Glycolic acids are known as being a 'light' peel and induce collagen development. I've been doing this type of peel for several years now and my skin looks much healthier today.

If you look at my baseline photo taken in February of 2009, you'll see that I had a tremendous amount of collagen loss due to the acne scarring and aging.

By focusing on better nutrition, taking supplements that encourage collagen development (Vitamin C, Zinc, etc.) going through four rounds of subcision, three rounds of Laser Genersis, one round of Pearl Fractional Laser, one round of TCA Cross, and countless chemical peels coupled with good topicals (Retin-A, Ester-C, Alpha Lipoic Acid, DMAE, etc.), I have seen good results with the reduction in the appearance of my acne scars.

I also think that Lactic acid peels are also good for your skin. For a more dramatic peel, TCA Cross (25%) may be the way to go. With TCA, you'll have about five to seven days of down time and have to wear sunscreen to prevent hyperpigmentation.

At home chemical peels are an affordable supplement to your skin care/acne scar revision regime.

As far as finding docs who perform subcision, this site is a good place to find others who've found success with a certain doctor. Other than that, you'll have to call around in your city/state to find one. Unfortunately, it's not a common procedure.

At one point in time, I had thought about dermabrasion. I'm so glad that I didn't go that route. My mom did and had major pigmentation issues as a result and it didn't do much to reduce the appearance of her acne scarring.

Hope this helps.

Matt

On 7/2/2012 at 4:08 PM, mr. matt said:

Here is subcision in a nutshell:

1) Nurse cleans your face with an antiseptic lotion

2) Doctor marks your scars

3) Doctor injects your face with anesthesia (the most painful part of subcision)

4) Doctor inserts Nokor needle and fans it back in forth to break up the fibrous tissue holding down your epidermis

5) Doctor inserts need from various angles to undermine the scar tissue

6) Nurse applies pressure and ice to your face to minimize bleeding

7) Doctor/Nurse wraps your face with pressure bandages

8) You go home looking like a mummy and hoping for the best

You may need a series of subcision treatments to see the type of results you're looking for.

I went to www.columbiaderm.com and had all of my acne scar revision procedures done there with the exception of the chemical peels.

Yes, I think that you might benefit from a series of chemical peels. Keep in mind that they won't fill in deep cratered areas, but they will help with any hyperpigmentation and actually develop collagen within your epidermis.

Get into the habit of wearing sunscreen everyday to protect the collagen that you have in your face and to prevent further damage.

Hope this helps.

That is a great question that I'll have to ask my dermatologist the next time that I have an appointment with him.

Each time that I have gone in for the procedure, the surgical tray containing the needles is covered and behind the patient chair. I'm sure it is to help people from freaking out at the sight of the needles, etc. Getting subcision was easy compared to my Pearl Fractional Laser treatment. The laser treatment itself was like having hot grease splattered on your face for 30 minutes. I really had to try to focus my mind elsewhere during the procedure because it was so uncomfortable.

I hope that anyone reading this thread who has had subcision and knows the answer will chime in regarding the size of needles and angle. I honestly don't know.

matt your awesome for telling us all this ...also does he re attack the same scars at ever visit doing the subcision or is he going after other scars ...and can i apply a tca cross all over my face ? ...i've just seen people using it with broken tooth pics dipping the scars

is retin a a chemical peel matt ?

and thinkin about trying a 35% glycolic acid peel from amazon

Rob:

Retin-A is not a chemical peel. It is a chemical compound that promotes the development of collagen, causes cell turnover (very, very light peeling), and promotes blood flow to the skin.

I've been using it for several years and I saw a difference after six weeks of using it.

I purchased my 25% TCA peel from Skin obsessions and my glycolic and lactic acid peels from Skin Laboratory.com

Be sure to purchase any acid peel from a reputable vendor.

I think that you will find success with your acne scar revision search. You're asking the right questions, your determined to seek and obtain improverment, and you're willing to try a variety of ways to improve your skin and you've documented your scarring. Very few people chronicle their journey with 'pre' and 'post' procedure photos. You'll be amazed at how your skin will change over time. Don't expect 100% improvement, but do expect to see some type of improvement.

Looking forward to seeing your 'post procedure' photos in a year or two. If you're consistent with using Retin-A, doing the chemical peels, dermarolling, etc., you'll see an improvement in your overall complexion. All of these procedures/modalities will help with anti-aging, too.

Don't forget to wear your sunscreen - especially if you're using Retin-A and doing chemical peels. You don't want to develop hyperpigmentation.

Matt

k i guess i'll order the retin a ...how often do u apply it

I have a prescription for Retin-A and I apply it once a day - usually at night.

It can dry your skin out, so you might need to use a moisturizer with it.

wow! your pictures are amazing!!! Congratulations!

Hello Mr Matt,

Thanks for your posts on here. I am looking into the place where you received your treatments. However, I called today, and they told me I could only do a consult with an aesthetician. Did you run into the same situation?? You look great by the way, I thought they did a fantastic job, you must be thrilled! I am not too keen on this as I would rather see the Dr. I have severe scarring and will be traveling 10hrs to see them Just curious if you were able to consult with Dr. Despain.

Thanks!!

I would suggest that you call back and indicate that you would like to make an appointment for a pre-surgical consultation with Dr. DeSpain for subcision.

The only thing that I can think of is that the receptionist may have confused subcision with a cosmetic treatment which it is not.

If you still run into problems, I would ask to speak to Dr. DeSpain's nurse. If you still have problems, pm me and I'll see if I can help.

Yes, I am thrilled with how the appearance of my scarring has improved. I was at the point where I did not want to look at myself in the mirror - look at my baseline photos from February 2009. I had deep scarring on my cheeks and pitted scarring on my chin which looked horrendous under direct overhead lighting. I did not want to be the man I saw in the mirror - hence, the "Man in the Mirror' title of my thread.

So, I can imagine how much you want to minimize the appearance of your scarring. Be reasonable with your expectations. After all of my procedures over the past three years, I have not seen 100% improvement. However, my skin has improved to the point that I am happy with my appearance.

I may go back in a year for a fifth round to treat a few scars that evaded Dr. DeSpain's needle, but I'm content for the time being.

I think that you'll really like Dr. DeSpain. He is not at all arrogant, is very down-to-earth, compassionate, and, most of all, HIGHLY SKILLED at dermatological surgery. He does his surgical procedures on Friday's, so you may want to see if you can get an appointment on a Thursday with a potential appointment the next day for any surgical procedures.

Subcision has been, without a doubt, THE most effective treatment that I have had for my acne scarring. Take a look at the subcision/suction study and I think that you'll find some good information there.

Also, take a look at your diet to ensure that you're diet will support collagen remodeling (high protein, zinc, Vitamin C, etc.). Topicals are also important - take a look at my earlier posts regarding my daily care.

I've learned a lot about the role of antioxidants and would encourage you to research these as well. Finally, wear sunscreen everyday! You must protect your skin from the damaging uva/uvb rays - they decimate collagen!

I hope that you have tremendous success with whatever medical path you choose.

Take some 'before' photos as you'll be surprised at how your skin will change over time.

Matt

Hope all is going well with u man

bump

hi, I'm looking to do subcision on a really shallow rolling scar that unfortunately has had a large psychological impact on me. I want to do it now as I'm 20 and I don't want to wait till I'm older and the collagen loss sets in. I'm really impressed with your success and would like to ask u if you think there are any alternatives to suctioning post subcision because I'm unable to get a vacuum. Do you think if the scar is shallow that suctioning is needed? And what else should I note to maximize scar improvement?

I'm sorry for the many questions but last of all, did you hear popping and snapping sounds when the subcision was being done? i live in a country where there aren't many doctors who do subcision so I'm just afraid that if the subcision is done with no popping sounds due to lack of skill from the surgeon that there would be no improvement..

thanks a bunch!!

Hey Mr, Matt,

could you please give any details regarding the TCA-Cross treatment? Ive recently done one and Im a bit discouraged since still nothing has happened (the scabs just fell off a few days ago). Ive heard a lot about being patient because the main improvement is to set in only within one month after but can you confirm this?

How long did it take you to see improvements?

Regards !!!

PS: What are copper petides exactly?

hi, I'm looking to do subcision on a really shallow rolling scar that unfortunately has had a large psychological impact on me. I want to do it now as I'm 20 and I don't want to wait till I'm older and the collagen loss sets in. I'm really impressed with your success and would like to ask u if you think there are any alternatives to suctioning post subcision because I'm unable to get a vacuum. Do you think if the scar is shallow that suctioning is needed? And what else should I note to maximize scar improvement?

 

I'm sorry for the many questions but last of all, did you hear popping and snapping sounds when the subcision was being done? i live in a country where there aren't many doctors who do subcision so I'm just afraid that if the subcision is done with no popping sounds due to lack of skill from the surgeon that there would be no improvement..

 

thanks a bunch!!

 

If there is any way for you to borrow a small hand-held vacuum sweeper for two weeks after your subcision treatment, that would be ideal. I am still amazed at how well my skin responded to this combination of subcision and suction power to prevent the scars from re-attaching. You should also consider looking at dermarolling - I've been very happy with the results when combined with subcision.

Also, consider using topicals containing Ester C and Retinol to help with the collagen remodeling/formation.

Yes, I heard the 'popping' sounds on the vast majority of my scars when the doctor was performing subcision each time. It was very 'cathartic' to hear these sounds as I knew that he was getting at the heart of the problem.

Hope this helps.

Matt

Hey Mr, Matt,

 

could you please give any details regarding the TCA-Cross treatment? Ive recently done one and Im a bit discouraged since still nothing has happened (the scabs just fell off a few days ago). Ive heard a lot about being patient because the main improvement is to set in only within one month after but can you confirm this?

 

How long did it take you to see improvements?

 

Regards !!!

 

PS: What are copper petides exactly?

 

I had one TCA Cross done awhile back. My doctor did not use 100% strength TCA as he felt that it was too strong and could cause further scarring. He used a less concentrated percentage, but I don't know the exact percentage that he used.

He focused primarily on my nose and on my chin. Both areas looked somewhat like a 'pin cushion' due to the scarred pores.

I had a Pearl Fractional Laser treatment sometime after this and the appearance of the scarring on my chin, in particular, improved quite a bit. It looked horrible on direct lighting before the treatment(s).

I'm not as familiar with Copper Peptides - I used them once in a cream but I have not used them since. I believe that they are essential for collagen formation.

Matt

Hi Matt, how do i use Reviva night cream with my stieva A 0.025% ?

what is the proper procedure of doing a D.I.Y derma rolling ? i'm from singapore and i do not know where to purchase a proper and good derma roller , neither do i know how do i use it and what to use it with .

I'm a 20 Y.O student suffering from acne problems since 14. Just finished my course of isotretinoin at july 16th . I thought i would be happy again with a boost of self esteem after taking isotretinoin . My acne has cleared but my face is flooded with scars , pigmentations and holes from cystic acnes. still feeling depressed as ever , dare not look at people in their eye while talking . i've been through 3 rounds of fractional c02 laser during my course of isotretinoin . The lasers barely healed my scars and did nothing to the pitted holes. I am thinking of doing subcision in september should i have the money . below is my journey of battling acne.

Any enlightening on how can i cure my current problem ? i've redness and scars and several holes on my skin . still feeling very terrible about it .

Hi matt.

You said you had cystic acne since 8th grade , well I'm in 10th grade and just like you , after tooking accutane my face exploded in more cyst..can u tell me about ur accutane course?My dermatologist prescribed me prednisone with for the flare up and it helped because now the cysts are somehow in my skin I can feel them if i tauch , what is that mean?Will I develop scars?

Hey Zaccc ur not supposed to have co2 fractional laser done while taking accutane it will inhibit wound healing and potentially cause more scarring...u must wait at least 6 month to a year after tane to begin any scar treatment..and telling by ur scars/redness i think the best for u would be recell/co2 fractional laser..subcision will help too

Hi Matt, how do i use Reviva night cream with my stieva A 0.025% ?

what is the proper procedure of doing a D.I.Y derma rolling ? i'm from singapore and i do not know where to purchase a proper and good derma roller , neither do i know how do i use it and what to use it with .

I'm a 20 Y.O student suffering from acne problems since 14. Just finished my course of isotretinoin at july 16th . I thought i would be happy again with a boost of self esteem after taking isotretinoin . My acne has cleared but my face is flooded with scars , pigmentations and holes from cystic acnes. still feeling depressed as ever , dare not look at people in their eye while talking . i've been through 3 rounds of fractional c02 laser during my course of isotretinoin . The lasers barely healed my scars and did nothing to the pitted holes. I am thinking of doing subcision in september should i have the money . below is my journey of battling acne.

 

Any enlightening on how can i cure my current problem ? i've redness and scars and several holes on my skin . still feeling very terrible about it .

 

If you recently completed Acccutane, you need to wait a minimum of six months before you attempt any acne scar revision treatments of any type on your skin - no chemical peels, TCA CROSS, subcision, laser, etc. due to the high risk of permanent scarring.

Congratulations on the tremendous reduction in cystic lesions on your face - Accutane is a 'miracle' drug when it comes to dealing with cystic acne.

Returning your skin to a state that you're happy with will be a journey which will take time. Unfortunately, cystic acne can do quite a bit of damage in a short period of time and heavily damage one's complexion.

However, as you know, there are several modalities for treating acne scarring, so there is HOPE.

Slow and steady wins the race - allow the Retin-A to work itself out of your system over the next six months and then proceed with a course of treatment(s) to improve your complexion.

Hope this helps.

Matt

i've been through 3 rounds of fractional c02 laser during my course of isotretinoin . The lasers barely healed my scars and did nothing to the pitted holes. I am thinking of doing subcision in september should i have the money . below is my journey of battling acne.

 

Wow! I am surprised a doctor would do this while you're on Accutane. That's just crazy reckless. You should not do *any* scar treatment for a minimum of 6 months after Accutane. Some doctors will make you wait for one year.

Hi matt.

You said you had cystic acne since 8th grade , well I'm in 10th grade and just like you , after tooking accutane my face exploded in more cyst..can u tell me about ur accutane course?My dermatologist prescribed me prednisone with for the flare up and it helped because now the cysts are somehow in my skin I can feel them if i tauch , what is that mean?Will I develop scars?

 

I'm sorry to hear that you are dealing with cystic acne at such a young age.

I went through two courses of Acccutane. After starting the first round, my face EXPLODED in cystic lesions - it was so bad that I paged my dermatologist at the time on a Saturday morning in a panic. I was told that there was nothing that could be done at that point in time (this was in 1998) and that I had to wait it out. I was miserable and looked horrible.

The second round of Accutane was about seven years ago - I started to get a cyst every once in a while and wanted to eradicate this horrible disease once and for all.

I have been basically free from Cystic acne now for about fourteen years.

Dealing with the aftermath of cystic acne was truly a journey that begin while searching the internet for ways to reduce the appearance of my scarring - coming across this website was truly a 'God send' because I learned so much from people who had shared their experiences here.

This is the only place that I know of where people can put it all out there - their frustration with their current condition, things that work, things that don't and where people can cheer one another along to the finish line.

You may develop scarring from your current lesions, but at least there is HOPE - there are ways of dealing with the scarring and that can reduce it significantly or eliminate them entirely in some cases.

Hang in there - you're on a journey.

 

Hi matt.

You said you had cystic acne since 8th grade , well I'm in 10th grade and just like you , after tooking accutane my face exploded in more cyst..can u tell me about ur accutane course?My dermatologist prescribed me prednisone with for the flare up and it helped because now the cysts are somehow in my skin I can feel them if i tauch , what is that mean?Will I develop scars?

 

 

I'm sorry to hear that you are dealing with cystic acne at such a young age.

 

I went through two courses of Acccutane. After starting the first round, my face EXPLODED in cystic lesions - it was so bad that I paged my dermatologist at the time on a Saturday morning in a panic. I was told that there was nothing that could be done at that point in time (this was in 1998) and that I had to wait it out. I was miserable and looked horrible.

 

The second round of Accutane was about seven years ago - I started to get a cyst every once in a while and wanted to eradicate this horrible disease once and for all.

 

I have been basically free from Cystic acne now for about fourteen years.

 

Dealing with the aftermath of cystic acne was truly a journey that begin while searching the internet for ways to reduce the appearance of my scarring - coming across this website was truly a 'God send' because I learned so much from people who had shared their experiences here.

 

This is the only place that I know of where people can put it all out there - their frustration with their current condition, things that work, things that don't and where people can cheer one another along to the finish line.

 

You may develop scarring from your current lesions, but at least there is HOPE - there are ways of dealing with the scarring and that can reduce it significantly or eliminate them entirely in some cases.

 

Hang in there - you're on a journey.

 

Yes thank matt , what about my nodules in my skin?

When I asked my dermatologist if that can flare up again he said : I don't know..

What that supouse to mean?If he dosen't know who will?HE said it could flare up again or it could not .

I don't wanna to flare up again?

In ur first course aback in 98', how long until ur acne was gone?Was it really severe?Thanks,this helps

 

 

Hi matt.

You said you had cystic acne since 8th grade , well I'm in 10th grade and just like you , after tooking accutane my face exploded in more cyst..can u tell me about ur accutane course?My dermatologist prescribed me prednisone with for the flare up and it helped because now the cysts are somehow in my skin I can feel them if i tauch , what is that mean?Will I develop scars?

 

 

I'm sorry to hear that you are dealing with cystic acne at such a young age.

 

I went through two courses of Acccutane. After starting the first round, my face EXPLODED in cystic lesions - it was so bad that I paged my dermatologist at the time on a Saturday morning in a panic. I was told that there was nothing that could be done at that point in time (this was in 1998) and that I had to wait it out. I was miserable and looked horrible.

 

The second round of Accutane was about seven years ago - I started to get a cyst every once in a while and wanted to eradicate this horrible disease once and for all.

 

I have been basically free from Cystic acne now for about fourteen years.

 

Dealing with the aftermath of cystic acne was truly a journey that begin while searching the internet for ways to reduce the appearance of my scarring - coming across this website was truly a 'God send' because I learned so much from people who had shared their experiences here.

 

This is the only place that I know of where people can put it all out there - their frustration with their current condition, things that work, things that don't and where people can cheer one another along to the finish line.

 

You may develop scarring from your current lesions, but at least there is HOPE - there are ways of dealing with the scarring and that can reduce it significantly or eliminate them entirely in some cases.

 

Hang in there - you're on a journey.

 

Yes thank matt , what about my nodules in my skin?

When I asked my dermatologist if that can flare up again he said : I don't know..

What that supouse to mean?If he dosen't know who will?HE said it could flare up again or it could not .

I don't wanna to flare up again?

In ur first course aback in 98', how long until ur acne was gone?Was it really severe?Thanks,this helps

 

Based upon my experience with Accutane, it took many weeks for the cysts to subside. My skin took on a reddish hue that you could see in pictures that were taken of me at the time.

After about eight weeks on Accutane, I don't recall having any further breakouts. However, the damage, in my case, was done during the first eight weeks on this drug. I developed cysts on my left cheek which, up until that point in time, had been pretty much acne-free. I developed cysts on my right cheek and ALL over my chin.

I didn't have another cystic lesion for about another six years or so which prompted me to go back on Accutane a second time.

The Prednisone should help with the inflammation and, hopefully, you'll have less of a chance of scarring.

It's no fun while you're going through this, so hang in there. Eventually, you'll clear up and be on the road to better skin.

I've checked with various doct they told me they don't do lasers for patient on accutane too . but the doctor I did with told me it was safe and that he treated alot patients on accutane too . he claimed that some patient see better improvements after the laser as accutane helps to enhance the healing . im off accutane on July and I intend to do subcision in end of September before my school reopens . do you all think it's fine ? and how do I use reviva ala dmae ester c night cream together with stieva A? just apply both of them ? thanks