austra

Great that you're back on the forum! I'm very happy to hear your skin has improved and your confidence has gone up. I hope it means that your scarring has improved, not just overall texture or whatnot. Looking forward to your update when you get back to Japan.

Interesting study. I found the results fairly surprising, to be honest. As I understand, normally omega 3 fatty acids would suppress the immune system (since omega-3 EPA and arachidonic acid both compete for the same enzyme, COX-2, which turns AA into inflammatory prostanoids). Of course that can be a good thing, as often quite a lot of the tissue damage after an infection is caused by the immune system going berserk (too much inflammation etc) rather than the actual pathogen causing the damage. But it's good to keep in mind that overdosing on omega 3 would definitely not support the immune system, as it would downregulate the defense mechanisms against pathogens. Here is a good example of how too much omega 3 can be harmful in some cases.

 

I can't really explain or understand the mechanism behind the stronger immune response for those who got omega 3 in the study you linked to. I suppose things often tend to be fairly complex when it comes to the human body.

 

But anyway, I agree that omega 3 fatty acids are beneficial for most people. I take cod liver oil on a regular basis and have found that it tends to help with inflamed acne and make me feel better in general.

I'm sorry to hear about the chicken pox! I'm not in the best position to say if subcision is a good idea as i'm not too familiar with it, but here are my thoughts based on my own acne scar research and dealing with new scarring.

 

I honestly think it's too early to say what treatment would be best for your scars, as they are still healing and will probably do so for another 6-12 months - and they can fill in, to some extent at least, during this time. So if I were you, I'd come back here and start another thread with new pictures in 6-12 months. I wouldn't dermaroll at this point, because at worst it could disturb the healing process. You'll have plenty of time to dermaroll once your scars have matured. I know it sucks to wait, but it is the best thing to do in my opinion. 

 

What I would do right now, is try to improve the healing process as much as possible. Sleep well, have a healthy diet, exercise, take vitamin c. Bone broths are a great source of collagen and nutrients, which could be helpful at this point. Keep the scars moisturized and be gentle with your skin, as new collagen is supposedly very fragile. Once your scars have matured, you can better assess what treatments they need, or if they even need treatments.

 

With new scarring, I've used Terproline professional to keep the scars moisturized and red LEDs pressed against the skin for four minutes a day, since I've read that they're supposed to improve collagen synthesis and skin healing, and at least a few people on this forum have recommended them in the past. However, they are expensive and the scientific research to back these claims seems fairly scarce, so I can't be sure if they work. I've noticed positive changes in my new scarring, but I can't tell if that's normal skin healing or caused by these products. However, there is hardly any harm trying these methods apart from losing some money, so I personally think it's worth it. If you can spare the dollars, getting these for when your scars are still healing (and possible post-treatment aftercare later on) could be worth considering. There isn't much else you can do now except wait and be healthy.

 

I think chicken pox scars are usually boxcars which do not respond to subcision that well, although some people have got some improvement. However, I can't really see what your scars are like because of the hyperpigmentation. Once that has faded, it will be easier to assess what treatments would be suitable. Your scars look fairly shallow though, and I'm sure they'll look much better once the hyperpigmentation is gone.

 

Hope this helps at least a bit, and good luck.

Based on my dermarolling research, don't use it more than once a month. I would use it at 6-8 weeks intervals, even. It takes time for collagen to build and you have to allow that time for skin to recover, otherwise you could be causing more damage. Some people do dermaroll once a week because the initial microswelling lasts for about a week and makes the scarring look much better, but this really could just worsen the skin in the long term and is not advisable.

I would try to get a hydrocolloid bandage for the open wound pimple and leave it on for at least 3 days, preferably even 5-7 days if you can bear wearing a bandage that long. It seems like the best option in a situation like this, and will let the pimple heal on its own as well as possible. There should be some in pharmacies, if you can't find any thin ones for wounds specifically, then blister hydrocolloid bandages (Compeed etc) work just as well.

 

This is what a hydrocolloid bandage looks like. You just cut a piece out of it that is big enough to cover the wound completely, and just stick it on. It should adhere on its own. Please be sure to wash/sterilize and air dry the wound beforehand. Don't use any moisturizers or creams underneath.

 

 

 

If there's a scab on the wound, then I wouldn't recommend putting a hydrocolloid bandage on, as it can rip the scab off when you take it off. If you do put a hydrocolloid bandage on a scab, you should leave the bandage on until it comes off on its own.

 

I'm not sure if using salicylic acid on inflamed areas is a good idea, as that could possibly irritate the skin and impair healing. Also it looks like you have tooth paste (?) on the pimple in the second picture, and the same thing goes for that. Don't use anything harsh (tooth paste, retin-a, any acid) on the pimple since there's now an open wound. Be gentle with your skin. After you've had the hydrocolloid bandage on for a few days, you can take it off and check the situation. If (and when) the wound has closed off, keep moisturizing the wound with some gentle moisturizer. If you for some reason don't want to use the hydrocolloid bandage (although I highly recommend it), then just make sure it's clean and keep it moisturized. Take fish oil, sleep well, have a healthy diet etc and let it heal on its own, don't pick. Don't use anything that seems irritating to the skin until the pimple has completely healed - then you can consider things like retin-a and copper peptides.

 

I'm not really experienced with rolling scars, so I can't advice you on those. But if you search the forum, there should be plenty of information.

Hope you are doing well, Inspired. Can't wait for your next update.

I think TokyoGirl (or nowadays Inspired) said that at exactly 1 month after her first DeepFX treatment, she was disappointed with her results and didn't see improvement. But at around 3 months or so after the treatment, her scars had got about 50% improvement. So don't lose hope yet. In another 6 weeks things may look much better.

You could try wearing a silicone sheet for a few months, and if that doesn't help, consult a plastic surgeon if it could be revised. 

It looks like we're researching the same thing, ForeverAndPatience.

 

I've concluded that excision is a very effective treatment - basically a one-and-done solution - if everything goes well. I'm interested in trying it for my most recent scar - and if I'm happy with the result, possibly some others, too. 

 

If it goes well, you would still in essence be trading one scar for another, but in the best-case scenario, the new scar would be fairly unnoticeable except on close inspection. It could even be practically invisible. The thing that does worry me, though, is that the new scar would be hypopigmented, which is always permanent. So, if it goes badly and the resulting scar is bigger than you'd like and noticeable, the only way to try to fix it would be getting more excisions (or possibly stem cell treatments, which would be too expensive for most). So there's no going back. If the surgical scar is indented or hypertrophic, you could have other types of treatment to level it off, but nothing would fix the hypopigmentation apart from another excision (trading it with a hopefully smaller hypopigmented scar).

 

To ease one's mind though, this is pretty much the same thing as getting a mole surgically removed from one's face. Plastic surgeons do it all the time. After reading some mole removal experiences, most seem to be happy with the scar and say that it isn't noticeable once it has fully healed. So the chances of everything going well, especially if one takes all the precautions, seem pretty good. We're lucky in the sense that facial surgical scars tend to heal very well, unlike elsewhere on the body.

 

This is what I've found based on miramar's (and a few others') posts:

 

- Get a good experienced plastic surgeon (of course), which is the most important thing. Derms or GPs might do excisions and even get good results, but they may not be that experienced and you really don't want to take the risk.

 

- A scalpel excision (an elliptical cut) as opposed to a punch excision (a round cut) seems safer, since the tension on the excision scar would be less intense and thus the scar is less likely to widen or rip open during healing. This though would mean a longer incision and a longer scar, but it seems worth it. As far as I understand, punch excisions aren't very common at all, except when treating acne scars (and usually by a derm).

 

- The excision needs to done according to natural relaxed tension lines on the face. They basically tell you which way the line scar should be for there to be minimal tension, and thus the best chance for a good cosmetic outcome. This may mean having to make a longer incision, if the scar is "facing the wrong way". I'm lucky because my scar is already aligned to the natural tension line, so the excision wouldn't have to be that much longer than the scar.

http://www.merckmanu...nsion_lines.gif

 

Some surgeons use Langer's lines, which is the outdated method. These actually are based on tension lines on cadavers' faces and they don't correspond with the tension lines on a living person's relaxed face. There are a few areas on the face where the Langer's lines are completely opposite the relaxed tension lines, and you should make sure your surgeon is not using Langer's lines and is planning to make the excision in the right direction.

More information: 

http://rlbatesmd.blo...e-used-for.html

 

- Get external stitches removed by day 4-6 to avoid them denting your skin. The longer they stay, the less likely it is for the wound to open up, but then the more likely it is that the stitching leaves scars. So it's a trade-off, and leaving them for 5 days or so seems ideal.

 

- Use steri-strips, micropore or some other tape on the scar for at least five weeks (or a few months, to be on the safe side) after the stitches are off. This is to relieve the tension on the scar, making it less likely to widen or open up. Apparently the tape is fairly unnoticeable, so for one excision, this shouldn't be too big a deal.

 

- Miramar recommends an "everted closure", lifting the edges of the excision higher than the surrounding skin, and a "mattress" suture type of stitching. I haven't looked into these yet, and I haven't found out if most plastic surgeons already use these techniques or not. I hope they do.

 

- I don't know if internal stitching is necessary for smaller scars, although it would seem safer to have internal stitching in any case. However, there are some cases when the internal stitches have caused complications, and e.g. come out of the scar. It would be wise to get internal stitches at least if you're treating a bigger scar though. 

 

- Excision seems best on isolated scars, and scars that are small and deep. Bigger scars can be treated as well, but there seems to be more of a risk of the scar being more noticeable. Smaller scars tend to heal better, because there's less tension. Ice-picks would respond best, but it seems suitable for small boxcars as well. If treating many scars with excision, it would be best to do one at a time, if they're in any way close to each other. If something goes wrong, re-excising the scar is possible after about 5 months.

 

That's all for now, but I'm still researching. I'd like to get consultations with a couple of plastic surgeons and also question them about their techniques beforehand (shame consultations are so goddamn expensive here, too). 

 

If there are people here who have done excision, it would be great if they could share their results here - especially after the scar has fully healed (6-12 months). But if you can't find anyone, ForeverAndPatience, you could try to search for stories of surgical facial mole removals to get some kind of an idea of what to expect.

I'm sorry to hear this. The collagen remodeling takes several months and people have reported their scars filling in during the first few months after laser, so you may well feel better about the procedure by March or April. It does suck to have red marks from the laser, but they will fade! Best of luck.

Keep us posted.

Your skin looks good and your family and girlfriend are probably telling the truth when they say they don't notice it. I know even the tiniest facial scar can feel like a big deal at your age, but it's really not and I'm sure you won't give a damn about this very minor scarring issue in a few years. Scars do get softer and nicer looking over the years in my experience. I'd continue using Retin-A maybe for a year or two, but wouldn't consider anything else. Even retin-a isn't really necessary, but you're right in saying that it may help with superficial scarring if used for a long time.

I'm feeling a bit distressed by the state of my skin. It's relieving to read someone else's opinion. My friends and family have not been supportive over my latest procedure. They think I'm being vain at this point. Of course, they also don't have acne scars and can't possibly relate to how I feel about my skin.

My family has had a similar attitude, even though I've tried to explain how scarring affects me emotionally and how I need to get at least a little bit of improvement to get over it. I've had quite a few arguments with my boyfriend about my scarring in the past months, which has been a bit surprising. He admits that my scarring is noticeable, but at the same time he doesn't seem to take my concerns seriously and regards me as vain, and I've really had to justify to him why I'm distressed with my skin in the first place. He's recommended that I see a therapist over my anxiety (which is probably a good idea). Right now he is in favour of my plans to get consultations for laser treatments in the near future and get some objective opinions on my scarring and treatment options in general, but if I actually do decide to go through with Total FX/Deep FX, I don't know how supportive he would be. I'm very surprised by how hard it is for him to see how the scarring affects me and why it's important for me to get improvement. Sometimes I wonder if it's because I am making this a bigger deal than it should be, or because people with no scarring just cannot realize the full emotional effects it can have.

Hopefully after you've completely recovered from this treatment, you'll be in a state where you're happy with your skin and can focus on other things in life. I'd like to reach that point after 1-2 Total FX treatments, even though I realize I'd probably need more to get the best results. Are you planning on more treatments after this one?

I don't know, but perhaps if you were to have laser resurfacing (Total FX), at least once a year and think of it as simply maintenance, polishing, and anti-ageing (in the same way that celebrities have seasonal botox, or semiyearly - twice a year - laser treatments) and not think of them so much as acne scar reduction), hopefully you might even eliminate them completely in the long term. Just a thought.

Would someone really be willing to have yearly laser treatments for maintenance? Going through the treatment is very extreme, painful, and costly (not to mention possible risks if something goes wrong) and I have the impression that after the initial recovery, the hyperpigmentation would take at least 1-2 months to fade. You'd only have 'normal' skin for 8-10 months of the year, even if it was practically scarless. I find it hard to believe that someone would be willing to go through with it.

If maintenance treatments even every five years or so are necessary, then I don't know if I'm ready to take the laser route. I'd like to move on with my life and stop obsessing over scars at some point.

And besides expressing my concern over the sustainability of results, I did also want to say that so far your results look very promising, Inspired. I'm very excited to hear what your skin looks like in a few months. All the best!

If you want advice - don't do anything. The risks + costs aren't worth it considering your scarring is very minor.

I second this. Your skin looks good based on those pictures, no need to treat it.

However, if you really want to do something, you could look into just Retin-A (may help a little bit if used for a long time), dermarolling or TCA peels (done by a professional!, and I don't mean TCA Cross). I'm not sure how effective they are in the long run as I'm quite inexperienced with scar treatments myself, but they might help and they're the least risky options.

I don't think you should consider laser, it's too risky for such minimal scarring.

I'm surprised by how beautiful your skin looks like after the peeling. I thought it would be much more red than this. Looking very promising so far!