Hi guys, I haven’t been here in a while but some of the veterans might remember me. I joined this site back in 2009 and I promised myself if I ever managed to fix my acne scars I would come back and document my journey in case it will help anyone else. So this is me fulfilling my moral obligation. I don’t know what will help and what won’t so I’m just going to detail everything i've learned over the years.
In case you don’t want to read through this entire thread these are the treatments I did in a nutshell –
Chemical peels (Vi Peel)
And now details. This will be a pretty long thread so i'll try and structure it so it's easy to read.
Type of scarring
My scars were pretty unsightly. I had a bunch of giant boxcar scars on the left side of my face with jagged edges that just looked awful. They were about medium depth and very wide. I also had seborrheic dermatitis on the same area which made them look twice as bad. Also hyperpigmentation. Basically everything that can make your skin look ugly, I had a combination of all of them. I didn’t however have ice pick scars so if that’s your ailment then this thread may not be relevant to you.
Having said all that, it’s very important to identify your skin type and make a conscious judgment about how your skin will react to a particular treatment before doing it. Don’t go with what a doctor tells you if your instinct tells you otherwise. You know your own skin better than anyone else. Just because someone else has had success with a certain protocol doesn’t mean it’s going to work for you.
I’m Middle Eastern/Bengali so I would say I have Fitzpatrick Skin Type IV. So if you’re any darker than me you will have to take extra precautions. I would also classify my skin as extremely sensitive, I can’t really use any moisturizer without my skin clogging up and getting red and irritated.
My journey started with chemical peels. At first I was very reluctant to try anything since I have Asian skin which is more prone to hyperpigmentation, but then I heard about a new supposedly revolutionary peel called the ‘Vi Peel’ specifically tailored for darker skin. I had mixed results with this, looking back I think I was almost fooling myself that the results were positive. There were some slight improvements in texture but it also seemed to uncover some very old scarring making my boxcar scars significantly more visible. It also gave my skin a shiny plastic look a few months down the line. Overall I would not recommend chemical peels. Though it didn’t do any lasting damage as it was quite a mild peel, if I could do it all over again…I wouldn’t. I would’ve used microneedling from the very beginning.
I’m strictly against any treatment that causes surface damage unless absolutely necessary. As I’ll explain later on, the beauty of treatments such as microneedling is that the damage is vertical which maintains the structure of the skin. The chances of scarring are significantly increased when there is wide surface damage.
Microneedling was a revelation to me from the very beginning. I had read about it here and there but didn’t consider it seriously until I read testimonies from Lamar and a few others. I started with a 0.5mm dermaroller and saw positive results from the beginning. I quickly shifted to dermastamp after the first treatment. I find the dermaroller awkward to use, it’s hard to apply the correct amount of pressure and the needles are going in at an angle which can cause unwanted damage. It’s also horrible for targeting specific scars.
1.5mm seems to be the most popular choice here for scarring which I agree with, but only for the fleshy parts of your cheek. Anywhere else and it’s too long and can cause complications. One thing you must do when choosing your needle length is use your common sense. Touch your face and feel where the skin is thicker/thinner. For example, forehead skin tends to be very thin, I wouldn’t use anything above 1.0mm max. I used a 1.5mm dermaroller on a small section of my forehead during the trial and error phase and had hyperpigmentation there for months. Don’t needlessly use long needles if it’s not required.
To give you a clearer understanding of what I’m talking about here are the needle lengths I used when dermastamping –
Forehead – 0.5mm
Temple/bony areas/chin – 1.0mm
Fleshy part of cheeks – 1.5mm
Even more important than needle length is needle diameter. If the needles are too thick you are risking additional damage. Make sure they are 0.3mm thick at the absolute maximum. 0.15mm to 0.25mm is what I go for. This goes back to what I was talking about with the chemical peels. We want controlled vertical damage, horizontal damage is what generally causes scarring.
Hygiene was something that I thought a lot about as I was paranoid about getting a skin infection. I ended up delaying my first treatment for a while so I could come up with the right protocol to wash the needles after the treatment. Looking back now that was pretty stupid. Dermastamps cost around $15 if I remember correctly, so I decided to just buy a new stamp for each treatment. If you’re that cheap that you want to save $15 at the risk of infection and bent needles, I don’t know what to tell you.
For cleansing your skin prior to the treatment I recommend buying 70% Isopropyl Alcohol wipes and also Saline wipes. So wipe the skin with the alcohol wipes first to kill off any bacteria, then use the saline wipes. You probably don’t want to needle with the alcohol still on your skin.
Topicals and LED’s
First of all let’s get LED’s out of the way. I’ve never done a treatment without LED’s so can’t really say whether they genuinely help. But I like to leave no stone unturned. And the science behind it also makes sense. I started out using the red/infrared LED (660nm/880nm) for 5 minutes followed by the yellow LED (590nm) also for 5 minutes. I’ve since phased out the yellow led and not noticed any difference. I keep the red/infrared just in case.
Now let’s move on to topicals. I’ve used a lot of topicals and I mean a LOT. Everything from Korean growth factor serums to mesotherapy vitamin cocktails. My favourites were –
Dermaheal Stem C’rum (very expensive)
Amino-plex wound healing spray
I would use these (one or the other) during the actual treatment to take advantage of the holes created in the skin. Both of these encourage the growth of new tissue and speed up wound healing. However I wouldn’t say these are mandatory, more like icing on the cake. What is mandatory is using a moisturizer. You need to keep the skin moisturized for at least a few days following the treatment, as this will facilitate healing. My favourites are -
Mesoestetic Post-Laser Cream
Terproline Professional is probably more potent but Post-Laser Cream just feels so smooth on the skin. It’s one of the few topicals I’ve used that doesn’t irritate my skin whatsoever. Terproline feels a little clogging.
Having said all that i've been using home made Platelet Rich Plasma for the past year (applied during treatments). I hire a phlebotomist and make it myself using a centrifuge. This is my favourite topical to use but I understand its unrealistic to recommend it unless you're having it done in a clinic. For the moisturizer I’m still using the Post-Laser Cream.
If your head is spinning from all the things I’ve named then don’t worry. I got the bulk of my results in the beginning using just Terproline Professional and LED’s. So if you’re just starting out keep it simple. Buy a dermastamp, a moisturizer and a red/infrared led and get started. Over time you will naturally evolve to using other things if you feel they are needed.
This is something that a lot of people neglect. They become so preoccupied with fixing their indents that they forget about their general skin tone which is just as important when it comes to aesthetically pleasing skin. I remember looking at celebrities with acne scars like Brad Pitt and thinking how does he get away with it? Well it’s usually because their skin tone is still quite even, it makes the indents far less noticeable. So keep that in mind when treating your scars. Use safe but potent topicals to improve or get rid of any hyperpigmentation. A few that I like –
Fusion Mesotherapy Radiance
The second I’ve bought but haven’t tried yet, but the ingredients list looks good. Take advantage of the fact that absorption of topicals is increased ten fold after needling by using the right products. Even skin tone makes a world of difference.
I’d say your overall diet is the most important thing, but here are some supplements that I’ve taken and liked over the years.
Vitamin C – absolutely mandatory. I take 500mg once in the morning and once at night post treatment, either in the form of a pill or a Berocca tablet.
Zinc – important for wound healing, even more important if you’re a guy. I try and take 15mg a day.
MSM – I take one teaspoon of Doctor’s Best MSM Powder a day. I noticed my hair growing thicker and faster when I take this regularly, so it must be good for the skin. I haven’t been taking it lately however I’m planning on starting again.
Wellman’s Skin Technology – specifically made for maintaining healthy skin. All in one, definitely recommended.
To keep things simple, start off with just Vitamin C and Skin Technology/multi vitamin. Those are the main ones.
Protein – this one isn’t really mentioned by people but it’s extremely important. I once did a treatment after an extreme diet with very little protein and experienced delayed wound healing as a result. Since then I’ve always made sure I’m getting a good amount of protein in me.
As I said, general diet is the most important thing for building a healthy immune system which will enhance your results. You want a balanced diet consisting mainly of whole foods.
If using a 1.5mm I would recommend every 6 weeks at most, 8 weeks is optimal. Also take into consideration your age. I started needling around 22 years old, so consider your healing ability.
Also of importance is how thorough you are, don’t be so gung ho for your first treatment, my first few treatments were all about watching and observing. I started out practicing on my leg, then only on my forehead. By the time I did a full face treatment I was fully prepared. You want to get nice even coverage, don’t keep going until your skin is raw and bleeding excessively. Start off slowly, the last thing you want is additional damage.
After using the dermastamp for about 5 treatments I then purchased a Dermapen. This is basically the same thing, it’s just quicker and easier to use. I would only buy it if money is no object, otherwise you can pretty much get the same results with a dermastamp.
For me this is the future of scar treatments. I done a great deal of research before I decided to try Intracel as the radio frequency aspect of the treatment made me a little nervous. If you don’t know what Intracel is, it’s basically the same as dermastamping but the tip of the needles are heated i.e. they emit radio frequency energy. Depending on the power level, this can vaporize scar tissue without damaging the surface. So you get the results of laser therapy without any of the risks.
I’ve only had one treatment so far but I can see some subtle differences already. I used it primarily to treat a few seborrheic patches which are still lingering on my skin. Seb derm is caused mainly by overactive sebaceous glands, the Intracel needles can target these and destroy them.
However don’t worry about this if you’re just starting out, try dermastamping first and if it works for you, you can move onto radio frequency microneedling in the future.
Unfortunately I don’t have any before pictures, but this is what my skin looks like today for what its worth. This was the most unflattering light I could find in my house, I’m standing directly under a light bulb with my head tilted to show any textural deficiencies.
The camera quality isn’t great but at this point my scars are indistinguishable on camera.
I plan to buy an Intracel type machine in the next few months and combine it with PRP. This is the ultimate treatment in my eyes. I’ll use it about 2 or 3 times within the span of a year and then I’ll probably give this whole thing a rest for a while.
So that’s my story folks, hope it can help someone out there. I know what it’s like to be at rock bottom so if that’s you right now keep your head up. Things can change if you really want it.
P.S. Forgive the sensationalist title, I used it because that was one of the first things I typed into Google when researching acne scarring. A thread like this would've helped!
Edited by Liquid_Ocelot, 29 May 2014 - 03:58 PM.