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Acne Scar Advice Please!

scarring redness treatments

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#1 NewbieGirl25

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Posted 20 November 2012 - 07:08 PM

Hey everyone,

I have been lurking on this site for years but now I want to actually do something about my scarring. I've had the scars for about three years or so but couldn't treat as I was still breaking out. I do still get a breakout now and again but due to antibiotics and birth control I think it has helped some.

Could anyone tell me what kind of scars I have? and what treatments would be best? I've spoken to skin clinics and one suggested IPL (Blue) laser specifically for indented scarring...has anyone tried this or know about it? they said it would be more aggressive than pixel laser. I'm just scared of lasers though! another suggested going on a Obagi nu-derm system, and thought maybe dermaroller. I have had dermaroller 3 times last year but did not notice any improvement.....so don't know if I should try again.

The worst one for me is the one in between my eyebrows, it's the deepest and just in an obvious place Posted Image


Please can someone shed some experience and thoughts. I would be very grateful as this problem makes me so depressed.

Thanks for reading.

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#2 acnescar123

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Posted 20 November 2012 - 08:04 PM

If doing lasers - stick with fractional co2 lasers (re:pair, smartxide etc). You'll need multiple treatments - but they're the gold standard in treating acne scars. The other lasers are most likely a waste of money.

#3 Quirky Fox

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Posted 21 November 2012 - 02:55 AM

Hiya NewbieGirl! Welcome to the forums.

Firstly, I know how you feel but I can't stress enough how important it is to keep your chin up! There is hope and with patience and determination you will go far.

The scars on your cheeks are similar to what mine were before I started treatment. I'd class them as a mixture of mild to moderate boxcar and rolling scars. It might be the lighting you're under, but I can't see any ice-pick scars. Is that right?

The scars between your eyes look much deeper, I'd say moderately severe rolling scars. But this is just my personal take. :)

The way forward is with multi modality! Don't just think of one treatment option, combine multiple. I have tons of experience with Obagi products, the Fraxel Re:Store laser and the Dermaroller so am happy to answer any questions you have.

For your cheeks, an ablative laser is a good option. You may need multiple treatments but I would suggest looking into Fraxel Re:Pair or CO2. I had the Fraxel Re:Store (5 sessions) and if I could have my money back I would go back and have the Re:Pair. Downtime is significant though, around 2-4 weeks before you really feel like you're over it and lasers make your skin extremely sun sensitive. Yes, lasers are scary but the right laser in the right hands is magic.

After my 5 sessions of Fraxel Re:Store I only saw around a 30% improvement after all the micro swelling had gone. Better than nothing but not worth the thousands I paid for it (again I wish I had had the Re:Pair instead). I then waited a full year before starting my Dermaroller treatments. I've had three professional Dermaroller treatments and started seeing exciting results after the second session. You said you gave the Dermaroller a go, do you mind sharing your experience? What length were the needles, how long did you wait between sessions, did you do it at home or professionally and, most importantly, what brand/make of roller?

I'm no doctor but I wouldn't waste my money on IPL for acne scarring. It might improve your overall skin texture and pores but I doubt you'd see dramatic results with your scarring.

Between your eyes I say subcision and fillers! :D The reason the scars there are much deeper is that they are "bound/tethered down" to the deeper layers in the skin. A few rounds of subcision will raise those scars significantly and the use of Hyaluronic Acid based fillers would add to the improvement in the short and long term. Stay clear of silicone injections as they're way too risky.

I used Obagi products religiously while going through my Fraxel treatments (2010) and for the year where I didn't have any treatments done (2011). I was using the Clenziderm range and I would recommend the products to anyone. It wasn't cheap, but the good stuff never is. I had a cleanser, a toner, an acne serum and a sunscreen. I got my acne under control and the occasional big breakout (normally under my jaw) always cleared quickly. The only thing I didn't like is that the products had a very strong chemical smell. Since they're heavy in AHA's, which are good, I felt that it might have been a bit of overkill for my skin.

Since starting my Dermaroller treatments my technician convinced me to switch from Obagi to Dermaquest. I really love the Dermaquest range and I will be sticking with it now. It feels more natural and the products absorb a lot better for me. They're also the recommended products when using the Dermaroller so I'm confident I'm on the right track. :)

Before you start any treatments for scarring I strongly suggest getting your skin as healthy as you possibly can, to maximise the outcome of your treatments. If you're not sure where to start then go for a good sunscreen (every day, without fail!) and boost your intake of Vitamin C and Zinc.

I could waffle on for hours but I'll stop. Feel free to pick my brains any time!

#4 FruitBiscuits

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Posted 21 November 2012 - 07:56 AM

Between your eyes I say subcision and fillers! Posted Image The reason the scars there are much deeper is that they are "bound/tethered down" to the deeper layers in the skin. A few rounds of subcision will raise those scars significantly and the use of Hyaluronic Acid based fillers would add to the improvement in the short and long term. Stay clear of silicone injections as they're way too risky.


I agree with Quirky Fox. Sub should help your scars between your eyes. I would also combine with filler if I were you. I had my first filler/sub treatment back in July. This month, some of my scars came back. I see some improvements, but not enough...so I am going to another sub/filler soon!

Also I really want to improve my skin texture, so thinking about getting an ablative laser...! But I am so scared to get hyper-pigmentation..On top of that..., I am not sure how to tell...or hide from my boyfriend for 2-3 weeks...Posted Image He would definatly try to stop me lol

I also had Fraxel re:store, and yes, I want my money back, because I didn't see any improvement on my indented scars or enlarged pore! I also had IPL(I had a few times). I know several girls had the treatment, too. No improvement! It's mostly for sun damage and discoloration and NOT for indented scars or enlarged pores. It didn't help my indented scars at all..and I didn't see any improvement in my pore size! But it did help my discoloration a bit though...!

Good luck NewbieGirl25 Posted Image
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Posted Image

Edited by FruitsBiscuit, 21 November 2012 - 08:21 AM.


#5 NewbieGirl25

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Posted 22 November 2012 - 10:35 AM

Thank you both so much for your advice. It really means a lot that people actually replied as I was worried no one would!

Quirky Fox: Thank you for your very detailed and informative reply. I think it's great that you answer so well and give your own experiences.
In answers to your question about the dermaroller - I had it done professionally by a skin/beauty salon. I had three treatments about 8 weeks apart or so. They said it would help the redness as well as the indents but I didn't see any improvement. I was disappointed. I wasn't using any vitamin C creams etc at the time so could this make it not so effective? How are your treatments going? That's great that you are seeing improvements already, why do you think that is?

See my problem is that I have limited options with the subcision/some lasers due to my location. I'm in Scotland and unless I travelled (which I will as an alternative), dermaroller is more readily available, possibly fillers and I would have to research into fraxel. Do you think that I should start dermaroller again until the beginning of next year? As I wouldn't be starting more serious scar treatments until then due to no holidays from work left for downtime etc. Or could you recommend any topicals I should start? I have thought about Retin A as I have read it can help, however some people have said it made scars worse! ahhhhh, everything is so confusing.

I do have a multi-vitamin (A,C,E) that I've begun to start taking. Do you think that should be sufficient? Also, i'm using liz earle moisturiser and it doesn't contain an SPF however my make up does contain this....is that still okay to protect me from the sun?

Lastly, after all your treatments how are your scars looking now? do you feel more confident? I just want hope that mine can get better and I don't have to stress over them ALL the time.

Also thanks Fruit Biscuit for your input too! It seems subcision is the way to go...please keep us updated with your treatments.

Also Quirky Fox: You're right no ice pick scars. I've examined them a lot and I can't see any.

#6 Quirky Fox

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Posted 23 November 2012 - 03:31 AM

Posted Image Happy to share what I know! We're all in this battle together.

With your Dermaroller treatments it sounds like they were doing the right thing by you. Waiting 6-8 weeks in between treatments is required as that is how long it takes collagen to build completely (it goes through stages). Three treatments however really isn't enough. My technician has told me I will need a minimum of 6 sessions and can have more if needed. Do you know how long the needle length was? For collagen induction it should be 1.5mm. Anything less will not do anything for scarring as the needles don't penetrate deep enough into the layers of skin that are damaged.

Many medical professionals believe that you should be on a Vitamin A based product before undertaking Dermaroller treatments. I have to say that I was not using an A based product until a few weeks ago so it will be interesting to see how much better my 4th treatment is now that I've been using A for a while. Vitamin A thickens the deeper layers of skin and therefore is said to help maximise the results from a Dermaroller session. I've never heard of it causing scarring. It can make the top layer of your skin thin (as it speeds up skin turnover) but that shouldn't lead to scarring. The product I use is super strong, and since it is absorbed so quickly by my skin I have to combine it with another product before putting it on my face, otherwise I end up with dry, flaky (and sore) skin.

The thing about the Dermaroller is that it takes longer for it to work than say, Fraxel, as the Dermaroller is repairing more than just damaged skin tissue. It's also promoting blood flow to the skin, hair follicles to regenerate (as they don't grow in scar tissue) as well as improving our scars, wrinkles and redness. For me, Fraxel didn't give me the results I had hoped for but I did not have the fully ablative laser. I wasn't well educated when I went into those treatments. I don't regret having it done but I'm done with lasers now.

I love talking about skin care products. Posted Image I have tried so many and have only just now worked out what my skin needs. My skin is still acne-prone, I get a few blackheads here and there and during the day I can get a bit oily. I've managed to beat all of these things with this stuff:

Morning:

1. C-Lipoic Cleanser (DermaQuest): http://www.dermaques...Lipoic+Cleanser
2. Pat face dry
3. B Serum (DermaQuest): http://www.dermaques...vanced+B5+Serum
4. Vitamin C (DermaQuest): http://www.dermaques...tioxidant+Serum
5. Sunscreen! (DermaQuest): http://www.dermaques...otection+SPF+15

Because of the B Serum I don't need a moisturiser any more. Posted Image It seems like a lot of products to put on before make-up but they all absorb really quickly. I use mineral make up, so no clogging of pores etc and it's an extra layer of sun protection. As an awesome bonus, a friend got me into using something called "face blotting paper". It's been a life-saver on hot days where my face has gotten oily. You pat the paper on your face and it absorbs all the oil, taking away that icky shiny appearance and leaving your make up intact. The ones I buy come from Japan but you can get them on eBay. Best of all... it's cheap!

http://www.ebay.com....=item43afa0af8f

Night:

1. C-Lipoic Cleanser (DermaQuest): http://www.dermaques...Lipoic+Cleanser
2. Algea Facial Scrub (DermaQuest): http://www.dermaques...ea+Facial+Scrub
3. I cleanse again if I had been wearing make-up
4. Pat face dry
5. B Serum (DermaQuest): http://www.dermaques...vanced+B5+Serum
6. DermaClear (DermaQuest): This is for acne spots and not all over my face. http://www.dermaques...ucts/DermaClear
7. A2 Serum (DermaQuest) mixed with Ultra Clear Treatment Lotion (Ultraceuticals): http://dermaquest.co...e-care/a2-serum + http://www.ultraceut...otion.html#tab3

Again, a whole stack of things but I am so in love with the products that I can't help but rave about them. I'm in Australia so some of the DermaQuest products have different names, but they're the same inside the bottle. If it's all too much at this stage I would at least highly recommend these five things:

1. C-Lipoic Cleanser morning and night.
2. Algea Facial Scrub every second night.
3. A2 Serum or similar (ease into this though... maybe every third night to start. Your skin would need time to adapt as vitamin A products can be harsh at first).
4. Sunscreen! Sunscreen! Sunscreen! Posted Image
5. Zinc! You've got good intake of vitamin A, C & E but zinc is also essential for collagen formation and sun protection.

Lastly, to answer your questions. Before I started my treatment journey I was a mess. I never wanted to go anywhere, see anyone... date. No self esteem! Now I can finally look back on where I was with pride knowing that I didn't give up and that there are only even better times ahead. I used to close my eyes when near a mirror and couldn't put make-up on for fear of catching a glimpse of my hideous skin. When I did stuff up and see myself my heart used to skip a beat in fear! Now I am looking at my face more and more. It's been a long, long time (5 years) but it's gone quickly and I'm happier!

After my first Dermarolling session I felt that maybe I had wasted my money but after the second treatment I got excited. Around the 4th week after my second treatment I started to see my deeper scars filling in and my face overall looking more plump. I have a rolling scar on my left cheek which is similar to the scars between your eyes. This is where I have been seeing the most improvement as it fills in. I'm also finding my skin is less oily and that my pores are much smaller... oh, and a frown line on my forehead vanished! Bonus, hehe.

I'm sorry that I tend to go on and on and on. I am just very passionate about my treatment journey and if I can help others along the way then that's a double win for me. Just remember that there IS hope and you CAN get there, just takes determination. My only firm advice is not to take shortcuts or fall into gimmicks. Research the heck out of everything before you make a decision.

A good starting place is this link: http://www.scribd.co.../Acne-and-Scars

xx

Edited by Quirky Fox, 23 November 2012 - 03:44 AM.


#7 *Inspired*

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Posted 23 November 2012 - 04:03 AM

As a suggestion, if you try dermarolling, you might want to stop Vitamin E or Fish Oil a few days prior to treatment. I just know that doctors recommend it prior to laser treatment because both are blood thinners. For optimal results and proper healing, you don't want a blood thinner in your system prior to treatment.

Edited by *Inspired*, 09 December 2012 - 05:42 PM.


#8 Relentless Rasta

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Posted 23 November 2012 - 06:27 AM


Between your eyes I say subcision and fillers! Posted Image The reason the scars there are much deeper is that they are "bound/tethered down" to the deeper layers in the skin. A few rounds of subcision will raise those scars significantly and the use of Hyaluronic Acid based fillers would add to the improvement in the short and long term. Stay clear of silicone injections as they're way too risky.


I agree with Quirky Fox. Sub should help your scars between your eyes. I would also combine with filler if I were you. I had my first filler/sub treatment back in July. This month, some of my scars came back. I see some improvements, but not enough...so I am going to another sub/filler soon!

Also I really want to improve my skin texture, so thinking about getting an ablative laser...! But I am so scared to get hyper-pigmentation..On top of that..., I am not sure how to tell...or hide from my boyfriend for 2-3 weeks...Posted Image He would definatly try to stop me lol

I also had Fraxel re:store, and yes, I want my money back, because I didn't see any improvement on my indented scars or enlarged pore! I also had IPL(I had a few times). I know several girls had the treatment, too. No improvement! It's mostly for sun damage and discoloration and NOT for indented scars or enlarged pores. It didn't help my indented scars at all..and I didn't see any improvement in my pore size! But it did help my discoloration a bit though...!

Good luck NewbieGirl25 Posted Image
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Posted Image

I had ipl a few times and was left with indentations from it..whether it was on too high of a setting I don't know for sure but it has only added more scars to my face.

#9 Quirky Fox

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Posted 23 November 2012 - 07:31 AM

As a suggestion, if you try dermarolling, you might want to stop Vitamin E or Fish Oil a few days prior to treatment. I just know that doctors recommend it prior to laser treatment because both our blood thinners. For optimal results and proper healing, you don't want a blood thinner in your system prior to treatment.


That's a good point, I hadn't thought of that.

#10 NewbieGirl25

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Posted 24 November 2012 - 07:51 PM

Quirky Fox: My treatments were performed with a 1.5mm roller. I'm now thinking that I should maybe start them again and do perhaps 3-4 treatments whilst loading on vitamin C etc to boost healing. I think I will try my doctor as she has her own beauty clinic and I would trust her more than the salon that did it before. Do you think dermaroller could help the deep linear scar between my eyes? do you know why it is they form in a line? it's so strange. That area must be prone to scarring as that seems to be my worst ones and I can't really remember even having bad breakouts there and I certainly wasn't a picker at all!

Do you still have redness in your skin from the acne? as I do and i'm wondering if dermaroller/laser will lighten that? from your experience.

Thanks *Inspired*, for the advice. Duly noted! I wouldn't have thought of that.

I looked up your Dermaquest products and they are available online in the UK. Some look expensive but I am tempted to maybe try. I don't know what to do now though,
Obagi nu-derm first then dermaroller or just straight into dermaroller?? any thoughts?

#11 Michelle Reece

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Posted 24 November 2012 - 08:26 PM

Fraxel re:pair is a CO2 ablative laser, which removes the top layer of skin. There are more side effects to this later and a long downtime (a period of a few weeks, sometimes longer for fairer skin) but the results are dramatic and can be seen within two months. Most of the time, patients only need one treatment.

Fraxel re:store is a non-ablative laser, which means it doesn't penetrate the skin. While the results aren't as "stunning" as CO2 lasers and you need more treatments over several months, there is very little downtime (a few days of some redness).

If you have a busy work and/or schooling schedule where you can't "recover", the dermatologist may recommend Fraxel re:store. A dermatologist may also recommend fillers and perhaps chemical peels for other discoloration or acne maintenance, but lasers are the best for pitted scars. Blue-light IPL is best for acne, while an IPL photofacial is best for discolorations and generally uneven skin tone.

Keep in mind that a dermatologist or plastic surgeon should be operating the lasers -- do not go to medispas.

Hope this helps!

#12 Quirky Fox

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Posted 25 November 2012 - 03:17 AM

Quirky Fox: My treatments were performed with a 1.5mm roller. I'm now thinking that I should maybe start them again and do perhaps 3-4 treatments whilst loading on vitamin C etc to boost healing. I think I will try my doctor as she has her own beauty clinic and I would trust her more than the salon that did it before. Do you think dermaroller could help the deep linear scar between my eyes? do you know why it is they form in a line? it's so strange. That area must be prone to scarring as that seems to be my worst ones and I can't really remember even having bad breakouts there and I certainly wasn't a picker at all!

Do you still have redness in your skin from the acne? as I do and i'm wondering if dermaroller/laser will lighten that? from your experience.

Thanks *Inspired*, for the advice. Duly noted! I wouldn't have thought of that.

I looked up your Dermaquest products and they are available online in the UK. Some look expensive but I am tempted to maybe try. I don't know what to do now though,
Obagi nu-derm first then dermaroller or just straight into dermaroller?? any thoughts?



Yay! Glad that your doctor is using the 1.5mm. The scars between your eyes are similar to the scar that troubles me the most on my left cheek. Strangely this is where I've been seeing the biggest improvement since Dermarolling. :) It's taking time though. In that link that I posted to you it mentions the following about the Dermaroller. It talks about the similarities that the device can have with the subcision procedure:

"Because the needles are set in a roller, every needle initially penetrates at an angle and then goes deeper as the roller turns.Finally, the needle is extracted at the converse angle; therefore,the tracts are curved, reflecting the path of the needle as it rollsinto and then out of the skin, for about 1.3 mm into the dermis."

Whilst subcision alone is generally better/faster, the Dermaroller will actually break up the tethered scar tissue to a certain degree and will help to raise the scar. :) The scars look long like that because they're deeper and are tethered down. They tend to merge with scar tissue close-by thus making a rolling scar longer. My scar is getting better every month but I am still considering subcision if I'm not completely satisfied after my next three Dermaroller sessions.

I say go for it! Jump on the Obagi nu-derm (make sure there is both an A based product and a C based product in there somewhere) give it maybe a fortnight of good use then try the Dermaroller again. What have you got to lose? Oh that's right, scars! Haha!

xx

#13 NewbieGirl25

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Posted 25 November 2012 - 05:55 PM

I really appreciate your responses and the link you sent was so informative, thank you!

Okay i'm going to contact my doctor about the obagi nu-derm. If I remember correctly i'm sure she mentioned that you have to use it for 6 weeks to get the full effect? so do you think I should wait until this is completed and then start the dermaroller?
,
Oh, and do you have any before/after photos of your skin that you would be willing to post? it's understandable if you don't want to. x x