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Mixto Sx Co2 Fractional Laser Surgery Diary: Asian With Ice Pick Acne Scars On Cheeks/temples.

ice pick co2 fraxel cortisone needling aha alpha hydroxy acid concealer hyperpigmentation

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#1 slee3

slee3

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Posted 18 November 2012 - 12:10 PM

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 sad.png. 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. 

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#2 awesomenesssquared

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Posted 18 November 2012 - 12:25 PM

thank you for doing this. you are helping alot of people by documenting your journey.

Keep us updated!

Thanks!

#3 pursuit of happyness

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Posted 18 November 2012 - 01:56 PM

thanks for sharing and i hope the best for you,, also i would to ask u about doxycycline?? are you know the role of it?,cuz my docter gave it for me to treat my face redness that caused from using 10%hydroxy acid exfoliator 7 months ago..

Edited by pursuit of happyness, 18 November 2012 - 01:57 PM.


#4 *Inspired*

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Posted 18 November 2012 - 02:01 PM

Thank you for sharing your experience.

You said Vicodin ES for cold sore prevention. Do you really mean Valtrex? Vicodin a painkiller. It won't do anything for cold sores.

180 micrometers (0.18 mm) is actually very superficial for scar treatment. 300 micrometers (0.3 mm) is deeper. 0.3 mm is how deep Active FX penetrates. This is the reason I chose not to proceed with MixTo.

70 MJ is the maximum energy setting for Re:pair. You can't really compare it to other lasers because every laser uses energy differently. In other words, 70 MJ is only relevant to depth when you're talking about Re:pair. You get about the same depth with Deep FX around 18-20 MJ. I'm not sure of Deep FX's setting exactly but it's much lower than Re:pair at the same depth.

I hope this treatment works for you, and am hoping for the best! Best of luck!

thanks for sharing and i hope the best for you,, also i would to ask u about doxycycline?? are you know the role of it?,cuz my docter gave it for me to treat my face redness that caused from using 10%hydroxy acid exfoliator 7 months ago..


I am using Doxycycline right now for active acne, and used it before and after laser treatment to prevent acne. Does your doctor think you have an infection? It is an antibiotic.

#5 pursuit of happyness

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Posted 18 November 2012 - 02:47 PM

yes it's oral antibiotic,i don't know if i have infection or not,and this redness is here from 7months ,so can infection still for this long period?? another doctor said to me that's may be Butterfly rash or eczema,redness make scars looks more worse:(

#6 slee3

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Posted 18 November 2012 - 03:29 PM

Yes, your right Tokyo girl, hmmmm not sure why he stated the 180 micrometers....maybe he got confused, ill need to double check with him.

Actually im a bit confused, the mixto website states that the 180 micrometer is for the deeper settings, but then contradicts itself and says 300 micrometer is good for acne scars.

http://www.mixtoskin...cians/faq3.html

not sure anymore, I emailed Dr. Rahimi, Ill see what he says.

#7 *Inspired*

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Posted 18 November 2012 - 04:19 PM

Yes, your right Tokyo girl, hmmmm not sure why he stated the 180 micrometers....maybe he got confused, ill need to double check with him.

Actually im a bit confused, the mixto website states that the 180 micrometer is for the deeper settings, but then contradicts itself and says 300 micrometer is good for acne scars.

http://www.mixtoskin...cians/faq3.html

not sure anymore, I emailed Dr. Rahimi, Ill see what he says.


On the MixTo site, they're talking about spot size, not depth, when they mention 180 micrometers vs. 300 micrometers. 180 micrometers is actually their microfrational spot size. I don't see any mention about depth on their site but I do know MixTo has a maximum depth that's a bit more than Active FX.

I guess Rahimi was mentioning spot size, not depth. I was confused by your comment because I was thinking about depth. I assume the Watts determine the depth. Can you ask Dr. Rahimi how deep MixTo actually ablates at the settings he provided you? I'm really curious about the depth settings.

Edited by TokyoGirl, 18 November 2012 - 04:46 PM.


#8 *Inspired*

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Posted 18 November 2012 - 05:28 PM

I just came across a MixTo study. You might find it interesting:
http://derm.md/dev/l...White paper.pdf

It discusses the settings (index & watts), 20% vs.100% ablation modes, depth and spot size a bit. According to the study, MixTo has a depth of 20 to 500 microns (0.02 to 0.5 mm). I'm not sure if that's ablation depth or total depth (ablation plus heat).

#9 DRaGZ

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Posted 18 November 2012 - 08:22 PM

I forgot where I read the study, but the ablation depth for the Mixto is not as deep as the Re:pair or DeepFX, but the heat value is much higher and goes deeper than any other laser. Apparently, this is why they had to do the weird lasering quadrant pattern for the Mixto whereas Re:pair and DeepFX did not, because it was just so much dang hotter, and that is likely where there is less actual ablation.

Basically, it'll heat up the skin deeper than other lasers (other than probably the SKAAR FX), but it doesn't ablate as much. Mixto has apparently been an oddity amongst fractionally ablative lasers and some doctors wonder if this means it's better or worse because it's so much hotter but doesn't ablate as much.

When I have some time, I'll find the study and post it.

Edited by DRaGZ, 18 November 2012 - 08:24 PM.


#10 slee3

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Posted 22 November 2012 - 11:25 AM

Thank you for sharing your experience.

You said Vicodin ES for cold sore prevention. Do you really mean Valtrex? Vicodin a painkiller. It won't do anything for cold sores.

180 micrometers (0.18 mm) is actually very superficial for scar treatment. 300 micrometers (0.3 mm) is deeper. 0.3 mm is how deep Active FX penetrates. This is the reason I chose not to proceed with MixTo.

70 MJ is the maximum energy setting for Re:pair. You can't really compare it to other lasers because every laser uses energy differently. In other words, 70 MJ is only relevant to depth when you're talking about Re:pair. You get about the same depth with Deep FX around 18-20 MJ. I'm not sure of Deep FX's setting exactly but it's much lower than Re:pair at the same depth.

I hope this treatment works for you, and am hoping for the best! Best of luck!


thanks for sharing and i hope the best for you,, also i would to ask u about doxycycline?? are you know the role of it?,cuz my docter gave it for me to treat my face redness that caused from using 10%hydroxy acid exfoliator 7 months ago..


I am using Doxycycline right now for active acne, and used it before and after laser treatment to prevent acne. Does your doctor think you have an infection? It is an antibiotic.


Yes your right, i mispoke, I corrected my orignal post. He prescribed me acyclovir tabs to take one day before and one day after to help prevent possible cold sores/viral infections. He prescribed Vicodin ES just in case the pain is too intolerable after the surgery. He said 90% of the time tylenol will do the job but wants me to have the vicodin just in case. 180 microns is *NOT* the ablation depth, but rather diameter of beams, supposedly the finer the diameter the better ability to go in deeper, makes sense since the intensity or rather the Energy per unit area will be much greater therefore having a higher intensity and better ability to ablate deeper acne scars.

Edited by scottjlee333, 22 November 2012 - 12:02 PM.


#11 *Inspired*

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Posted 22 November 2012 - 11:53 AM

I've read the finer spot size allows for deeper penetration. Good luck with treatment!

#12 slee3

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Posted 15 December 2012 - 07:06 PM

Updated original post.

#13 acnescar123

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Posted 16 December 2012 - 02:15 AM

Good luck, hope it goes well for you. Keep us updated!

#14 rentedname

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Posted 16 December 2012 - 08:31 PM

good luck man. will be following your thread.

#15 slee3

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Posted 17 December 2012 - 01:32 PM

12/17/12 updated original post.

#16 slee3

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Posted 19 December 2012 - 02:19 PM

12/19/12 Day 5 Update.

#17 rentedname

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Posted 20 December 2012 - 01:48 AM

Nice, I can definitely see the improvements. The temples look dramatically different and the cheeks look better. thanks for the updates dude

#18 DRaGZ

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Posted 20 December 2012 - 09:11 PM

I'm honestly really happy to see it's working out.

I was honestly originally very uncomfortable about posting my pictures online, since I tend to be a pretty private person about personal matters, but I decided to do it because I had never really seen any other definitive postings about the laser resurfacing process. So, to see that it's actually had enough of an impact to make others braver and more informed about their own scar treatments has made it all worth it.

#19 blahblah82

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Posted 21 December 2012 - 03:38 AM

Looking good so far. Having gone through the process myself, I would encourage strict sun avoidance as the hyperpigmentation usually sets in at the 3rd or 4th week.

Can you clarify a couple things? When you say you've been getting HA injections, do you mean you've been getting fillers of some sort like Restylane / Perlane / Juvederm? I'm confused because I didn't think estheticians are able to do medical procedures like filler injections. Are you referring to facials with topical hyaluronic acid? I've seen those advertised in med spas before so I'm wondering if that is what you are referring to.

Also, did you have subcision done as part of the package? I remember Dragz stated that his included the subcision as well. From your pics, it seems like you didn't really have any rolling scars, so that may not have been appropriate in your case.

Good luck.

#20 slee3

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Posted 21 December 2012 - 12:39 PM

Looking good so far. Having gone through the process myself, I would encourage strict sun avoidance as the hyperpigmentation usually sets in at the 3rd or 4th week.

Can you clarify a couple things? When you say you've been getting HA injections, do you mean you've been getting fillers of some sort like Restylane / Perlane / Juvederm? I'm confused because I didn't think estheticians are able to do medical procedures like filler injections. Are you referring to facials with topical hyaluronic acid? I've seen those advertised in med spas before so I'm wondering if that is what you are referring to.

Also, did you have subcision done as part of the package? I remember Dragz stated that his included the subcision as well. From your pics, it seems like you didn't really have any rolling scars, so that may not have been appropriate in your case.

Good luck.


Hello Blah Blah,

Are you referring to facials with topical hyaluronic acid? Yes I was referring to that, as she would place the hyaluronic acid liquid all over my face and start needling my face intensely. That is what I meant by HA injections, sorry about that confusion.

I wasnt aware of rolling scars myself as well, but Dr. Rahimi said I did have a couple, he actually only did the subscisions in like 3-4 areas near the middle of the temple/cheek region (near my eyes). I guess I did have some that i wasnt aware of.

but yes it was part of the package, he did it right after the laser session.


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