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First of all apologies for any bad english, its not my first language.
I did a session of Mixto Laser 14 days ago for my acne scarring, approximately 5 months after I ended my Accutane course. I know that there are a lot of people who are currently taking Accutane and want to fix their scarring in the future, so I hope this helps. Of course, everything is anecdotal and based on my own research and conversations with 3 different derms.
My info:
-20 years old, male
-Asian, Fitzpatrick Type III skin, prone to hyperpigmentation
-Right cheek: Mild-Moderate rolling scars, a small patch of mild boxcar scars. This side is not so bad
-Left cheek: Mild rolling scars, couple of ice-picks, a few deep boxcar scars. My worse side
-Nose: Large pores
-My 2 deepest boxcar scars lie in the area between my eyes. The doctor said I would need 2 or 3 sessions of subcision to repair them.
-In addition, my skin texture was very bad after Accutane. It looked dry and dead, even though I have oily skin.
-If I were to rate my scarring on a scale of 1-10 I would say 5. Its definitely noticable, but not horribly disfiguring.
When I talked to different derms about treating my scars, all of them said that I could start before the 6 months period was over. The first one, who prescribed my Accutane, recommended 3 sessions of an Erbium Glass non-ablative laser, which is basically Fraxel Restore. He said I could start treatment 3 months after Accutane and promised at least 25% improvement after 3 sessions.
The other 2 derms agreed that it was safe for me to go for the Mixto ablative laser after 5 months. The general waiting time of 6 months is to ensure whether
1. Sebaceous glands have regained most of their ability to produce oil/sebum, and hence produce new skin cells
and
2. Acne is completely under control. If you still have acne, you cannot do the procedure as if you have a breakout afterwards, it may leave very bad hyperpigmentation or new scars on the fresh and fragile skin.
For the procedure, the doctor only did 1 pass on medium settings for the full face and a second pass on low settings for my cheeks only. Make sure your derm knows how long you've been off Accutane so that he/she doesn't do multiple passes on medium or high settings. Its better to be safe on your first session because you never know how your face will react to the laser. The safest course of action would be to do a single pass on low/medium settings. If you're more confident about your skin's ability to heal like me, ask for the second pass, but again avoid high settings.
The pain wasn't so bad during the procedure but after the numbing cream wore off, my face felt like it was on fire for the next 3 hours. I experienced very little bleeding. Peeling began 48 hours after and everything was peeled by day 6, so I could finally leave the house. The redness was much more prominent on the areas where I did the second pass. It just looked like a really bad sunburn.
Now its 2 weeks later and the swelling/tightness is long gone, so I can evaluate my results.
1. Skin tone and texture is improved. The new skin looks pink, smooth and healthy.
2. Mild boxcars and other superficial scars are greatly reduced
3. Mild rolling scars are greatly improved, almost gone
4. Moderate rolling scars are better, can be considered mild now
5. Deep boxcars look better in certain lighting due to "sanding" of the edges but I think the depth is unchanged
6. It does nothing for ice picks
This affirms what most people on this forum say about lasers - good for shallow and rolling scars but not as effective on deeper ones.
Of course these are not my final results, there may still be collage growth in the upcoming months which I am excited about. Overall the results exceeded my expectations and I am satisfied. However, I will be going back for subcision and another laser session 6 months from now. I estimate that I will need another 2-3 subcisions and 2-3 laser sessions at higher settings to achieve something close to 100%.
The important thing for those wanting to do laser a few months after Accutane is to find a good and reputable derm and not to do multiple passes on high settings.
Will be adding pics at a later date.
From what I understand, the actual "depth" gets improved 30 days - 6 months after the procedure. Will be interesting to see how your results change from now -> a few months later.
"After 30 days, the collagen remodelling begins and tightening occurs and continues for the next 36 months. A recent study using fractionated CO2 resurfacing of the skin showed collagen remodelling as early as 7-days after the treatment and persisted up to at least 3-months after the via the measurement of heat shock proteins. This particular study did not measure the collagen beyond 3-months."
Thanks for the post & good luck.
i thought u cant have any laser until at least 6 months post tane?
Thats what I thought too. But after consulting different derms they all agreed it was possible and there were very little risks. I didn't get "damaged" at all by the laser, and even though I'm super prone to hyperpigmentation, my skin is just a little pink. I guess it all depends on how much your skin has recovered after accutane (as indicated by sebum production) and the intensity/no. of passes of the laser.
I'm not saying its fine or even recommended for everyone to do laser before 6 months, but in my individual case 2 very reputable derms said it was okay, so I went ahead with it.
From what I understand, the actual "depth" gets improved 30 days - 6 months after the procedure. Will be interesting to see how your results change from now -> a few months later.
"After 30 days, the collagen remodelling begins and tightening occurs and continues for the next 36 months. A recent study using fractionated CO2 resurfacing of the skin showed collagen remodelling as early as 7-days after the treatment and persisted up to at least 3-months after the via the measurement of heat shock proteins. This particular study did not measure the collagen beyond 3-months."
Thanks for the post & good luck.
That is good news. Hopefully my deeper boxcar scars will fill in a bit. Right now they're almost completely unchanged. But I'm really satisfied with this treatment overall, because my skin looks so much better and all the smaller scars are gone.
SPOILER: GROSS PICS
Here are some pics that I took some time ago.
Left side - this is my better side. mainly wavy rolling scars, a few shallow boxcar scars
(before) my skin looks very white and oily here because I applied a LOT of sunscreen
Right side - worse side. all my deep boxcar scars are here. also some mild rolling scars and a couple of ice picks
As you can see in my before pics, I still had some hyperpigmentation and bad skin texture with a lot of open pores. The laser has helped diminish those greatly, along with all the tiny scars.
72 hours post-procedure, my skin has started to peel in small patches and you can see the grid marks clearly. The laser didn't cause any hyperpigmentation.
I'm waiting for the redness to fade completely before taking any more photos, so in another week or two I'll update.
Serious question because I honestly have no knowledge regarding laser treatment... Are those dark marks in your recovery photos normal? Is that generally what happens in the peeling stage after a laser treatment?
Serious question because I honestly have no knowledge regarding laser treatment... Are those dark marks in your recovery photos normal? Is that generally what happens in the peeling stage after a laser treatment?
That's the peeling skin falling off - completely normal.
i thought u cant have any laser until at least 6 months post tane?
Thats what I thought too. But after consulting different derms they all agreed it was possible and there were very little risks. I didn't get "damaged" at all by the laser, and even though I'm super prone to hyperpigmentation, my skin is just a little pink. I guess it all depends on how much your skin has recovered after accutane (as indicated by sebum production) and the intensity/no. of passes of the laser.
I'm not saying its fine or even recommended for everyone to do laser before 6 months, but in my individual case 2 very reputable derms said it was okay, so I went ahead with it.
>From what I understand, the actual "depth" gets improved 30 days - 6 months after the procedure. Will be interesting to see how your results change from now -> a few months later.
"After 30 days, the collagen remodelling begins and tightening occurs and continues for the next 36 months. A recent study using fractionated CO2 resurfacing of the skin showed collagen remodelling as early as 7-days after the treatment and persisted up to at least 3-months after the via the measurement of heat shock proteins. This particular study did not measure the collagen beyond 3-months."
Thanks for the post & good luck.
That is good news. Hopefully my deeper boxcar scars will fill in a bit. Right now they're almost completely unchanged. But I'm really satisfied with this treatment overall, because my skin looks so much better and all the smaller scars are gone.
Well, I took accutane for about a month. It has been 4 months now and my sebum production has returned to its original stage (i.e. tons of sebum). Does that mean my skin is back to normal?
@HeftyMug - Yes, it turns from red to brown, then black and peels off. I was freaking out about it initially as well.
@whoartthou1 - Sorry, that is something that only you and your derm can decide. We aren't doctors and don't know enough about your skin to tell you that.
blahblah82, thanks for the warning. I do notice some mild discoloration and redness, and the area around my eyes is lighter than the rest of my face. But it isn't too bad overall and there are no areas that particularly stand out. Its surprising considering I've been under the sun for the past few days.
runnyeggsham, I paid a little over $1k for everything.
Unfortunately, my improvements seem to have gotten a little worse.
Some of the shallow scars have disappeared, including one shaped like a horseshoe near my eye that I recognize very well. Shallow scars on my temples are much improved, maybe ~50%, but the ones on my cheeks are only ~25% improved. Some of the rolling scars did not get as much improvement as I previously thought. The deeper and wider boxcars still look pretty much the same as pre-treatment, although its hard to judge.
Even though I knew this would happen, I was still pretty sad when all my scars came back after the swelling was gone. Plus, I've been covering my face with thick layers of moisturizer for the past weeks and I can't use my Retin-A, so I've been getting a few small breakouts. Right now I'm just hoping that collagen growth will occur over the next few months and my deeper scars can fill in a bit. I plan to do a round of subcision 6 months from now as well if necessary.
- right side, deeper scars are mostly unchanged
- left side, fair bit of improvement
Took these a few days ago under a strong light but it's not really that clear, so sorry about that. Anyway, the scars are there if you look closely.