone it can slice and dice and do miracles light-based treatments of acne scars, patients are often encouraged to receive a greater number of treatments to get more satisfactory results but are seldom told that the clinical results are good for only 2 years (see the harmful side effects below an Dermabrasion which is permanent). Start with non-energy devices: your diet, hygiene, topicals such as Retin A, Accutane, Food allergy or allergy test from beauty products, acid peels, tca cross for those ice picks, microneedle, subcision to lift the tethered scars w/ filler to keep things plump. As acne scar sufferers we heal poorly, or we would not have the scars to begin with. Next step is move onto the big guys - energy devices that have high side effects (fat loss, healing worse) and only possible rewards. V-Beam / QuadroStar Pro Yellow Laser is safe for discoloration and most lasers are for surface texture only (acid peel also do this), it will not make fat appear or magical new skin. Laser smooths and softens texture and makes scars wider (the rough sharp edges). Q: What are the side effects of laser? A: I go into this in-depth in the below post... Burns, additional scars, hypopigmentation, hyperpigmentation, thinning of the skin, long-term redness, scar worsening, bacterial infections, breakouts, fat loss, blistering, scabbing, crusting, months of down time, demarcation lines, bruising, sun sensitivity, pain, swelling, itching, milia, lumps, bumps, large pores / orange peel, and acne. http://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/ Q: I did all the non - energy device recommendations first with no changes in my scars. What lasers should I take a look at now (remember it is a gamble of outcomes...as acne scarred individuals, we do not heal properly)? https://www.youtube.com/watch?v=sQUM3Xxzm3Q Q: What is the difference between ablative and non-ablative lasers? Definition of ablate from dictionary.com: "To remove by erosion, melting, evaporation, or vaporization." Ablative lasers are much more invasive than non-ablative lasers. Ablative lasers are not recommended for use on darker skin colors. Of course, with higher energy and removal of skin (in fractional cores) better outcomes are often had than non-ablative means. Also higher side effects, and in fact may make it worse. Seek an experienced professional of acne scarring. Always try non energy device solutions first. Laser is a gamble. Examples of ablative lasers: - CO2 - Erbium: Yag Non-ablative lasers do not remove layers of skin, but instead penetrate through the skin in an attempt to stimulate collagen growth from underneath the surface of the skin. They also are not very effective. Q: Will ablative lasers (CO2 or Erbium) reduce the appearance of my scarring? A: It is possible that it will reduce the appearance of your scarring but it can come with a hefty price tag, a significant amount of downtime and a risk of new scarring (see below). Q: What are the side effects of Ablative, Non-Ablative Laser Procedures / IPL / RF? A: Risks from ablative procedures include: Swelling, scabbing, and oozing Bleeding, flaking, and redness Significant irritation that requires a longer time to heal Long-term skin discoloration and more scarring Fat Loss, Filler Loss Poor Healing by Acne Scar Sufferers (who already heal poorly) Does nothing, a waste of money with long down time and healing For ablative resurfacing with a laser, the quality of the postoperative techniques is as important as the skill of the physician during the procedure. After ablative laser treatment, the skin oozes, crusts, and needs to be cleaned and dressed for about two weeks before you look even vaguely normal. Because the top layer of skin has been stripped away, the raw, exposed skin needs to be cleaned and treated very carefully. Patients need to make sure they follow post-op care instructions precisely, because inconsistency or incomplete care can cause infection, delay healing, and increase irritation. Non-ablative resurfacing has none of the side effects associated with ablative resurfacing. However, non-ablative resurfacing doesn't produce the same dramatic or impressive results. The advantage for non-ablative resurfacing is its minimal downtime and they work on ethnic skin without hyperpigmentation. Women can reapply makeup before leaving the doctor's office and return to work the same day. Non-ablative lasers can cause: Swelling and potential bruising (this fade within days) Enhanced redness or a sunburn-like reaction (this is temporary) Temporary darkening of treated spots (these lighten as they heal) No improvement, a waste of money Q: What should I get instead of laser if my scars are bad? A: Microneedling, subcision, and several medium TCA peels. This is done over 2 years. ___________________________________________________________ 11. MICRONEEDLING & Derminator In Depth Thread on Subject: http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ Q: What is Microneedling A: This is a technique whereby an aesthetician, doctor, or tattoo artist uses either a hand tool or a tattoo machine to needle the skin without using pigment. This is said to "break up" the scar tissue thereby smoothing the appearance of the skin. This is also known as a cheap man's laser, the skin heals the tiny cores that are made. NOTE: It is possible to needle yourself, but there are risks associated with this. Also, results are generally not as pleasing. It is best to see a specialist whenever possible. For more information, read this thread: http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ To buy an automated machine to do this at home: http://shop.owndoc.com/product-list.php?Derminator-pg1-cid61.html Q: What is the "Dermaroller"? Can it improve scarring? A: The Dermaroller is an instrument that has tiny needles embedded in it that is rolled across the surface of the skin. It is mainly used for better absorption of topical treatments and does not appear to actually break up scar tissue. ___________________________________________________________ 12. TCA CROSS FOR ICEPICK SCARS, TCA FULL FACE AND SPOT PEELS, All Other ACID PEELS ** MUST READ -Everything About Acid Peels! How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ Q: What is the difference between TCA CROSS and a TCA peel? TCA CROSS is a method whereby a doctor or skilled practitioner uses a high percentage of TCA Acid (100%) and spot treats each scar. This procedure is especially beneficial for ice pick scarring. TCA CROSS is something that should be done by a skilled practitioner because the risk of damage to your skin can be great. TCA peels (Spot Peeling) are of a much lower percentage (15-35%) than TCA CROSS. TCA peels are done by dermatologists and aestheticians and affect hyperpigmentation and more shallow scarring. Buy TCA, Excellent Customer Service (Not Chinese Made Industrial Chemicals!): http://www.makeupartistschoice.com/ What is TCA Cross for Icepicks, Please Read The Below Link for All Things Acid Peels: ** MUST READ -Everything About Acid Peels! How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ https://youtu.be/hE7ckq2T8Kc What is A Full Face or Spot TCA Peel (Video Below): Please Read The Below Link for All Things Acid Peels: ** MUST READ -Everything About Acid Peels! How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ https://www.youtube.com/watch?v=7qRj0pLXPIQ ___________________________________________________________ 13. LIST OF ACNE SCAR TREATMENT DOCTORS ** Please note we are not responsible for your treatment and care. Please be informed before you contact the physician for acne scar improvement. Further doctors can be found that are board certified on the Real Self website. Some Great Places for Reviews are http://www.yelp.com and http://www.realself.com Dr. Davin Lim ** Highly Reccomended, Famous Specialty Acne Scar Dr, Youtube Channel : Lasers and Lifts Brisbane, Australia Specialty: **Lasers for Acne Scars, Subcision, TCA Cross, Filler, PRP, Vbeam / Picosure, multiple treatments at the same time. http://www.lasersandlifts.com.au Dr Adrian Lim Sydney, Australia Dr. Lim's Mentor While in Med School and Famous Derm Specialty: Fillers, Microneedle, Subcision, TCA Cross, Vbeam, Lasers http://urepublic.com.au/our-expertise/ Dr Naomi Sydney, Australia Specialty: All Things Filler Core Interest (Expert Injector), Skin Boosters, Lasers http://drnaomi.com.au/ Professor and Department Head Tony Chu Chiswick, London Specialty: Dermatologist Expert, Subcision, TCA Cross, Microneedle http://www.westlondondermatology.co.uk Dr. Emil Henningsen Denmark / Nyborg, Sweden Specialty: Subcision, TCA Cross, Microneedle, Lasers http://www.emilhenningsen.dk/behandling_ar/ Prof C.L. Goh Singapore, Malaysia Specialty: Lasers for Asian Skin http://www.nsc.com.sg/Patient-Guide/Our-Doctors/Pages/Dermatologists.aspx Dr. Rullan ** Highly Reccmended as a Top Scar Dr For the West Coast by Many Fourm Members Chula Vista, California Specialty: Fillers, Microneedle, Subcision, TCA Cross, Vbeam, Lasers http://www.drrullan.com/ Dr. Emer Youtube Channel: Dr Emer Hollywood, California Specialty: (Expensive) Lyposuction, Fat Grafting, Microneedle RF, TCA Cros, PRP, Bellafill, Fillers, Lasers /QuadroStar Pro Yellow Laser , multiple treatments at the same time http://www.jasonemermd.com Professor and Department Head UC Irvine Chris Zachary Irvine, California Dr. Lim's Mentor While in Med School Specialty: All Things Dermatology, TCA Cross, Subcision http://www.drzachary.net/ Dr. Sandra Lee AKA Dr. Pimple Popper Youtube Channel Upland, California Specialty: General Derm, Popping Pimples and Cysts, Acne Scars, TCA Cross, Microneedle, Subcision http://www.skinps.com/ Donna Owner & Nursing Supervisor of Washington Hospital - Tri Valley Health and Aesthetics Med Spa ** Highly Recommended for the SF Bay Area - Expert Injector Livermore, CA Specialty: Ask for "Nokor Subcision + (Sculptra Vollbella) for scars", TCA Cross, Lasers, Microneedle + PRP http://www.trivalleylivewell.com Dr. Suzanne Kilmer Sacramento, California Specialty: Lecturer and Trainer on anything about Lasers http://www.skinlasers.com/ Dr. Greg Morganroth Mountain View, California Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.morganroth.com/ Dr Evan Ransom San Francisco, California Specialty: Facial Plastic Suergon, Infini RF, Lasers, Aesetics, Dermabrasion http://www.sanfranciscofacialplasticsurgery.com Dr. Seven Swengel Los Gatos, California Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.RefinedMD.com Dr. E Victor Ross San Diego, California http://www.scripps.org Dr. Philip Young Bellevue, Washington Specialty: Acne Scar program with multiple treatment at once ... TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.drphilipyoung.com Dr Joe Niamtu Youtube Channel: Joe Niamtu Midlothian, Virginia Specialty: plastic surgeon and trainer laser expert, fillers, subcision, chemical peels, excision, dermabrasion, and scar revision http://www.lovethatface.com/ Dr. Nelson Lee Novick ** Highly Recommended Acne Scar NYC Favorite Dr. NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.doctornovick.com Dr. Yang NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.GeorgeYangMD.com Dr. Ron Shelton NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.thenyac.com Dr. Roy Gerononus in NYC, NY Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.laserskinsurgery.com/Dermatologists/Roy-G-Geronemus-MD Dr. Berry Dibernardo Montclair, New Jersey Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.newjerseyplasticsurgery.com Dr. Weiner Youtube Channel: Dr Weiner Panama City, Florida Specialty: Famous trainer, pioneer, Infini RF spokesman, Fillers, Laser, Plastic Surgery, Aesthetics http://www.theclinique.net Dr. Jill Waibel Laser Burn and Traumatic Scar Specialist Miami, Florida Specialty: Jill specializes in major burn scars with lasers and steroids, grafting, surgeries, General Derm http://www.miamidermlaser.com/jill-waibel/ Dr. Richard Sadove ** Highly Reccomended Acne Scar Fat Grafting Facial Plastic Suergon Gainesville, FL Specialty: Fat Grafting For Acne Scars, Subcision, Excision http://acnescarflorida.com/about-dr-sadove/ Dr. Philip Bekhor Box Hill, Melbourne, Australia Specialty: Lasers, TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.drphilipbekhor.com.au/ Dr. Sam Lam Plano, Texas Specialty: Fat Grafting, Plastic Surgery, TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.lamfacialplastics.com/ Dr. Michael Gold Nashville, Tennessee Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.goldskincare.com Dr. Tina B. West Chevy Chase, Maryland Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.westskinlaser.com Dr. Noelle S. Sherber Washington, District of Columbia Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://sherberandrad.com/ Dr. Moon Choi Vancouver, Canada Specialty: Subcision, TCA cross, infini Dr Jerffrey Orringer Ann Arbor, Michigan Specialty: Subcision, TCA CROSS Dr. Mark Taylor Salt Lake City, Utah Specialty: Extensive subcision Dr. Payman Kosari Charlotte, North Carolina Specialty: Subcision, infini Dr. Murad Alam Chicago, Illinois Specialty: Subcision Dr Steven Mandrea Chicago, Illinois Specialty: Subcision with sculptra ___________________________________________________________ 14. ANATOMY PICTURES
  15. The 1.5 year war with acne, and my success

    This is going to be a long post. A little background info, I have had acne since I was 10 years old, and I am turning 20 this year, finally with clear skin. I call the past 10 years the "decade of hell". I think we all encounter some kind of moment where we go, damn, I've had enough of this crap. And thus began my last ditch efforts to salvage my skin, which I am happy to say has finally become beautiful. Having lurked on this forum for years, I feel like its time for me to give back. 1. Diagnosis First I narrowed down and diagnosed what conditions I had. Cystic acne on forehead, painful boils on my butt and pityrosporum folliculitis on my back (recurrent, would flare up from time to time). Now this was tricky, because I had both bacterial AND fungal infection. Am I supposed to care for my face and butt and aggravate the situation on my back, or the other way round? Damn this body of mine. 2. Prevention Having determined all the skin conditions to be treated, the most important thing now was to PREVENT FURTHER SCARRING AND PIGMENTATION. I cannot stress how important this is, because deep scarring is so much more difficult to cure, and being fair skinned, my hyperpigmentation takes a hell lot of time to clear. I'm talking about dark spots that remain even after a year. For my bacterial infections (acne on butt and face), I immediately went on doxycyline. Cheap, effective, doesn't cure the root problem but it did the job for now. The doctor would only prescribe me 3 months of doxycyline, 2x100mg pills per day. What I did was take a 100mg pill a day with breakfast, which lasted me for 6 months and worked fine. For my fungal infection on my back, I began orally taking oil of oregano by Swanson. The dosage is 150mg per softgel, and you are recommended to take 1-4 pills per day. Now this varies by manufacturing brand, so follow guidelines accordingly. I started off with taking 2 a day in the afternoon and evening (not clashing with my doxycyline). In addition, I would also apply topical oil of oregano to my back (either buy the liquid in bottle kind or cut open a softgel). Be sure to do it sparingly, and dilute it with an oil/cream of your preference if its not diluted beforehand because the strong stuff can burn your skin. Last of all, I used Head and shoulders shampoo to wash my back as it had 1% zinc pyrithione. All this is gonna make your back dry as hell, but do not moisturize because the fungus thrives in wet environments. Along with all these, I was applying 5% benzoyl peroxide on my forehead and 2.5% on the rest of my face as a precaution. I use the brand Benzac, but probably any kind of BP will do. All of these worked to curb the acne from ever rising to the surface for the time being. 3. Dealing with scars/pigmentation Now the acne was gone, but there were A LOT of scars and pigmentation, which looked especially terrible because I'm a fair skinned Asian. This is the part where it all gets expensive. For my face, I caved and did a full ablative Fraxel on it, which removes pigmentation, scars, and returns pores to original size. This is very costly in most countries, but I was in Seoul, South Korea for a month, and I managed to find a clinic that offered Fraxel for 280 usd. Fraxel was significantly painful and I had red peeling monster skin for about 7 days, but the end result was flawless. For my back, I did a 35% TCA peel for about 130 usd. Once again, skin blisters, angry red skin, the whole works. This was truly painful as hell after the numbing cream they used wore off. However, I had clear skin after it all peeled off and the one week mark. For my butt, I had been using arbutin and hydroquinone creams, but the results were too slow for my liking. I did a ng yag laser for brown spots at about 130 usd. I believe that alexandrite lasers could do the job as well. One session was all it took for the brown spots to dry up and flake off, but if I had not been using creams beforehand I might have required more sessions. 4. To cure the root cause Now this was the hardest thing of all, because I suspect my acne has hormonal causes (it got drastically better when I was on hormonal birth control for 6 months). However, I am not willing to be on hormonal bc full time (I use a copper iud), so that made things difficult. In addition, as a female who is open to having kids in the future, what the hell am I going to do when I get off bc? Suffer the same skin conditions once more? So I did it. I WENT ON ACCUTANE. Now there are smart ways to do this, and stupid ways. One stupid way is to go on low dosage accutane (about 10mg-40mg) and then complain that the results don't last. I am horrified at the number of derms and docs that actually allow this. Of course it doesn't work, accutane is not meant to be used this way. One good way to calculate dosage is by body weight: 1.0mg x ___ kg = your dosage I weigh about 45 kg, and this was my dosage for 6 months Month 1: 40 mg (To adjust to the dryness etc.) Month 2, 3, 4: 60 mg Month 5: 80 mg Month 6: 120 mg to knock the acne senseless forever Depending on whether your weigh more or less, your dosage will vary. Monitor yourself, don't push the limits of your body and take care of yourself. Note the side effects you suffer from accutane and DO NOT STOP taking it halfway just because your skin has cleared and you think you're set. You are not using accutane as an antibiotic to keep acne at bay, you want to knock out this pesky acne once and for all. Be smart about this, take a fatty meal with accutane so your body can absorb it better. For dry skin, any rich moisturizer will do, for painful cracked peeling lips, go to the pharmacy/get a prescription for certain brands of lip ointments that not only moisturize but promote healing of lips. (there are several, they cost about 10 bucks a tub, ask your doc/derm about it) Most people do not experience the feelings of depression that may come as a side effect, but if you do get a family member/friend to monitor you. Remind yourself that this lasts 6 months, but the results will be for a lifetime. Now I know some of you are firmly against accutane and prefer changing your diet/using whatever topical creams and solutions. I'm happy it works for you, but you have to understand that for a lot of people acne is not necessarily caused by diet, and topical treatments only keep the acne at bay, not cure the root cause. Do you really want a lifelong battle to keep the acne from erupting to the surface? 5. Aftercare All the problem skin areas on my body are finally clear after approximately one and a half years since I started this entire war against acne/pityrosporum folliculitis. For maintenance, I use very simple and gentle products on my face, just a face wash, toner and moisturizer. Sometimes I apply some 2.5 % bp on my nose, to keep it from getting too oily. For my back, I bought a znp bar to wash my body with, and I am starting with a new treatment-ELECTROLYSIS. Yes, without the hair follicles, there is no way for the fungus to survive. Ha! This is because although I no longer have even a single red spot on my back, 10 years of suffering have made me paranoid as hell and I will never go back to that ultimate emotional and physical low I was at before. Summary: Acne: Doxycycline, Accutane, 2.5% and 5% BP Pityrosporum folliculitis: Head and shoulders, oil of oregano (oral and topical), znp bar, electrolysis Scars and pigmentation: Fraxel, Ng YAG, 35% TCA chemical peel, arbutin cream, 4% hydroquinone cream Long story short, a battle with skin conditions can be long and tedious, but in the end when you look in the mirror and have clear beautiful skin after a decade of hideousness, it will all be worth it. Honestly, now I have friends who only knew me after I solved my skin problems, and they complain over a single small pimple and tell me "Omg you're so lucky, your skin is so good and you don't understand how stressed out I am over my pimple". This makes me think about just how much effort, money and time I put into researching and healing my skin, and just how far I have come. I hope this post can help some of you readers out there, if only in the slightest way. I love you guys and may we all achieve clear, beautiful skin. Work hard! Lots of love, Pursuitofperfection
  16. Executive Summary: After 7 years waiting and months of research I decided to undergo treatment for my severe acne scaring with Dr. Khan in Hayley Street, London. On December 24th I will undergo Subsicion, Fraxel Re:pair and Re-Cell all in one go over a period of 4 hours. I have created this post to share my story with you all. -------------------- Dear All, I joined this forum a while ago when I started a long research process to find out how to get rid of my severe acne scaring. It took me a lot of reading and browsing through the message boards to understand all different types of scar treatments, their benefits, risks, etc. The very first challenge was to understand all the different type treatments (leave the types of lasers alone!) and my own skin type and condition to finally determine what was the most advisable procedure I should go for. After a few months of research and the help of many of you fellow acne.org users I came to the conclusion that Fraxel Re:pair was probably my best option. The second challenge was to then find out what doctors in the UK do the procedure and also find references and talk to people who had met them and had previous experiences with them. I did all that research, used all the search options of these message boards and came up with a list of 12 doctors in the UK who could do the procedure. Of those 12 I chose five and made appointments to go and have different opinions. I visited some famous doctors in London, from Hayley Street to Knightbridge and other areas of London and I must say that I wasn't very impressed with some of them. Specially those who i had to even pay consultation for. I finally felt that Dr. Khan in Hayley Street was the most professional and experienced and I somehow felt a connection with him. He also show willingness to take me up as a case, whereas other doctors where reluctant to do even Fraxel Restore give my dark features. Dr Khan, not only recommended me to do Fraxel Re:pair but also said that subsicion would be very good and suitable for me, specially having it done just before the Fraxel. I had come across the subsicion techniques during my research but never considered as an option. He explained well and I became more interested in the possibility of a COMBINATION PROCEDURE which could bring better results. I slept on it, consulted other dermatologist and surgeons (friends of mine abroad) and also did my own research and my finding were that the combination was supposed to create great results, so I decided to go ahead. A few days later, the Khans also suggested to have Re-Cell during the same day (not sure if this is the right spelling!). Basically to take a sample of healthy skin from my neck, and produce a solution based on a mix of enzymes with my own collagen which the Dr then would spray onto my skin after the laser. This procedure, apparently very recent, is supposed to enhance the healing of the skin and accelerate the regeneration of collagen. I decided to have the three procedures done on the same day. So, this Thursday 24th December I will be going to have subsicion first, then Fraxel Re:pair and Re-Cell. An estimated 4 hours procedure all together. In order to prepare my skin Dr. Khan has injected Botox on my forehead and put me on Pigmanorm a week before the procedures. To give you a bit more info about my case: I had terrible acne outbreak between I was 13 and 26. Unfortunately I didn't manage to control it until I was 21 by the time I had already lot of damaged skin and scaring. I am from South America (Latin Skin), Skin Type IV with -apparently- dark features, brown eyes, black hair. I have taken photos for you to see. My risk include: bronzing, hyper-pigmentation and the typical possibility of another acne outbreak. I have requested Dr. Khan to put me on antibiotics just in case. My story begins this Thursday 24th December 2009. This is probably the best Xmas Present I have ever give to myself. PHOTOS TO FOLLOW
  17. Hi everyone, I am a 21 year old Asian-Indian origin female struggling from moderate-severe acne scars. I first battled moderate acne for years before going on a low dosage of accutane (10 mg) for four months after which my breakouts stopped. I haven't had a new pimple in months now (yeeeeaas, thankfully) but I have horrid horrid acne scars all over my cheeks. These are almost impossible to conceal with makeup so I had decided to visit a dermatologist who could help me get rid of these using different techniques. I went through 4 rounds of subcision+ co2 laser over the span of 2 years and I recently (last month) had a fraxel treatment done at a new dermatologist's place. Needless to say after spending all this money, time and effort I have had barely 10-15% improvement in the scars. This is incredibly upsetting and I was wondering if people here who have had scars and have successfully minimised them to a large extent could provide some insight here. I have attached two pictures here. This was the harshest light I could find and my scars do look pretty pretty bad here. appreciate the input!
  18. Scarring

    I'm 22 and have acne scarring. If you would please help me and suggest what treatments I would need. I also have a scar on both my mouth lines. Is there anyway I can make it normal again?
  19. VBeam didn't work

    I no longer have acne (accutane) but I have horrible redness on my cheeks which has existed for at least 10 years. I had VBeam done recently which caused purpula and heavy bruising, but it still hasn't got rid of the redness. I just want an even skin tone. Is fraxel worth a shot? Co2? I don't know what to do anymore.
  20. About 4 hours ago I had Fraxel:Repair (the ablative CO2 fractionated laser) done on my temples, forehead and cheeks. The doctor also used the Ultrapulse CO2 done around the eyes because it was better for skin tightening. The total cost 3000 USD here in California. I decided to have the treatment done for icepick scarring on my cheeks and poor texture. I should also note that I have had 6 treatments of the non-ablative laser treatment, Cynosure Affirm Multiplex, with ok results but I decided it was time to take a more aggressive approach. Scroll down to next post for after pictures.
  21. Holy cow.. that must have taken a long time to do, but I think this guy has covered a lot in that time slot. Great video - a must see as he tell it like it is.
  22. Hello guys, Just wanted to give you guys a heads up, this thread will be extremely detailed and thorough because 1) It is for myself to keep as notes just to make sure I do not forget to do anything Pre-Op/Post-Op after my Mixto laser surgery I am planning ot have on 12/15/12 with Dr. David Rahimi, located in Beverly Hills, CA. 2) So that in the future, anyone who is planning to have fractional laser surgery for acne scars will know the in and outs of what to expect, what needs to be done for preparation of the laser, and what needs to be done after the laser. 3) And most importantly, if it actually works or not. Brief History: I am currently 23, suffered with acne ever since I hit puberty at the tender age of 13. I suffered with extreme acne break outs during my high school years. I am not a doctor or expert in this field, but I can tell I have multiple conditions that seem to make me break out more than the usual person. first of all, genetics. My mom and dad (especially my mom) have pretty horrible skin, and had bad acne when they were teenagers as well. My mom still breaks out to this day, and not only that, my mom's whole side of the family have really bad skin in terms of acne, acne scars, and dark spots. So one of the main underlying reasons I have had bad acne is simply due to the genetics. Secondly, my second condition that seems to exacerbate my first condition is that I have hyperhydrosis, in laymen terms, known as "extreme sweating disorder". Simply put, I sweat A LOT on my face, whether I am working out in the gym, or simply in a state of rest, if their is any kind of heat or temperature above 80, than I will start sweating. When I mean I sweat a lot, its not like a normal person, simply put, after a work out, you would not be able to tell whether my work out clothes was soaked with a hose or if I was just working out. It is extreme, and I believe this has exacerbated my acne issues. Lastly, like an idiot that I was, I picked/popped my pimples during my high school years, unfortunately. Why you might ask? I was naive, stupid, and friends told me to do so...and I totally regret it. People, DO NOT Pick/Pop your pimples! It will cause acne scarring. I wish I knew this before and I wish I could have been more patient with my acne, but that is the past, and I have to move on from it now. So after stating all of that, here is where I stand currently, (see below for pictures, please excuse me for the quality, using my IPHONE, which isnt the great of quality): Current Things I Have Done to help with the acne scars is doing extreme needling with HA (hyaluronic acid) injections as well as some seaweed facial peeling done with an esthetician. I have been doing the needling 2/month for almost a year now, and the seaweed acidic facial peeling just once. All in all, i believe the treatments did help with some of the acne scars in terms of depth, but in terms of visibility and shape, it is unfortunately still there. Therefore, 11/16/12, I went to go see Dr. David Rahimi for a pre-op appointment. I mainly chose him due to a recent thread that had been floating around this forum where User name "Dragz" performed 2 mixto treatments from Dr. Rahimi and was happy with his results. His Post is listed below: http://www.acne.org/...cars-on-cheeks/ Anyhow here is a summary of how the appointment went with Dr. Rahimi. 1) Cost: 3000 for two treatments, second treatment 3-4 months after the first treatment. 2) 3rd treatment, if needed, would cost an additional $500. 3) Settings he plans on using on mixto: 7/20/9 or 7/20/10. With the 180 micrometer, not the 300 microumeter (300 micrometer I believe is for superficial scars/wrinkles/fine lines, while 180 micrometer is for deeper acne scars). further, not sure what the equivalent MJ that is? Ive read from other posts fraxel repairs goes as high a 70 MJ? Not sure how many MJ the mixto will go with those settings he quoted me. 4) Current medications that I am currently using for my acne are: Dan's Kit (facial cleanser, BP, moisturizer, AHA), Mint Julep Sulfur Masks, tazorac. I was on accutane twice, first round was about 4 years ago and second round was about 2 years ago. Definitely helped my acne and cleared everything up, but I feel it may have exacerbated my acne scars. 5) Additional medications that he prescribed for me that I will need to start taking two weeks before the surgery: 8% Hydroquinone cream 4% hydrquinone cream twice a day, Differin Retin A, doxycycline. 6) will need to take Vicodin ES Acyclovir tabs (400 MG) one day before the surgery and one day after the surgery to prevent cold sores and possible viral infections. 7) Possible use of Benadryl/1% hydrocortisone cream after Facial peeling is done (usually 5-7 days after surgery) just in case of itchiness. 8) Heavy use of Aquaphor and cetaphil facial wash for the first 5-7 days so that the skin can stay hydrated and heal properly. 9) Esthetician (from my needling sessions, which I do go see once a week to help with my acne) also provided me with EGF Blemish Balm self moisturizing sun protection infused foundation to use 2-3 weeks after the surgery to cover the redness that will probably persist. She also provdied me with Dermaesthetics EGF UV SHIELD SPF 50 to apply for sun protection, since obviously my face will be extremely fragile to the sun. 10) Vicodin ES prescribed just in case the pain is too unbearable. Doctor told me 90% of the time tylenol will do the job, but just wanted me to have the Vicodin just in case. (Might decide just to take one just for the heck of it, never took vicodin before but am curious since I use to watch House the main character was addicted to it lol!) Planned date of surgery will be on 12/15/12. I will update this post with pictures and my progress. If everything runs smoothly, I will most likely go for my second, and possibly third treatment throughout times next year. If so, I will be updating this thread periodically. I am not looking for 100% improvement, since I know that is not possible. But will be extremely happy with even 50% improvement. Anyways, I would like to thank this board and community for helping me become more knowledgeable about acne and acne scar treatments. I hope that this thread will help future people like me who would like to get rid of their acne scars. Anyways best of luck to you all, Ill keep you guys posted within a month. God Bless. 12/15/12 Update: I just got back from the mixto laser surgery at Dr. Rahimi's office. I posted up pictures of myself slathered with aquaphor. Ill post cleaner pictures once all the skin is peeled off (most likely in about a week or so). But the surgery went great! I think he went a little conservative this first time around however, just to see how my skin will react to the laser. I have no hyperpigmentation whatsoever, and the pain of the laser was very bearable. It didnt even hurt as much as i thought it would. Then again, he did give me these 2 pills to take (not sure what they were), also injected some liquids in my mouth near the upper jaws, probably some kind of sedative/anasthetic? Also, i was slathered with numbing cream all over my face for about an hour or so. And his assistant was so amazing! She was so nice....we were just having random conversations and just talking about the most randommest things, she was a cool cat. But anyways, ill try to post up clearer pictures next week once there is no more aquaphor needed on my face. But ya surgery went great, barely any pain, no hyperpigmentation, and we will see how the results turn out! God is good! Also i forgot to mention, my face is extremely swollen which is why i can barely see my scars, i know once the swelling goes down my scars will most liekly appear, but hopefully they will continue to get better overtime. Also, he performed about 3-4 subscicions, which is why you might notice some huge bumps on my face. 12/17/12: Just woke up, today is the beginning of my 3rd day after the Mixto Laser. Im still on the regime of slathering aquaphor all over my face and then washing it off 4 hours later with a light cetaphil cleanser. I took off two weeks of work, so ill just be managing my face and also doing some work at home. Anyways, ive uploaded 4 new pics below (2 on each side of the face). I know its way to early to judge, but a lot of the scars seemed to have diminished, and are barely noticeable. But I have read in other cases that its just due to the micro swelling which is why the scars seem invisiible. So ill wait a little longer before I judge, but right now my scars look soo much better! I wish it will stay like this lol. However, one thing is my skin texture feels horrible, it feels like rough sand paper. Im hoping that will return to its normal state after fulling healing. 12/18/12 Day 4 After Mixto: So apparently, the day 3 to day 4 transition is when the skin peeling really starts to begin. I uploaded 4 new photos (2 on each side) to show you the dramatic difference between day 3 to day 4. I woke up with a bunch of skin residue all over my face ready to get peeled off. Also, yesterday i mentioned my skin felt like rough sand paper, well that is apparently because the outer most layer was the skin layer that was on the transition of getting ready to get peeled off. So underneath that layer of skin, is a silky smooth brand new skin that will be apparent after a couple of more days. Further, I just got back from a post op appointment with Dr. Rahimi. He examined my face and told me that everything is going according to plan, and that I will need to stick with the aquaphor/cetaphil treatment for another 3 days. He then notified me after the next 3 days, most of the peeling should be complete. I will then have bright pink spots (the brand new skin basically), and told me to spot treat those areas with 1% hydrocortisone because that will help reduce the redness. After 3 days of applying the 1 % hydrocortisone, he said I could start applying my SPF 50 sunblock. Another thing i should note is that i have been taken 4x the dosage of doxycycline ( ~400 MG). I actually didnt ask the Doctor if this was okay, but Ive been taking 4 times the dosage (2 after breakfast and 2 after dinner) because I really really do not want to break out from this aquaphor treatment. and so far, havent broken out yet! so pretty happy with that. Furthermore, Dr. Rahimi also mentioned that although my face looks pretty good right now (scars are barely evident), they will come back, but told me not to be discouraged because overtime they will start to heal, fill in, and essentially look better. Also, he notified me after all my healing is done, we can start talking about a time frame for a second touch up, most likely in about 3 months. Anyways, steady as it goes, ill keep yall posted. 12/19/12 5th Day After Mixto: Hey guys, just wanted to give you an update on how my face is looking, I posted 6 new pictures below. NOTE: The pictures i uploaded dont seem to be portrayed in a chronological order in the thread for some odd reason, even though I have been uploading all the pictures chronologically. So some photos may be mixed from different days, hopefully you guys will be able to decipher which photo corresponds to which day I have been documenting. So moving on with my update, apparently, The 4th to 5th day transition period (at least for my case) is when all the shedding of the skin begins and swiftly ends. As you can see a dramatic difference in the day 4 and day 5 pictures, where all my skin has shed. However, inevitably and foreshadowed, is the fact that all the scars have reappeared, unfortunately. The positive note is that even though I can see all my original scars, they seemed to have faded somewhat and look less prevalent, which is what I was looking for. I know its way, way, too early to judge because Ive read in many cases that it takes 6 full months until you can actually start to see the changes, so Ill wait patiently before I come to a quick judgment. But in any case, the initial observations I do see is some improvement, which I am happy with. Secondly, there is some hyperpigmentation in the regions (mostly the cheeks and temple area) where Dr. Rahimi probably went over the most with the laser in terms of strength and quantity of passes. Originally, before the surgery as I was going reading a lot about the lasers and other people's journeys, I was really really scared about the hyperpigmentation issue. But to be honest, it Really isnt that bad. It is definitely noticeable, but luckily, if you recall, my esthetician gave me this concealer type lotion/cream to use to cover my face which matches my skin tone. So once my skin is ready and I do go out for work and other activities, I will definitely be applying that. That being said, hyperpigmentation should not be a concern for me whatsoever, luckily. My current regime as we speak is the continuation of aquaphor/cetaphil combo, and will do this for another 3 days. Then I will start the hydrocortisone treatment shortly thereafter. Ill keep yall posted, maybe in about a week or so, God Bless. 12/22/12 Day 7 After Mixto: Hey guys, I posted up 4 new pics (2 on each side of the face) to give you guys a sense of where I am at Post 7 days Mixto. Nothing has changed much from my previous post, other than that some more old scars did come back, but it seems like they have faded somewhat. But from an overall perspective, my face does look better (scars look slightly more diminished), and I still have some hyperpigmentation @ the cheeks/temples, but definitely can be covered up with some concealers. I am currently on the regime of 1% hydrocortisone and cetaphil face wash, will do this for 3 more days, and after that I will just be using my SPF50/lotion/concealer/cetaphil cleanser for about 2 weeks before I start back on my acne regime (2% BP, Tazorac, Retin A). 12/29/12 Day 14 After Mixto: Hello, its been officially 2 weeks since my first highly anticipated mixto sx laser surgery. I have not posted up new pictures yet, because it is currently raining right now in SoCal, so the lighting in my bathroom will not be the same (it will tend to hide more of my acne scars without the sun reflecting through my window). So once the sun gets back up, ill take some new pictures. Anyways, the results have been somewhat disappointing as of now. 2 weeks post mixto, I have finished peeling completely, and do have some minor hyperpigmentation still. But all in all, after the micro swelling disappeared, all of my original acne scars have returned . The improvement has been extremely minimal, if you were to ask me what %, I would say maybe like between 5 to 10%? No where near the 50% Dr. Rahimi quoted me. although, like I have diligently mentioned in my previous posts, Ill need to wait 3-6 months to let the collagen do its work to help restore most of my ice picked acne scars. I was even talking to my mom yesterday, and as we were talking she checked out my face and even mentioned to me she doesnt see any improvement whatsoever, none, 0%. But I told her I need to be patient, and the process with these lasers is that it takes time for the results to show. anyways, Im not sure if this is true or not, maybe other people who have done fractional CO2 lasers chime in? Did you get NO improvement whatsoever 2 weeks post laser? Because, unfortunately, that is the case with me. But I DO think that Dr. Rahimi went conservative this first time around with me. For my touch up, I will ask him to go more aggressive. There are other things I should also mention, during weeks 1-2 post mixto, I did experience some negative side effects such as bruising near the eye, but that has all faded away, nothing permanent. Another thing is that there is this one region right between my cheeks and temple zone (couple of inches from the eye) where he may have made a mistake with the laser. What I mean is that either he went into deep or it didnt fractionalize, because there is a patch of skin where ALL the entire surface area got ablated, not fractionated. And right now its currently white....im scared it may be permanent hypopigmentation. I emailed Dr. Rahimi my photos and he thinks it should heal back to its normal skin color and blend in with the rest of the skin, but he's not sure, and that he will need to take a look. Luckily, this mark is on the side of my face, nowhere in the front of my face, so the only way you would be able to see it is if you look at me from the side and look closely. But if you do look, it is noticeable and quite disappointing to see, It was evident from the first day of the procedure. WHen I saw it, I was like hmm in my head, why is there this one localized region of skin that is totally ablated? During the healing process, I was hoping it would heal and cover up, but 2 weeks post mixto, it has not. Basically, it doesnt look right, and I am hoping it is not permanent. Those are just two negative side affects I have been experiencing. Anyways, Ill come back on this post in another 2 weeks to keep you guys updated on my progress. God bless. 1/13/13- Day 30 Post Mixto, Hello guys, just wanted to give you my post one month update. Ive uploaded 6 new pics (3 on each side of my face @ the cheeks and temples). So, apparently, laser results do have a time lag in terms of results, I am happy to say that I have noticed some improvement from Week 2 to Week 4 after the mixto laser. Although results have been very subtle, slight improvement, nothing drastic in any way. If you were to ask me what % of improvement do you see thus far? I would say anywhere ranging from 15-20% improvement, in terms of overall complexion and look. But all my scars are still there, but look less prominent. If you were to ask me are you happy that you did the procedure? I would say yes, because I do see some potential in this laser to help improve my scars. But let it be known, that if you have ice pick scars, dont expect any dramatic improvement just after one treatment. Just by judging my results after one mixto, I probably will need 3-4 more procedures, and I will ask the Dr. To be more and more aggressive each time. On the other hand, if you have superficial scarring, or scars that are not very deep at all, I definitely believe this laser can help. And if your worried about the side effects, dont, because the side effects have been extremely minimal for me so far at this point. One of the biggest concerns about lasers were the side effects other people were experiencing such as textural change of the skin from smooth to rough, long lasting hyperpigmentation, extreme acne breakouts after laser, possible hypopigmentation marks. I have experienced none of these except for the last one, where I had an extremely minor and small area where it looked different in the sense that it looked a bit white, like a hypoppigmentation spot. Right now, after checking myself out in the mirror, it is slowly fading away. Although, it is some what of a disappointment to have, I do not think much about it since it is small and not very noticeable. the spot has actually turned from a pinkish/whitish color to a darker brown/tannish color. Hopefully it will fade over time, and will not be permanent. Anyways, I did not experience any other adverse effects like hyperpigmentation, right now, the hyperpigmentation is very very minimal and is easily concealed by my color lotion and sunblock. skin texture did not change whatsoever, skin feels pretty smooth, and i have only minor acne breakouts thus far. Anyways, I cant wait until my next procedure because i definitely see the potential in this laser. Judging by my pics, you can definitely notice improvement, but i hope you all agree with me that it is minor. Ive come to the realization that my scars will always be with me, but my main goal is to lessen the severity and make them look less prominent on my face, that is my end goal here. Anyways, im probably going to go back and do the procedure in 2-3 months, hopefully i will be less busy at work during that time, since I will be taking 2 weeks off. Also, i should mention my daily facial regime has been pretty basic and simple, cetaphil facewash, cetalphil face lotion, dermaesthetics SPF50 sunblock, and dermaesthetics color lotion (brown). I have also been going to my esthetician every tuesday and saturday for the past 2 weeks, and will continually do so. Shes been treating me with an array of different types of treatments ranging from facial massaging with this cold metallic piece while applying serums such as anti aging serums, hyaluronic acid, facial moisturizers, etc etc...stuff you get for facials lol. And also been doing some acupuncture on my face with these very fine needles, collagen masks, and other stuff haha. But ya, I think if any of you plan on doing lasers, AFTER CARE is extremely important. Always use SPF50 ++ sunblock, and if you can afford it, go see an esthetician to help with your healing after lasers. Luckily my insurance covers seeing my esthetician since its at an acupuncture clinic. Also, ill update my post in about another month to give you guys a 60 day post op update. Take cares. Saturday 2/9/13: 8 Weeks / 56 days Post Mixto Update- Hey guys, just wanted to give you guys an 8 week update on my progress so far from my first mixto treatment. Ive uploaded 5 new pics. The healing has been going well, my current regime has been the cetaphil face wash/cetaphil ultra hydrating lotion, with a dermaesthetics sulfur mask used to spot treat acne that flares up. Also, been going to my esthetician twice a week, she has been popping my pimples that flare up by using a very fine needle to poke a hole in the pimple and squeeze out the insides of the pimple, face acupuncture, facial massage, and applying other varieties of ointments. With all that, not much has really changed since my last update, improvement from day 30 to day 60 has been minimal, and I still stand by my 15% improvement, not much more. Also wanted to make a note that since I havent been using any acne prescriptions on my face such as tazorac for a while, one day I did use it due to some acne flare ups and man, my face reacted really badly to it, I put on a bit too much for my face to handle, so I was dealing with some pretty bad hyperpigmentation for about 3-4 days, so just remember, when you do stop acne prescriptions after the laser treatment, make sure you let your face get acclimated to the prescriptions once your face is ready...meaning put on a little bit and gradually put a little more every night. Other than that, still somewhat disappointed after this first laser, and I hope the second one can bring upon more improvement, which leads me to my next topic. I have scheduled a second mixto laser session with Dr. Rahimi on March 9th. I am excited to go at it once again, but that date is tentative as I am pretty busy at work, and I am unsure Ill be able to take 2 weeks off of work, so I may need to schedule to a later date. Ill keep you guys posted, take cares. 3/2/13: Week 11 Update. Hey guys, ive uploaded 4 new photos to show where im at 11 weeks 1st post mixto. I had some bad acne breakouts due to my hyperhydrosis.....so I stopped working out for the past 2 weeks and have been swimming to maintain my cardio fitness. I hope the acne subsides by next week because I will be getting the 2nd mixto treatment next Saturday. Luckily my manager has given me the green light to take 2 weeks off of work. I also saw Dr. Rahimi last week just for a check up. He stated to me that he went medium-level the first time, but will be going aggressive this time around. He stated that he will probably be using the same settings but will just go over my face with more passes with the laser. Judging by my pics, i would say after one mixto treatment, I got 15-20% improvement. I'm pretty excited for my second treatment hope it goes well. Take cares. 3/10/13: 1 Day Post Mixto #2: Hey guys, Ive uploaded 4 new photos. 2 Photos are from right after the surgery, and 2 are from today in the morning. I had my second mixto done yesterday, went very smoothly. I arrived there around 8 am, he gave me these 2 small pill/tablets to leave under my tounge, applied numbing cream, applied a heart rate monitor on my middle finger, then injected about 8 shots of some kind of sedative (i forget what its called), 2 on my right arm, 4 in the 4 quadrants of my mouth, and another 2 above eye brows. I asked him to go more aggressive this time and to focus mainly on the cheeks/temples since those are where my scars are localized. Unfortunately, this time around, I wasn't knocked out like last time. If you recall last time I was literally unconscious for the whole procedure. But this time around, i was at a state of semi-unconsciousness, meaning i could feel the laser burning my skin. luckily, it didnt hurt whatsoever, it literally felt like how you could imagine, this light beam of high intensity heat in small fractionated diameter holes burning through the surface of your skin). but it didnt hurt fortunately since the combination of numbing cream and sedatives were working blocking the pain receptors. If anyone is wondering how long the procedure takes, it takes about 30-60 min for the numbing cream and sedatives to take settle in, and the procedure takes about another 60 min. So total about 2 hours. If you want to leave immediately right after the procedure, you will need someone to take you back because it takes approximately 4 hours for the sedative to wear off enough to the point where you will be able to drive back home. If you cannot find a ride, you will probably just have to wait 4 hours after the procedure in one of his waiting rooms. I will probably not be journaling my experience from day 1 - day 7 like i did last time, because it will probably be the very same. But ill be back in a week or so to give a Week 1 Post Mixto # 2 update. Anyways steady as it goes, God Bless. 3/16/13: 7 Days Post Mixto #2 Hey guys, ive uploaded a ton of new photos which i took along this entire week to give you a glimpse of how my face looked as I was going through the first week process after the mixto. Please note that some pictures may not be in chronological order. I am not going to go into too much detail because the experience was identically the same as the first mixto (scroll up near the beginning to read about my experience during the first week of my first mixto treatment). Anyhow, Ill state some main points however in this blog entry. Make sure you continuously apply aquaphor, wash it over 3-4 hours later, and apply again. Extremely important during the peeling process. And yes the peeling process (Days 1-4) is very irritating and uncomfortable when you sleep. Because you have all this aquaphor on your face and it starts to produce a not too pleasant stench during your sleep, and it does dry it up after 3-4 hours (especially if you roll your face around on your pillow unconsciously during your sleep), which will than dry out your face and it will force you to wake up because it feels like your skin is crushing your face...and will need to wake up in the middle of the night and reapply some more aquaphor and hopefully will be able to go back to sleep again. Anyhow, other than that, after the peeling, it is smooth sailing from there. I finished peeling around Day 4, and day 5 - day 7 , i started my aquaphor/1% hydrocortisone combo. Further. today (day 7) i started to apply a dermaesthetics DNA Serum that my esthetician provided for me. Not sure exactly what it does, she explained to me it will help hydrate and heal my skin, so ill be applying that as well. So i think around day 7 you do not need to apply anymore aquaphor because all the peeling is definitely done by than. So I will just be using the 1% hydrocortisone until i finish the tube, as well as the DNA serum until i finish the bottle. Also, Ive been living like a vampire in my room, blinds closed, no lights, for this past week. Trying to stay away from the sun rays as much as possible. But ya steady as it goes....ill be back in a month to give a 1 month post mixto # 2 update and will check periodically if any of yall have any questions, God bless. 3/25/13 Day 16 Post Mixto #2 Hey guys, ive uploaded 4 new pics. Healing has been going well, hyperpigmentation is still active, but has been deterioriating slowly. I actually went back to work after one week, although i was still a bit red, it was good enough for me to go back to work. Since the doctor went a bit harder this second time around, ive been noticing some better improvement. Although not major, and not microscopically better, when I do look in the mirror from a distance, my face does look like its improving, which I am very happy with. I do hope that 2-3 more times of these sessions will get my face where I would like to be ultimately. But as of now, healing has been going great and hopefully ill see some more improvement in a month or so. God bless. 4/7/13 Day 30 Post Mixto #2 Hey guys, I put up some new pictures up. Ive basically healed up, still slight hyperpigmentation @ the temple region, but other areas of my face no longer have any hyperpigmentation. Healing went well, no negative side effects. But unfortunately, a lot of my acne scars did reappear, havent noticed any significant improvement after 1 month from this second treatment (relative after my first mixto). Ill need to wait a little longer around month 2 - month 3, ill probably see some gradual improvement like I did from my first mixto. Still not satisfied however, and will definitely be going in for a third treatment by month 3-month 4. Per someones request, I have uploaded my pictures within a gallery, please see the link below. http://imgur.com/a/5p3QB 05/04/13 Week 8 Post Mixto #2 and Around Week 20 Post Mixto #1 Hey guys, Ive uploaded some new pics today shown below. I did not update the imgur though cause kind of lazy, ill update that one next time (or when I have some more free time on my hand). also excuse me for my acne! i dont know why i keep breaking out (most likely due to stress from work, studying, lack of sleep, etc). Anyways, just to give a quick update, Ive definitely noticed improvement, it might be hard to gauge from the photos, but I do notice slow and gradual improvement. As of now, I would say Im around 30-35% improved from the beginning. There is definitely a lot more work that will be needed, but it makes me happy to see how Im improving gradually and slowly, I even notice some of my deep acne scar marks filling up with tissue, which was very exciting to see. But like i said, microscopically, All the scars are still there, but macroscropically, my face does look better. I plan on going in next month again for my third treatment, Ive scheduled a date for June 8th with Dr. Rahimi, but that is tentative as i might need to go travel for work, so i may push it off to a later date that month when i do come back. Furthermore, Ive had a lot more confidence lately when i do go out such as for work or going out with friends, I know this may sound really girly, but Ive been using this neutrogena liquid foundation (non comedogenic of course) which gives my face an even skin tone (not rugged like my pics), and tends to mask some of my acne scars. My sis introduced me too it since I was desperate to find something to cover up my scars when i do go out for events/leisure, date nights, glad i found that, haha! but HOPEFULLY, these procedures will start to improve my skin more and more so that in the future i wont need to rely on that. But anyways, steady as it goes, Ill come back with another update sometime next month. Happy May guys! hope everyone else is doing great, God Bless Take Cares. 06/01/13 Week 12 Post Mixto #2: Hey guys, ive uploaded some new array of pics. Healing has been going well, acne has been subsiding a bit. I would say overall improvement has been only 30%, IMO has been minimal. Unfortunately, all my acne scars are still there, they do look a bit better, but are still pretty evident. I dont know, I am having really mixed feelings about this treatment so far. Like Ive Noticed improvement, dont get me wrong I am totally grateful for the improvement, but I was talking to my family last night during dinner and they were saying they notice only 10% improvement and that it was NOT worth $3,000 for you to do this procedure. And furthermore, although i do notice minimal imrpvoement, it doesnt seem like this treatment will get rid of my ice pick acne scars, it will only be able to improve upon them. Anyone suggest another method that can get rid of my ice pick scars? (Possibly TCA or Excision?). I know it is still too early too tell, and maybe Ill need to do some more treatments to ultimately get it to where I would like it to be. But as of now, the improvement hasnt been all that great. I am scheduled for a third mixto next week (June 8th), im going to let Dr. R know of my concerns (of how I havent seen the improvement that I would have liked to see so far), and ill ask him to go a little harder with the Mixto so that I can start seeing some better improvement from my ice pick scars. Im pretty sure he will respond by telling me to be patient, which is probably correct. But as of now 3 months post mixto #2, I am a bit disappointed, sadly. But I will keep going at it, and luckily since Dr. R gives a cost reduction after the second mixto, it is a bit more affordable to say the least. But someone did PM me asking me if it is actually worth $3.000 in terms of the results, I would reply "Maybe", in a sense where I think it is a purely subjective response (depends on the person). Since i do see improvement it was sort of worth it, but the improvement has only been around 30%, which is a bit disappointing. Anyhow, Ill keep going at it with this mixto, maybe giving it 2 more sessions and wait a bit longer before I ultimately come to a final conclusion, so if you all can stay patient with me, Ill be able to give you guys a better feel of where I stand maybe a year from now. But as of today, sort of disappointed with the results, and maybe I just need to learn to accept my scars and live with them? I do not know, if others can shed some light of what other possible procedures i can do to help my ice pick scars i would greatly appreciate it! June 8th, 2013: Day 1 Mixto #3 Session- Hey guys, just gonna give a quick update, I went to have my third mixto today, i asked Dr. R to go harder since I still see lots more room for improvement, which he did oblige......because my face has A LOT more pin point bleeding on my cheeks/temples. Ill post the pics up tmw, pretty tired and drained out right now, but ill be back tmw to give a more thorough update. Im feeling pretty excited cause Dr. R definitely went a lot harder this time around. June 10th, 2013: Day 3 Post Mixto #3 Session- Hey guys, Ive uploaded a whole bunch of pictures to show you guys what my face looked like during the first 3 days of Mixto #3. I went into the office on June 8th (saturday) around 12:00 PM. I sat down with Dr. R to let him know my main concerns of how my deeper ice pick acne scars havent been responding as well to the laser, which is most likely attributed to the lack of depth in the settings of the laser in which Dr. R was using. He admitted that he wasnt going in too deep because he did not want to leave permanent damage to my skin (e.g. hypopigmentation or white spots). And I can totally understand where he is coming from, because obviously who would want white blotchy spots on their facial skin? So I understood why he wanted to stay conservative (especially since I have ethnic skin). But I let him know I was still unhappy with my results, especially the right side of my face where the deeper acne scars lie. He told me he will try to go a bit deeper this time around, but not to max settings. He quoted me he will use the same setting 7/20/10 with 3 passes, and where the deeper ice pick scars he may decide to go 7/20/13. Also, I hope people do not take one of my previous posts the wrong way (the post where I was pretty unhappy about the results). I do believe these Co2 Fractional lasers are of tremendous help and great benefit if you have shallower scars (i.e. rolling/box scars, or shallow ice pick scars). I say this because my face does look cleaner because some of the shallow scars I did have seemed to have disappeared and have been responding pretty great to the treatment thus far. On theo ther hand, if you look at my pics very closely, I have a lot of riddled ice pick scars , which are the dominant types of scars on my face. Furthermore, if you compare my left and right side pics, you will notice my left side has been responding very great to the treatment, thisi s because my left side had shallower ice pick scars and shallower scars in general. On the otherh and, my right side still needs A LOT more imporvement because they are where my deepest acne scars lie. I let Dr. R know of my concerns and you guys can judge yourself with the new pics I posted up. I do believe he did go more aggressive this third time around because my face had a lot more pin point bleeding, which i did not see from my first two mixto treatments. Ill be back after a week to give you guys my progress. EDIT: I forgot to mention, before my third mixto when I was having a short pre - op conversation with Dr. R, I inquired to him about the possibility of doing punch excision or TCA Cross for my deeper acne scars. He told me from his own expert opinion, that the Mixto is the best solution, even for my deeper acne scars, especially since I have a bunch localized on my cheeks. On a side note- I recently figured out the underlying cause of my acne break outs. This whole time (these past 10 years or so), I always thought that my "hyperhydrosis" was the main underlying cause of my acne break outs. But recently, in order to prevent my sweating, I started to swim instead of running and playing basketball. It was strange that even when I was swimming , my face still kept on breaking out. So after talking with my esthetician about why i still break out so much, and she told me because I have very high internal body heat. I looked up my condition , and figured out because I have high internal body heat, it leads to hyperhydrosis. Therefore, the reason why i still break out so much isnt because of my hyperhydrosis, but because of my high internal body heat. I did a bit more research and found out that bacteria "thrive" in warm blood, and therefore since the warm blood always circulates around my body (through the face, through the brain, etc)....my face is more prone to acne because of this. This can also become exacerbated through working out (since blood starts rushing through the brain, sweat starts to come out of my pores) as well as when i drink alcohol. Therefore, I decided the best thing I can do to help with my acne is to try to keep my blood at a normal temperature range. Im planning on doing this by staying away from things like caffeine/alcohol, eating more fruits/veggies (to keep my blood cleaner), staying away from meats, swimming more often, not stressing out as much, etc. Just wanted to post this to help anybody else who may be in the same shoes as me. anyways, God Bless. June 15th, 2013 Week 1 Post Mixto #3- Hey guys, ive uploaded a whole bunch of pics of what my face was going through this past week. The doctor definitely did go harder this third time around because it took an 1-2 extra days than to peel completely relative to my first two Mixtos. To elaborate further, i think the Day 4 to Day 5 transition is when the peeling usuaally finished for my first two mixto. But this time around it was between day 5 to day 6 when the peel was completely done. Im not going to go too much in detail because the recovery procedure was the same. But just to recap: 1. It really is like a part - time job, taking care of your face for the first week. Constant application of aquaphor, washing it off with light cetaphil cleanser, reapplication of the aquaphor...it actually is a lot of work. 2. Something new - Try to wear very soft gloves/mittens when you go to sleep. This is something I WILL have to do for my fourth mixto session. You will notice some "scratch" marks all over my face, I must have unconsciously during my sleep scratched my face constantly, because you do get itchy during the recovery process! Wear Mittens/Soft Gloves when you go to sleep. 3. Been taking doxycycline twice a day. 4. After peeling was done around day 5-6, I went on a different regime. Wake up, wash face with light cleanser, Dermaesthetics DNA serum, 1% hydrocortisone, reapplication of aquaphor. The reapplication of aquaphor is something new, something i didnt do after my first two treatments, Dr. R said you Do not need to apply aquaphor after your peeling is done, but I just felt that it wouldnt hurt for my skin just to keep some aquaphor on my face even after the peeling process. I just rationalized that it probably will enhance and help the skin heal faster. Overall, I think i might see some nicer improvements this third time around, im already starting to see remnants of improvement, although it is still to early to judge since my face still has some micro swelling, I think by month 1, Ill be able to gauge how much this third treatment has helped, but early signs point up, since I am seeing some improvement right now. I took a week off work, probably will go back to work Monday, hopefully the hyperpigmentation subsides a bit more by Monday, it is still pretty evident on my face, but definitely good enough to go into work (probably will use some concealers). June 30th, 22 Days Post Mixto #3: Hey guys, so ive uploaded a couple of more pics. Healing has been going well but hyperpigmentation has been a big issue!!! It seems that since the Dr. R went a lot harder this time around, the hyperpigmentation is lasting a lot longer relative to my first two mixto treatments. Although it sucks to have this long lasting hyperpigmentation (and very embarrassing going to work with a red face), I know that I will see better results because of this and I am already seeing better results, which I am very happy with. So I guess it comes with the territory, if you want results, doctor must be aggressive, this wiill thus lead to longer lasting hyperpigmentation. I have no worries that it will fade over time, but this experience is new relative to my first two mixtos. Goes to show that the first two werent as aggressive, because I recall the hyperpigmentation fading at around 2 weeks. But this third one , the hyperpigmentation hasnt faded yet! It has been embarrassing at work, but oh well this is what I must go through in order to get results. August 18th, 2013 Around 2 months Post Mixto #3: Hey guys, ive uploaded a whole bunch of pics of what my skin went through these past 2 months. Sorry for the lagging, Ive just been super busy (as well as lazy) in updating this blog. Anyhow, Im glad to see that I have noticed significant more improvement from this third mixto. I am really starting to nice a difference in the scars in terms of depth + width, both are smaller. However, I am still not yet satisfied, because all the scars are still there unfortunately. I believe my left side of my face has seen much greater improvement than my right side because my left side had the shallower scars. Overall I notice around 60 % improvement on my left side where as i notice about 40-45% improvement on my right side. All Scars are still on my face, but are definitely less prominent and less noticeable. Although if you were to see me face to face, you will definitely still notice the scars. That being said, I believe i should repeat important things that should be done after the procedure. ALWAYS use high SPF sun block, if you can afford it go to a skin care clinic. I went twice a week of the first month after my third mixto, and have been going once a week since. She has been doing these collagen masks, and applying other ointments to help heal my skin. Further, HP was REALLY REALLY bad this time around, because he went so much harder. Since he went so hard, the HP lasted a good 2 months. I was literally tomato red from week 2 - week 6. There was a time lag in the HP, meaning the first 1-2 weeks after the mixto 3, my face looked sunburnt red, but than week 2- week 4 my face was literally tomato red. IT was embarrassing at work, and im pretty sure next time around I will need to take off a month from work. Anyways, ill come back on month 3 to give another update. Take cares. September 14, 2013 Around 3 Months Post Mixto #3: Hey guys, just wanted to give an update. Posted some new pics of where I am currently at. Im definitely noticing more and more improvement, but ultimately its not where I want it to be yet. Its definitely has improved in terms of both depth and width. Some things to note that i may have forgotten to mention before, HP really sucks the first 2 months...Im a huge gym guy so it sucks walking around the gym with a SUPER red face between months 1 and months 2. And the first month, it was so bad that I did not even dare show my face around the gym, so i just did some mini workouts at my home. Also, dont have such big expectations that your scars will Disappear completely, because they wont. But they do get better after time and after more sessions, especially if you have deep embedded scars like I do, which I believe are the worst ones to have. But like i said, I am starting to see some nice improvement, even my esthetician said she notices around 40-50% overall improvement before I started any of the treatments. I plan on doing some needling sessions with her like 1-2 times a month, and most liklely in december I will go for my 4th mixto treatment. October 12, 2013 Around 4 Months Post Mixto #3: Hey guys, just wanted to post up some new pics of myself 4 months after mixto #3. There definitely has been some improvement over the last month, slow, gradual, and subtle. I still stand by my overall 50% improvement (prob around 60% on my left cheek, around 35-40% on my right cheek). Still a lot more room for improvement, but I am somewhat satisfied with the results thus far. I know I have mentioned this in many previous posts, but Ive come to the realization that my deep ice picked scars will never ever return to normal, something I am starting to accept now. However, I do believe that treatments can improve the appearance of these deep ice picked scars such as the laser. I am completely healed from the treatment, face color has returned back to its normal color. Ive been swimming to maintain my cardio fitness (i try not to do any other types of intense workouts because i do believe the sweating leads to breakouts). Also another thing to note is that, I am starting to get a couple of dark spots (sun spots) around my face, not a lot maybe 4 spread out over my face. It does seem to me that the laser does weaken the skin, leading my skin being more proned to sun spots. I have been using SPF50++ sunblock everyday, but it still seems like weakened skin can still lead to black spots. Its not that bad since i only have like 4, but i do hope i do not start to get anymore, as it is not very appealing to have. This is something worth of note, just note that after lasers make sure you wear a lot of sun protection and try to stay away from the sun as much as possible. Anyways, take cares. November 28th, 2013 Around 5-6 months post mixto #3: Happy thanksgiving to everybody! Sorry for the lagging, just really busy with life now and I am happy to say that the scars are not bothering me as much anymore! I think its a mixture of both actual improvement and also improvement from a psychological perspective. I really think that this laser has definitely improved my face, because I can totally see it now. It is not at 100% though, but im fine with that because like i mentioned previously in my previous posts, any types of improvement will satisfy my desires of skin improvement. That said, I think I have improved about 55-65% on my right and 60-70% on my left, and I think maybe 1 or 2 more treatments will get me to the point of where I want to be with my face. I think the deep embedded acne scars will ALWAYS stay on my face, but Im actually fine with it because I noticed a lot of the other smaller acne scars are really going away, which is making my face look a lot lot lot cleaner. And to clarify, a lot of my scars are still there on my face, but they look A LOT less noticeable and less prominent, its much harder to see them now. My acne has also IMPROVED tremendously. Ive been seeing an esthetician every week who has been helping me with my scars and my acne. Further, I have kept up with my swimming routine, eating healthy, not worrying/stressing, and just trying to be a happier person. And Im glad to say I have been very very happy just with life in general. I even asked this really cute girl out last week and she said yes! I dont mean to be gloating here, i just wish and hope for everyone on this board to realize that even with acne scars, you can always try to improve it in whichever ways you feel the most comfortable, but dont let these acne scars hinder your quality of life. Just remember everyone goes to struggles, and that even with acne scars, we cant let that affect other aspects of our lives. We should always be nice, courtesy, respectful, humble, helpful, kind, gentle with others with or without acne scars. And just live your life to the fullest the best you can and be confident with yourself. Yes i know it really sucks having acne scars, I believe there are ways to improve it like this laser treatment. I really have seen tremendous improvement this past year, and I am extremely grateful for it (grateful to Dr. R, and others on this board who taught me a lot about acne scars). Anyways I wish everyone the best of luck on your endeavors in trying to improve your acne scarring, but just remember, to live your life to the fullest with or without acne scars. I am planning for my four mixto session with Dr. R in Dec. 23rd time frame, so I will keep you guys up to date on that as well. Also one thing i would also like to mention, Ive been drinking green tea with lemon and honey 3 times a day during work , and its really helped my skin as well, something to just consider. December 28th, 7 days post mixto #4- I got my 4th mixto done with Dr. R one week ago. Its been a week and I've healed extremely fast. Dr. R stated to me this is the hardest he has ever gone on anybody with the laser, but judging from my pics, I may have to respectfully disagree with his assessment. I think with this 4th mixto, it was probably at the intensity level between the 2nd and 3rd mixto treatments. I think the 3rd mixto i had with him was definitely the hardest he went on me thus far. You can come to this assessment just by looking at my photos, if you look at my photos right now after my 4th mixto, the redness has mostly already dissipated! Whereas after my third mixto, the redness lasted a good 6 weeks. The quick reduction in redness may also be attributed to my consistent usage of the hydroquinone cream weeks before this 4th laser, as well as my after care....applying aquaphor, hydrocoritsone, and other ointments that my esthetician gave me. How do i feel? I feel okay about it, I was hoping that Dr. R would go as hard or even harder then my third mixto level of intensity, because it is quite obvious that the harder you go, the better results you will most likely get. I do believe Dr. R is trying to fine that right balance of level of intensity and at the same time not going tooo hard and causing permanent damage to my skin in terms of hypopigmentation spots. So Ill let the Professional do his thing, and trust him with what he think its best for my skin. But like i stated, i only have minor hyperpigmentation right now, i can actually go out already and go back to work within a week which isnt what i was expecting. So its also a blessing in disguise i guess, cause the downtime after this laser has only been a week. I actually do see remnants of improvement of my face, looks cleaner, but i think that may be more attributed to the micro swelling that has not gone down yet. Hopefully in a couple of months ill continue to see gradual improvement over my skin, ill keep yall updated. thanks. February 22nd 2014, 2 months post mixto #4- Hey guys, its been a while since ive updated the post. Just wanted to give out an update to everyone. Glad to say that things are going well . Ive uploaded photos throughout these past 2 months to give you guys an idea of what my skin looked like throughout this 4th mixto session. Like I stated previously in one of my posts, I do feel that he didn't go as hard as my third mixto, but just a bit lesser in strength. Also, I would really like to point out that there is a lag in HP. What I mean by that is, for the first 2 weeks, or one week after you finish completely peeling, you will have no HP. Unfortunately, by week 2, the HP starts to surface and it will last a good 2 months. Throughout these next two months, it will slowly start to fade week by week. Just a heads up to everybody who is considering this procedure, you will be red for a good 2 months. I would also like to mention that the most latest photos taken today , that I have uploaded, are from a different light setting. Ive finally moved out of the nest egg, and am living on my own, so the lighting is a bit different. More importantly is the fact that I do have a lot of sun block on and a bit of a light concealer (yes I know its very girly... but gotta do what i gotta do lol), so you will notice a slightly different skin tone, and some of the scars concealed a bit more than usual. Although I do have ointments on my face, my scars arent too much different with the ointments or without the ointments, my next update ill update the pics without anything on my face. Anyhow, in terms of results, Im glad to say that I have noticed significant improvement. I should note that the scars are still noticeable, if you were to see me in person, you would definitely notice the scars, but I do feel like the appearance of the scars have reduced, which I am very happy and grateful for. I do not think more laser sessions will completely eradicate all the scars, its just the nature of the beast and that my ice pick scars are simply hard to fill , and a laser isnt the best treatment to fill ice pick scars. That being said, my face has improved with these treatments, and I am proud to say that I would really would recommend this laser to anyone that is interested in getting improvement of the "appearance" of their scars. I really do feel a lot more confident with myself and I do not feel as nervous/scared when I meet new people. Anyhow, Ill come back later for more updates on my skin, take care everyone! May 17th, 2014 - 5 Months Post Mixto #4 Hey guys, its been a good while since I've been back on these forums, glad to be back and update you guys on the progress of my skin. I apologize for not updating more frequently, unfortunately life has taken over, and I have much much less free time, and much less time to worry about my skin and updating this my mini-blog here in acne.org. Anyhow, I will still continuously do my best do update these posts from time to time, but please dont expect them to be on a monthly basis, just FYI! So now on with my post.... I've uploaded 4 new photos of my face. Note that the lighting for the past few pictures have been different, I recently moved out of my parents home and moved into my own new place (I think i mentioned this in one of the previous posts). Anyhow, that is the reason why the lighting is different if any of you guys were wondering. I tried to do my best in terms of getting the harshest lighting angle so that my scars would be more apparent, but this is the best I could do. I do think that the pictures do not accurately reflect my true scarring, it makes it seem like my scars are less noticeable and apparent. Do not get me wrong, my scars definitely have improved! But, the pictures seem to make my scars look A LOT better than it really is, if you were to see me in person. Ill try to do my best next update to give you a better angle and picturing of my scars. That being said, there definitely has been more improvement over these past 3 months since my last update. I truly believe that there definitely is a time lag in results, you definitely get gradual, incremental improvements as time moves on. I do believe that incremental improvement probably caps out after around 6 months after a laser treatment (i.e. 6 months after a laser treatment, the way your face looks is probably where it will stay), but anyone that disagrees can correct me if I am wrong, this is just my observation from the empirical data that I have been noticing on myself. Life quality has definitely improved, I feel a lot more confident when going out to events, and talking to people. That being said, unfortunately, the scars are still noticeable. If you were to see me in person, you would notice my scars right away, it is still not normal. It definitely looks better and more bearable, manageable, and less noticeable, but still apparent to any observer. I do think people "notice" it, but it does not bother them at all or think much about it. This is just what my friends/family members have been telling me (at least just my close friends). Its funny because I recently met up with a college friend, and haven't seen him in 3 years, when he first saw me, he was completely shocked, he said quote on quote "dude Scott you look so good now". I think he was referring mostly due to a procedure that I did about 3-4 years ago, I had an underbite, and I got that fixed (it definitely changed my facial appearance). I also think he was referring to my skin as well, because my acne has definitely subsided, I still get the occasional pimple from time to time, but definitely not anywhere near what I went through that caused me to have these acne scars. (I had full blown out BAD ACNE, like literally every pore on my face was a pimple, thats how bad it got throughout my teenage years). Further, I do believe that the acne scars definitely look better and has definitely improved. You can notice quite a dramatic change from my first pictures to my most recent uploaded pictures. If you were to ask me how much improvement do you see so far just on the acne scars alone, I would respond by saying my left cheek with the more shallower acne scars has improved about 70%, and my right cheek with the much more apparent and deeper scars at around 60% improvement. If you were to ask me how i feel just in general, I feel so much better, not just because of the improvmeent of my acne scars, but the fact that I do not break out anymore. I do think that my esthetician i see once a week has definitely helped with my acne. Getting acne in any prominent areas on your face , IMO, is so much worse because it is the most noticeable thing on your face, more noticeable than the acne scars. I hated having big humungous zits and having to go out to social events with friends, definitely lost a lot of confidence. My esthetician has been placing this "blue light" thingy on my face for about 15 minutes every session, not sure what it is called, but if anyone has acne issues, they should look into this "blue light" technology, it has TRMEENDOUSLY helped my acne. Anyhow, after all that being said, I am still not quite satisfied completely with my skin, I still do not feel 100% confident with my skin, and that is natural for me and I would assume for everyone on this board. I will never be satisfied until I get 100% improvement, unfortunately, we do not have the technology that can produce such results. The only thing that we can do is improve upon them in the current procedures that are out there. I truly would like to have 100% flawless skin, but I know that it is not attainable, so I am still seeking ways to obtain that goal. I know I previously mentioned that even if i got 50% improvement, i would be satisfied. And I am satisfied because I have obtained that goal and I am there now. But, now that I am there, I still yearn and crave for more improvement, I really truly want my face to get to a point where a person viewing me will barely notice the acne scars, because I still feel that I am in a point where people notice it. Basically I am trying to get at around 85-90% improvement of my acne scars on both sides of my face, mainly on my right side which is the trouble side. The reason why I am saying all of this is because I have been debating on what my next steps should be to obtain this goal. I mentioned in some previous posts and replies on this thread that I am unsure if I want to continue on with these laser sessions because I do not quite fully understand the long term ramifications of continuous laser procedures on asian ethnic skin. If the doctor was to tell me there is no long term ramifications, I may consider doing 1-2 more of these procedures in the future. But then again, I am not fully sure If i want to trust his word, and would definitely like to do more of my own research. The other viable options that I have in front of me is to do the needling sessions with my esthetician, maybe once a month. I havent had much time on the weekends to do such sessions because doing one of those sessions will keep me from doing anything on the weekends (i would need to stay in my room for the entire weekend), so its been hard trying to find time for this. Another option ive been contemplating is trying out TCA, the reason why Ive been contemplating this is because the deeper acne scars on my right side have not responded as well to the laser. The deeper scars have definitely improved from the laser, but I feel like from what I've read about TCA, it will do a much better job in "filling" up the deep holes , or craters on my skin. The reason I have not done this treatment yet is because Ive been getting a lot of mixed reviews both on this board, as well as multiple dermatologists recommendations. One dermatologist recommended it to me, whereas 2 did not recommend it. Therefore, Ive been "stuck on the fence" about this treatment, so i guess any viewers on this forum, if you have any recommendations I would really appreciate it. But I do think I will try to start the deep needling sessions with my esthetician to try to get more improvement for right now, and look into the TCA somewhere in the near future, and possibly additional laser treatments. Anyhow, sorry for the long rant, I just wanted to let you all know where I stand and I wanted to be perfectly clear with everyone of you. I do understand the pain and agony that we go through with these acne scars, so I try to do my best in giving out advice, being clear with my messages, and updating my progress as best as I can. I'll keep you all posted in future progress and treatments, take care. December 6th, 2014- 12 months post mixto #4 Hello All, its been a while since ive been on this board, felt like today was the perfect opportunity to give everyone an update on the progress of my acne scars. First, I would like to apologize for not updating as frequently as I used too. Quite frankly put, I've had other priorities that needed my fullest of attentions, and quite honestly, ive been somewhat lazy. That said, I do still plan to update this post from time to time, but it will not be frequently as it used too. Anyhow, as for the progress, reference the two latest pictures I posted up. As you can tell from the pictures, my scars have improved, they are still evident on my right side but not as visible on my left. Even though they are still evident, they definitely have improved in appearance. That is, they are a lot less aggressive, hence less noticeable. Further, luckily, my acne has been improving, i do not break out as much as before, so that is a big plus. Lastly, I do still believe the picture shown is actually better than what it really looks like, it seems like the camera on my phone doesn't have HD quality, so it tends to masks the scars within the pictures. But, at the end, the pictures do show fairly accurate representations of where I currently am. Its been a whole year since my mixto #4, how fast time flies by. I can honestly say with great confidence that these procedures have definitely improved my skin. I definitely would recommend doing these types of procedures if you want to see some improvement in your acne scars. I am of the position that these types of treatment are most beneficial for people with shallow acne scars, since I do believe the procedure will help with the shallow ones. I do believe this treatment definitely improves upon the deeper type acne scars, but will not *cure* them. Evident from my photos, my deep acne scars are still there. As of now, my final conclusion would be that my face has seen about 75% improvement on my left side (the side with the shallower acne scars) and about 50% improvement on my right side. I do not plan on doing anymore of these procedures because I do think I am at the point where the improvements from an additional one of these types of procedures will not be as beneficial. For the right side of my face, I am starting to accept I will have to live with these scars , and just accept them. It is actually somewhat liberating in a way because after accepting them and realizing that they are not as bad as I make it sound to be, I do not think or worry about them that much anymore. I definitely will be open to future procedures if any new innovations appear in terms of dealing with the deeper type acne scars In conclusion, I plan to just accept my scars with where they are at now, and will move on with my life and not think/worry about them any longer. Good luck to everyone on these boards, ill definitely try to come back in the future to give you guys periodic updates. Take care everyone. May 17, 2015 - 17 months post mixto #4 Hi all, its been a while since Ive been on these boards. I have uploaded two new photos of where my face stands today. Not much change from my last post, like I stated in my previous post, I believe the improvements have plateued, and where my face stands today is most likely how it will be forever (unless I perform any other procedures in the future). The deeper acne scars have not improved since my last post, and I would just like to reiterate that these procedures I pretty good for shallow superficial scars, but not as good for deeper acne scars, although the deeper acne scars have somewhat improved. All in all, I still stand by my final conclusion that 50% improvement for my right side and about 65-70% improvement on my left side. The scars still do bother me everytime I look in the mirror, but like I stated previously, I am starting to accept them for what it is. Anyhow, hope you all are doing well and I hope that my journey has helped others. Like I stated previously, I'll drop from time to time to update this blog, but I do not expect to see any more improvement. Take cares.
  23. Hello everybody!!! I am very upset with my acne scars.These days I am only looking for the best treatment and best surgeon for the same.But I am very confused as I haven't seen any Indian discussing on the same.I am little scared with the risks....will Fraxel Repair or any other treatment will work on Indian skin...though I have fair Indian skin. Treatment History- I had 1 dermabrasion sitting 5 years back . Then after dermabrasion new acne broke out caused new scars... After 2 years of Dermabrasion I had started getting Fraxel Restore sittings....with no results:(......I had 4 sittings at the interval of 3-4 months.Last was in Aug 2009.Now I am not on any medications for last 16 months. I have faced no side effects of any treatment. Does any one with Asian skin gets result with Sublative treatment?? I am attaching my recent Images..... Please advice me for the best treatment and best place to go for it...
  24. Fraxel leaves scars?

    Has anyone had experience with Fraxel Restore/Repair? I have heard that some patients are left with needle pin size scars all over the face? Has this been the experience for anyone?
  25. Hey guys. I am going to be a lab rat here and get myself the Sublative Rejuvenation treatment. You can find out more here. http://www.matrixskin.com/ I'll do 3 treatment (whole face) with a complimentary re-firm treatment. for $2500. Quite pricey. But I've heard that it works better than Fraxel. Thank god they have financing options. I'll give you updates once I have them. The first treatment is gonna be in late November, and I gotta prepare my skin with hydroquinone serum. (another 100 bucks) I'll let you know. Hopefully, this is gonna be money well spent.