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Did Accutane, Have Scars, Need Advice (Pics Inside)


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#1 siodyne

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Posted 18 May 2013 - 04:48 AM

Hi I'm a 20 y.o. Asian male, suffered from pretty bad acne throughout my teens.  I finally started accutane around last Sept and my course ended in March '13.  Been on Retin-A since then.  So now it's been almost 3 months and its apparent that I have some mild or moderate scarring on my cheeks (look at my pic, I don't know how bad it is).  Its probably of boxcar and rolling type.

 

After reading around I'm really confused as to what kind of scar treatments are viable.  My derm said that subcision isn't suitable for me, and he recommended me to go for 3 rounds of a fractional erbium laser instead, saying that his patients have gotten an average 50% improvement, but from what I've read on these forums lasers are pretty ineffective and may have bad side effects.

 

So, I want to ask, are lasers, especially the weaker ones like fractional erbium, good for improving scarring or overall skin tone?  I've seen some before and after pics but they seem too good to be true.  Money is not an issue for me at all, but I do want to get rid of the scars as soon as possible, so should I look at something else?

 

Below is a picture of my scars taken under a light.  What do you think?

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#2 leelowe1

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Posted 18 May 2013 - 05:09 AM

I think you have amazing skin and you should leave it alone.  It's not very obvious in pictures but you may see something different in real life.



#3 blahblah82

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Posted 18 May 2013 - 07:43 AM

Dude, I'd pay good money to have your skin.  Seriously, it's not even remotely bad.  Your doctor gave you good advice, you definitely do not need subcision.  Lasers on Asian skin can have side effects, mainly hyperpigmentation.  Nothing substitutes doing thorough research, especially when it comes to your face.  If after you weigh the risks and are prepared for some down time, then maybe you can pursue some treatment.  

 

ALWAYS do a spot test on an inconspicuous area like near your ear / sideburns to see how your skin will react to the lasers.  A lot of people on here have come out looking worse after doing a procedure, so tread lightly.



#4 LewisS

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Posted 18 May 2013 - 08:31 AM

Your skin looks fantastic. Your *slight* scarring looks a lot similar to mine. Leave them alone I'd say, they will improve over time. 



#5 siodyne

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Posted 18 May 2013 - 09:11 AM

Thanks for all the replies.  It looks the worst when the sun hits from the sides and all the indents become very clear.  Also I feel that the texture and hyperpigmentation of my skin looks much worse in real life.  Ahhhhh well.

 

@blahblah82 - I'll remember to do a spot test first, thanks.

 

@LewisS - Did yours improve over time?  How long did it take?  I've been on Retin-A for 3 months since my Accutane course ended and I'm not sure if its helping.



#6 jsnjeppe

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Posted 18 May 2013 - 09:35 AM

your scarring is very light leave it alone i would say :)



#7 Ryouta

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Posted 19 May 2013 - 02:42 AM

i'd empty out my bank account to have your skin lol



#8 siodyne

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Posted 19 May 2013 - 03:49 AM

Maybe the indents are not very visible in the photos because I took them under a light.  When I look in the mirror and the light hits from the sides it looks so terrible that I cringe every time.  I also have large pores, hyperpigmentation and oily skin.  I am tired of having bad skin all my life and I really hope for a major improvement within the next 2 years.

 

I did plenty of research on the laser that my derm has recommended for me.  It is a non-ablative fractional erbium glass laser that was developed for Asian skin.  I read around 10 medical publications regarding this laser, and most people get above 25% improvement or even 50% after completing a series of treatments, and there is very low risk of hyperpigmentation and other side effects.

 

This obviously contrasts with what everyone on this forum says - that non-ablative lasers do nothing for scars, so I'm going to interrogate my derm about this on my next appointment and ask for some before/after shots.  If it looks like the patients have made improvements, I'll probably go along with it.  Sadly I'm at the point where I would be very willing to spend $3000 for just a chance at a 25% improvement.



#9 blahblah82

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Posted 19 May 2013 - 10:33 PM

Well regardless, you are going to have to wait a year at the minimum before pursuing any treatments since you only recently completed Accutane.  I've done accutane myself, and while it completely cured my severe acne, it has definitely affected my healing abilities following several procedures.

 

Which laser does this derm use?  Remember that derms are running a business, and oftentimes recommend the laser they have in their office.  They're trying to recoup the cost of a laser which is easily more than $100K.  There are folks here who have done much more aggressive treatments and are lucky if they got anything near 50% improvement, which makes your derm's claim a little far fetched.



#10 siodyne

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Posted 19 May 2013 - 11:12 PM

My derm told me I could start getting treatments after 6 months actually.  My skin is reverting back to its normal, oily state right now but I do feel that there is something different about it.  It does seem to be slightly thinner and more sensitive.  I'm not sure if this is due to accutane or being on Retin-A, probably both.

 

He has a few lasers, and the one he recommended to me at first was the Lutronic Mosaic laser.  Its not very common and the closest thing to it is probably Fraxel Restore.  He told me that 3 sessions would give me 25-50% reduction in scars and other improvements to my complexion such as reduced pore size and sun damage.  The scar improvement part is probably a lie, but looking at before/after pics, the laser really does seem to brighten the complexion and get rid of hyperpigmentation/large pores so I may just go for it.

 

He also has the MiXto laser of which I've read a few success stories in this forum and elsewhere.  It seems to give pretty stable results each time, around 20%, so it looks very attractive to me.  I will evaluate how my skin responds to the non-ablative laser first, and if its positive, I'm planning to go for 3 sessions of MiXto.  Does anyone know if the MiXto is safer for Asian skin compared to other ablative lasers like Fraxel Repair?



#11 justmeuk

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Posted 20 May 2013 - 04:18 AM

Please be careful, i started doing scar treatments when i was six months off of accutane and my skin actually got worse during that time.  Accuatane effects your healing abilities and skin can take many months to go back to normal.  If i had your skin i wouldn't be doing anything as your scars are virtually non existent and you risk doing more harm than good.  Your skin looks fantastic and most people on this board would love to have skin like yours, just be grateful for what you have and don't seek perfection. 



#12 siodyne

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Posted 20 May 2013 - 05:05 AM

Thank you for your advice, and I'm sorry to hear that.  May I know what treatment you did at the 6 month mark that made your skin worse?  I am very concerned about damaging my skin as well which is why I'm opting for a non-ablative erbium laser first before considering other more aggressive treatments.

 

My skin does look better in the pictures but in real life it is not like that.  Maybe my scars aren't very deep (not ice-pick type) but rather wide and numerous.  When I went to get a haircut the other day the overhead lamp made every single indent very clear, and I had to stare at my reflection for 20 minutes.

 

Everybody is their own worst critic.  I am not seeking perfection, just hoping for maybe 50% improvement to my scarring over the next year or two along with other improvements to my skin (hyperpigmentation, pore size, etc).  At the moment this looks very bleak mainly because I've been on accutane which limits my treatment options, but hopefully it works out for all of us at the end.



#13 justmeuk

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Posted 20 May 2013 - 12:25 PM

Thank you for your advice, and I'm sorry to hear that.  May I know what treatment you did at the 6 month mark that made your skin worse?  I am very concerned about damaging my skin as well which is why I'm opting for a non-ablative erbium laser first before considering other more aggressive treatments.

 

My skin does look better in the pictures but in real life it is not like that.  Maybe my scars aren't very deep (not ice-pick type) but rather wide and numerous.  When I went to get a haircut the other day the overhead lamp made every single indent very clear, and I had to stare at my reflection for 20 minutes.

 

Everybody is their own worst critic.  I am not seeking perfection, just hoping for maybe 50% improvement to my scarring over the next year or two along with other improvements to my skin (hyperpigmentation, pore size, etc).  At the moment this looks very bleak mainly because I've been on accutane which limits my treatment options, but hopefully it works out for all of us at the end.

 

I did dermarolling and my skin got worse, i would say by about 50%, i had new scars appear and the ones i already had deepened too.  I don't know if it was the rolling that caused it or if it was caused by the accutane impairing healing which can happen.  In the UK the recommendation is to only wait 6 months after accutane whereas in the states i believe they advise 12 months which is probably much safer.  If i could go back in time i would have waited.  



#14 AghhNe

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Posted 20 May 2013 - 12:55 PM

Hi I'm a 20 y.o. Asian male, suffered from pretty bad acne throughout my teens.  I finally started accutane around last Sept and my course ended in March '13.  Been on Retin-A since then.  So now it's been almost 3 months and its apparent that I have some mild or moderate scarring on my cheeks (look at my pic, I don't know how bad it is).  Its probably of boxcar and rolling type.
 
After reading around I'm really confused as to what kind of scar treatments are viable.  My derm said that subcision isn't suitable for me, and he recommended me to go for 3 rounds of a fractional erbium laser instead, saying that his patients have gotten an average 50% improvement, but from what I've read on these forums lasers are pretty ineffective and may have bad side effects.
 
So, I want to ask, are lasers, especially the weaker ones like fractional erbium, good for improving scarring or overall skin tone?  I've seen some before and after pics but they seem too good to be true.  Money is not an issue for me at all, but I do want to get rid of the scars as soon as possible, so should I look at something else?
 
Below is a picture of my scars taken under a light.  What do you think?

Ok. First of all, i believe the lighting in your pictures doesn't show your scarring too much. I believe i have the same scars as you and i've posted a picture of my skin and it looks much worse than yours. Mine looked much worse because of the lighting and the hyperpigmentation. I am a 16 year old Southeast asian(tan skin). I mentioned south because those from southeast asia usually have light brown skin to dark brown since we are nearer to the equator(no winter). Are you from east asia or southeast? I do believe southeasterns are more vulnerable to hyperpigmentation. I suggest you let your face heal. Leave it for 1 year. Your's aren't deep so there's a chance it may fill in plus your scars are still fresh. If you do notice some filling in, would you mind updating us(me)?


Hi I'm a 20 y.o. Asian male, suffered from pretty bad acne throughout my teens.  I finally started accutane around last Sept and my course ended in March '13.  Been on Retin-A since then.  So now it's been almost 3 months and its apparent that I have some mild or moderate scarring on my cheeks (look at my pic, I don't know how bad it is).  Its probably of boxcar and rolling type.
 
After reading around I'm really confused as to what kind of scar treatments are viable.  My derm said that subcision isn't suitable for me, and he recommended me to go for 3 rounds of a fractional erbium laser instead, saying that his patients have gotten an average 50% improvement, but from what I've read on these forums lasers are pretty ineffective and may have bad side effects.
 
So, I want to ask, are lasers, especially the weaker ones like fractional erbium, good for improving scarring or overall skin tone?  I've seen some before and after pics but they seem too good to be true.  Money is not an issue for me at all, but I do want to get rid of the scars as soon as possible, so should I look at something else?
 
Below is a picture of my scars taken under a light.  What do you think?

Ok. First of all, i believe the lighting in your pictures doesn't show your scarring too much. I believe i have the same scars as you and i've posted a picture of my skin and it looks much worse than yours. Mine looked much worse because of the lighting and the hyperpigmentation. I am a 16 year old Southeast asian. I mentioned south because those from southeast asia usually have light brown skin to dark brown since we are nearer to the equator(no winter). Are you from east asia or southeast? I do believe southeasterns are more vulnerable to hyperpigmentation. I suggest you let your face heal. Leave it for 1 year. Your's aren't deep so there's a chance it may fill in plus your scars are still fresh. If you do notice some filling in, would you mind updating us(me)?
Btw, i deleted my pics cause it was hard to look at it. :P

Edited by AghhNe, 20 May 2013 - 12:56 PM.


#15 siodyne

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Posted 20 May 2013 - 04:00 PM

@justmeuk - That's very unfortunate :(.  I'll definitely hold off any ablative procedures until my skin is back to normal, even if it means waiting a year.  Thank you for the information.

 

@AghhNe - I'm ethnic Chinese, not South-east Asian (which I'm assuming refers to Filipino, Vietnamese etc.).  Thanks for the advice, I'll definitely update if my scars improve naturally.  I don't think they have changed in the 3 months that I've been off Accutane, however, just less hyperpigmentation.



#16 AghhNe

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Posted 21 May 2013 - 09:03 PM

@justmeuk - That's very unfortunate :(.  I'll definitely hold off any ablative procedures until my skin is back to normal, even if it means waiting a year.  Thank you for the information.
 
@AghhNe - I'm ethnic Chinese, not South-east Asian (which I'm assuming refers to Filipino, Vietnamese etc.).  Thanks for the advice, I'll definitely update if my scars improve naturally.  I don't think they have changed in the 3 months that I've been off Accutane, however, just less hyperpigmentation.

@justmeuk - That's very unfortunate :(.  I'll definitely hold off any ablative procedures until my skin is back to normal, even if it means waiting a year.  Thank you for the information.
 
@AghhNe - I'm ethnic Chinese, not South-east Asian (which I'm assuming refers to Filipino, Vietnamese etc.).  Thanks for the advice, I'll definitely update if my scars improve naturally.  I don't think they have changed in the 3 months that I've been off Accutane, however, just less hyperpigmentation.


I woudn't be suprised if it did not change in 3 months cause you just got off from accutane. I think they slow down your healing from what i've heard. Theres this lady who gave me hope. Her name is tracy in this forums. Her acne scars filled in (ice picks and some boxscars) in a year or two. She said taking 1000mg of vitamin c a day would help. Your skin looks great btw. Good luck in your journey.

#17 siodyne

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Posted 22 May 2013 - 04:53 AM

@justmeuk - That's very unfortunate sad.png.  I'll definitely hold off any ablative procedures until my skin is back to normal, even if it means waiting a year.  Thank you for the information.
 
@AghhNe - I'm ethnic Chinese, not South-east Asian (which I'm assuming refers to Filipino, Vietnamese etc.).  Thanks for the advice, I'll definitely update if my scars improve naturally.  I don't think they have changed in the 3 months that I've been off Accutane, however, just less hyperpigmentation.

>>@justmeuk - That's very unfortunate sad.png.  I'll definitely hold off any ablative procedures until my skin is back to normal, even if it means waiting a year.  Thank you for the information.
 
@AghhNe - I'm ethnic Chinese, not South-east Asian (which I'm assuming refers to Filipino, Vietnamese etc.).  Thanks for the advice, I'll definitely update if my scars improve naturally.  I don't think they have changed in the 3 months that I've been off Accutane, however, just less hyperpigmentation.


I woudn't be suprised if it did not change in 3 months cause you just got off from accutane. I think they slow down your healing from what i've heard. Theres this lady who gave me hope. Her name is tracy in this forums. Her acne scars filled in (ice picks and some boxscars) in a year or two. She said taking 1000mg of vitamin c a day would help. Your skin looks great btw. Good luck in your journey.

 

Thanks.  If they fill in by themselves then it will be great, but I don't think its likely.  I won't do anything drastic in the meantime but if there aren't any changes by the 1 year mark maybe I'll look into ablative lasers again.  

 

I still feel the effects of Accutane in my skin and body.  My lips and mouth become dry very easily, and although my skin is oily again it has become prone to flushing and redness.  How long will it take for this accursed drug to get filtered out of my blood!?


Edited by siodyne, 22 May 2013 - 04:54 AM.


#18 ughhhhh

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Posted 22 May 2013 - 04:42 PM

Thank you for your advice, and I'm sorry to hear that.  May I know what treatment you did at the 6 month mark that made your skin worse?  I am very concerned about damaging my skin as well which is why I'm opting for a non-ablative erbium laser first before considering other more aggressive treatments.

 

My skin does look better in the pictures but in real life it is not like that.  Maybe my scars aren't very deep (not ice-pick type) but rather wide and numerous.  When I went to get a haircut the other day the overhead lamp made every single indent very clear, and I had to stare at my reflection for 20 minutes.

 

Everybody is their own worst critic.  I am not seeking perfection, just hoping for maybe 50% improvement to my scarring over the next year or two along with other improvements to my skin (hyperpigmentation, pore size, etc).  At the moment this looks very bleak mainly because I've been on accutane which limits my treatment options, but hopefully it works out for all of us at the end.

 

I did dermarolling and my skin got worse, i would say by about 50%, i had new scars appear and the ones i already had deepened too.  I don't know if it was the rolling that caused it or if it was caused by the accutane impairing healing which can happen.  In the UK the recommendation is to only wait 6 months after accutane whereas in the states i believe they advise 12 months which is probably much safer.  If i could go back in time i would have waited.  

ugh really? That was my plan 6 months from now, dermaroll until I am able to get laser. Did you notice a difference in your skin? Did you think you were back to normal? Were you dry or did you think you got your oil back? I read that once your oil is back so is your ability to heal but obviously the internet is full of lies.



#19 justmeuk

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Posted 23 May 2013 - 02:41 AM

 

Thank you for your advice, and I'm sorry to hear that.  May I know what treatment you did at the 6 month mark that made your skin worse?  I am very concerned about damaging my skin as well which is why I'm opting for a non-ablative erbium laser first before considering other more aggressive treatments.

 

My skin does look better in the pictures but in real life it is not like that.  Maybe my scars aren't very deep (not ice-pick type) but rather wide and numerous.  When I went to get a haircut the other day the overhead lamp made every single indent very clear, and I had to stare at my reflection for 20 minutes.

 

Everybody is their own worst critic.  I am not seeking perfection, just hoping for maybe 50% improvement to my scarring over the next year or two along with other improvements to my skin (hyperpigmentation, pore size, etc).  At the moment this looks very bleak mainly because I've been on accutane which limits my treatment options, but hopefully it works out for all of us at the end.

 

I did dermarolling and my skin got worse, i would say by about 50%, i had new scars appear and the ones i already had deepened too.  I don't know if it was the rolling that caused it or if it was caused by the accutane impairing healing which can happen.  In the UK the recommendation is to only wait 6 months after accutane whereas in the states i believe they advise 12 months which is probably much safer.  If i could go back in time i would have waited.  

ugh really? That was my plan 6 months from now, dermaroll until I am able to get laser. Did you notice a difference in your skin? Did you think you were back to normal? Were you dry or did you think you got your oil back? I read that once your oil is back so is your ability to heal but obviously the internet is full of lies.

My oil definitately came back, it was back a couple of months after accutane.  I think for most people it's probably fine to proceed once your oil comes back and i think my case is unusual but there are a few other people that have made things worse like myself. 



#20 siodyne

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Posted 23 May 2013 - 03:18 AM

 

Thank you for your advice, and I'm sorry to hear that.  May I know what treatment you did at the 6 month mark that made your skin worse?  I am very concerned about damaging my skin as well which is why I'm opting for a non-ablative erbium laser first before considering other more aggressive treatments.

 

My skin does look better in the pictures but in real life it is not like that.  Maybe my scars aren't very deep (not ice-pick type) but rather wide and numerous.  When I went to get a haircut the other day the overhead lamp made every single indent very clear, and I had to stare at my reflection for 20 minutes.

 

Everybody is their own worst critic.  I am not seeking perfection, just hoping for maybe 50% improvement to my scarring over the next year or two along with other improvements to my skin (hyperpigmentation, pore size, etc).  At the moment this looks very bleak mainly because I've been on accutane which limits my treatment options, but hopefully it works out for all of us at the end.

 

I did dermarolling and my skin got worse, i would say by about 50%, i had new scars appear and the ones i already had deepened too.  I don't know if it was the rolling that caused it or if it was caused by the accutane impairing healing which can happen.  In the UK the recommendation is to only wait 6 months after accutane whereas in the states i believe they advise 12 months which is probably much safer.  If i could go back in time i would have waited.  

ugh really? That was my plan 6 months from now, dermaroll until I am able to get laser. Did you notice a difference in your skin? Did you think you were back to normal? Were you dry or did you think you got your oil back? I read that once your oil is back so is your ability to heal but obviously the internet is full of lies.

 

Well I talked to my dermatologist and he explained the 6 month wait after Accutane to me.  There were a few cases where patients had a full ablative laser session (note that this is full, not fractional) done while they were in the middle of an Accutane course and their healing was compromised.  So this obviously led to panic and lawsuits and after that doctors decided it was safer to wait for a period of time before doing any procedures.

 

According to him Accutane inhibits the sebaceous glands, which in turn affects skin formation.  If your skin is oily again, this may mean that your skin is able to renew itself again.  He also told me that he has personally performed fractional lasers on patients who were still on Accutane because their skin was still producing enough oil, and it hasn't led to any complications.  It might sound a bit unprofessional considering how everyone else waits for 6 months but he is one of the most reputable and experienced senior derms in my city, so he must have his reasons.

 

But of course when it comes to such matters it is better to be 100% safe.