30 replies to this topic

[Freakshow]

Hi, I'm a 19 yo Asian male. I had a breakout of severe acne a couple of months back. I'm 100% clear of active acne now, but it left me with really bad scarring and pigmentation, especially on my cheeks. You can see some pics of my scars below. I think they're a bit blurry unless you zoom out, sorry about that.

Can someone recommend me what type of treatment to go for? I read the forums and it seems like lasers are really popular, but I'm concerned about the damage/pigmentation it can cause to my sensitive Asian skin. I'll be glad if anyone can share their experiences or knowledge about that. Also, I think subcision would be good because I think I have rolling scars (?).

Money is not an issue, and I can afford more than a month of downtime after whatever procedure I go for, so please help me out with suggestions

Edit: Uploaded another pic of my 'worse' side

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Edited by Freakshow, 29 June 2012 - 07:22 AM.

[staple]

You have mixed scarring and it'll probably take several different methods, including laser, to adequately treat them all. The risk of hyperpigmentation definitely exists with lasers, but that risk also exists with deep phenol peels and dermabrasion which are other options. It's difficult to tell from a photo but in this lighting you do not appear especially dark and there are not many brown marks, this might mean your risk of hyperpigmentation is less than you think it is. You'll be best off making an initial visit to a good cosmetic dermatologist to discuss those options rather than going in with one method preselected.

All of those methods treat hyperpigmentation as well, though gentler peels like glycolics and regular use of retinoids or acids can also help with hyperpigmentation. You can do some of that hyperpigmentation treatment at home (there are relatively gentle home peels available on the web) if you are very careful and use a good sunscreen.

[Remicade]

Dermarolling, it's safe for asian type skin.
In a study Percutaneous Collagen Induction with Dermaroller TM for Management of Atrophic Acne Scars in 31 Thai Patients they show
In conclusion, percutaneous collagen induction by skin needling with high quality
single-use device (Dermaroller TM, Horst Liebel Co, Germany) had been shown to be
highly effective and safe method for treatment of atrophic scar in Fitzpatrick skin
type III to V Thai patients.

Edited by Remicade, 28 June 2012 - 12:25 PM.

[Freakshow]

Thanks for the replies! I've scheduled my first derm appointment in about a month's time.

@staple - Do you have any recommendations for mild peels that can be done at home? I'm kind of worried that a peel would make my skin extremely sensitive and unsuitable for other treatments (e.g. laser) in the short term so I'll probably start with an extremely mild one. Appreciate your help!

@Remicade - Correct me if I'm wrong, but dermarolling seems to be more of a long term process while laser/subcision/etc gives significant improvements in the short term. I think I would pick up dermarolling after going for a more aggressive short term treatment.

[*Inspired*]

If money is not an issue, I would skip the home peel (it won't do anything for your scars) and start consulting with some cosmetic dermatologists & facial plastic surgeons on how to approach treatment. Looking at your photos (they're very blurry), they appear pretty deep on one side of your face. I wouldn't even risk or waste time with home treatment. At the same time, use caution when talking with doctors. You can find tons of great advice on how to select a doctor by simple reading through threads on this board.

Edited by TokyoGirl, 29 June 2012 - 12:32 AM.

[Freakshow]

If money is not an issue, I would skip the home peel (it won't do anything for your scars) and start consulting with some cosmetic dermatologists & facial plastic surgeons on how to approach treatment. Looking at your photos (they're very blurry), they appear pretty deep on one side of your face. I wouldn't even risk or waste time with home treatment. At the same time, use caution when talking with doctors. You can find tons of great advice on how to select a doctor by simple reading through threads on this board.

Thanks for the advice! Would really love to visit a derm as soon as possible, but I went for a minor knee op (too much sports ><) so I can't walk for a month. I've scheduled an appointment with a reputable derm in a month's time, so hopefully it goes well I'll be asking her if I'm suitable for fraxel repair, as it seems to have worked for a lot of people in this forum.

[Nope.avi]

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Edited by Nope.avi, 08 August 2012 - 08:04 PM.

[staple]

@staple - Do you have any recommendations for mild peels that can be done at home? I'm kind of worried that a peel would make my skin extremely sensitive and unsuitable for other treatments (e.g. laser) in the short term so I'll probably start with an extremely mild one. Appreciate your help!

As I mentioned, the home treatments will only help with hyperpigmentation, only a doctor can help with scarring. Basically, any gentle exfoliation process will help speed things up slightly, including very simple store bought products (like Neutrogena's "glycolic peel" which is not really a glycolic peel product, just a bi-weekly exfoliator) or starter level mandelic/glycolic/lactic peels available over the internet. (Spot test the peel for allergy first and follow the directions carefully. Discontinue any peel at least a week before your consultation.) Do not consider or attempt a high concentration peel or any kind or a TCA peel. Those are dangerous to do at home, especially if you have hyperpigmentation issues.

Since you'll be going to the dermatologist fairly soon though, if you already have a good exfoliation process, stick with it and find a good quality daily sunscreen that does not cause breakouts or irritate your skin that you can wear whenever you go out, including to go driving. Keeping your marks from darkening will help them fade faster.

Whatever you do, do not tan the marks or put lemons on them. I've read this elsewhere on the board and it's poor advice.

Edited by staple, 29 June 2012 - 08:20 AM.

[Freakshow]

@Nope.avi - Oh I'm not expecting instant results if thats what you were concerned about. I know it takes many months for collagen to grow after laser but compared to other scar treatments its considered short term right? Probably have to roll for more than a year to get the same kind of results as what laser gives in a few months.

Well I was completely clueless about how to treat my scarring a few days ago, and now I have a basic idea thanks to these forums and you guys. Needless to say I'll be doing more research and considering the derm's opinion. Whatever treatment I go for in the end, I'll remember to post back the results.

Edited by Freakshow, 29 June 2012 - 11:20 AM.

[*Inspired*]

Seeing your new picture, I would say your actual scars are not bad. The blurry picture made them appear deeper. I suffer from the same kind of hyperpigmentation as you. Mine normally starts off red, turns brown and then slowly fades to tan over time. I haven't had much luck with using peels for hyperpigmentation. Peels tend to irritate my skin and that always leads to hyperpigmentation for me. I have had success using a cleanser with 2% salicylic acid, AHA cream and Hydroquinone, as well as Retin-A 0.01% & Hydroquinone. Unfortunately, as soon as I stop using Hydroquinone, my hyperpigmentation starts to return in some areas. It's an ongoing battle. From what I've read on Realself, this is a common issue for some Asian skin types, so simply doing a peel is not going to be enough because it doesn't inhibit the production of melanin in your skin, like Hydroquinone & similar bleaching topicals.

For your scars, you'd probably benefit from co2 fractional laser. For faster results, subcision prior to laser would be helpful.

[Remicade]

Take a look here: http://www.jeban.com...ic.php?t=109268

[*Inspired*]

Take a look here: http://www.jeban.com...ic.php?t=109268

Do you consider this place a reputable source?

[Remicade]

Isn't ?

[*Inspired*]

Isn't ?

I don't trust any medspa's before and after pictures. They're selling a service.

[staple]

Peels tend to irritate my skin and that always leads to hyperpigmentation for me. I have had success using a cleanser with 2% salicylic acid, AHA cream and Hydroquinone, as well as Retin-A 0.01% & Hydroquinone. Unfortunately, as soon as I stop using Hydroquinone, my hyperpigmentation starts to return in some areas. It's an ongoing battle.

TokyoGirl,

Are you using a sunscreen with good UVA protection? Most sunscreens do not protect well against UVA rays, even high SPF ones which can pass through windows and also destroy collagen and pigment skin. Many very fair skinned people use Canadian and European imports to protect their skin better.

[*Inspired*]

Peels tend to irritate my skin and that always leads to hyperpigmentation for me. I have had success using a cleanser with 2% salicylic acid, AHA cream and Hydroquinone, as well as Retin-A 0.01% & Hydroquinone. Unfortunately, as soon as I stop using Hydroquinone, my hyperpigmentation starts to return in some areas. It's an ongoing battle.

TokyoGirl,

Are you using a sunscreen with good UVA protection? Most sunscreens do not protect well against UVA rays, even high SPF ones which can pass through windows and also destroy collagen and pigment skin. Many very fair skinned people use Canadian and European imports to protect their skin better.

Of course! I use Shiseido SPF 55 that's 16.3% Zinc Oxide & 2.2% Titanium Dioxide. Beats any sunblock offered by my dermatologist. I have Asian skin, like the OP. I avoid the sun, and have lived like a vampire over the last 6 months. I still hyperpigment. It's definitely not related to the sun because I don't allow the sun to touch my skin.

[Nope.avi]

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Edited by Nope.avi, 08 August 2012 - 08:04 PM.

[staple]

I have Asian skin, like the OP. I avoid the sun, and have lived like a vampire over the last 6 months. I still hyperpigment. It's definitely not related to the sun because I don't allow the sun to touch my skin.

Hyperpigmenting after injury to the skin is not unusual at all, even without much sun exposure, but it's unusual to re-hyperpigment after consistent successful hydroquinone use with good protection. I wonder what is going on there. Maybe your skin has become very sensitized to even miniscule amounts of uv rays?

[*Inspired*]

Taken from: http://www.acne.org/...-with-pictures/

You're wise to be skeptical of the before and afters. I am too. So much trickery in this industry. AFAIK the link isn't a medspa's site though, the girls blog is here http://pookyzchuthab...blogspot.co.uk/ , here http://pookyzchuthabhon.wordpress.com/ and Youtube here www.youtube.com/user/ThePookyz/videos

Look at that internet stalking.

I have to be honest, and say I didn't translate the page. I hit "home" and saw a doctor plus other treatments advertised. For that reason, I looked at it as promotional. I have no idea what the site is about.

[Nope.avi]

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Edited by Nope.avi, 08 August 2012 - 08:03 PM.