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I would recommend a C02 ablative treatment. You would need a series even if it is done at the most highest settings (high micron settings, double pass, spaced closely together etc). Even the most ablative and aggressive treatments would require multiple sessions. In my experience, there is no quick fix for scars. I have done fraxel restore, c02 fractionated lasers, and erbium lasers. All of them required sessions in order to get good results. As a rule of thumb if you do ablative lasers (fraxel restore is non ablative as are the other lasers such as smooth touch) you will get anything from 5-20% improvement in my personal experience. Do not waste your time with any non ablative lasers as they are not aggressive enough to get the best results. I would not worry too much about your skin color or ethnicity. I am Asian and fairly tan. I have done all the above lasers at very high settings and never hypopigmented. I did get red and dark areas, but this is expected with a large amount of laser treatments. (this can also be mitigated with hydroquinone as well).
You might also want to look into dermabrasions. I have done two dermabrasions and out of all the treatments I have done (c02 + erbium lasers, fillers, microdermabrasions, peels, smooth touch laser, fraxel restore) I noticed that dermabrasion got me the best results. I also did not hypopigment either. Keep in mind that lasers are a great way to treat scars but they also follow the contour of the pit. So they will ablate the scar evenly with the non scarred skin. This will not smooth out the edges in the sense a dermabrasion would. Lasers work by creating thermal wounds to generate new collagen to replace the lost collagen. This is one of the reasons why I like dermabrasion. It sands down the edges to make the scars less visible and will also stimulate the growth of new collagen.
In my opinion I would not go with any fillers. I have box car and rolling type acne scars. I had restalyn done and so 0% improvement. In addition, it created a lump on my face which can lasted over 6 mos. I have gone to a lot of consultations and the majority of doctors agree that fillers are best for wrinkles. In general pitted scarring is a poor candidate for fillers. I have read some people have gotten good results, so I guess it is up to you to decide. I personally would want something permanent because fillers are expensive and need to be done over and over again to touch up the fading results.
When you start to see drs take everything with a grain of salt. The unfortunate truth is that they are in the business to make money and can sometimes over promise. Good luck on your journey.
5-20% improvement from MULTIPLE ablative CO2 lasers? I doubt that's the norm..
I saw your gallery photo, you don't appear to have any scars. Are you getting re:pair despite your skin type?
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I never said I'm getting repair.
As you already know, you must wait at least 12 months post accutane before doing anything to treat the scarring. You clearly have a lot of redness / flushing. It will be a little harder to find a doctor who is willing to use a fractionated c02 laser on Asian skin that's for sure. That's not because it can't be done, but because most are not experienced with ethnic skin and don't want the potential liability. Clearly it can be done, just look at the threads for Slee, Dragz, Inspired, and this Asian guy who posted on Realself.
All of these people have Asian skin and got noticeable improvement from lasers (often combined with other procedures like subcision and fillers). That last guy I posted about in another thread. His results are stunning. It's only been about a couple months since his procedures, but the results are incredible nonetheless. There certainly is hope for treating acne scars in Asian skin.
Yes, I have read literally every dermaroller thread on here, realself reviews/Q&A, google, called/visited estheticians, etc. It really does seem like the only shot (other than fraxel re:pair, and for people who have exhausted the softer methods).
Did you read that huge thread started in 2002 by former moderator Maya? It was about skin needling in general, but it applies to dermaroller also. Some posters who unfortunately no longer post here wrote many interesting rewiews about skin needling.
BTW, if I lived in the USA I would try subcision or punch float before dermaroller/dermastamp. They could make the scars less deep.
Dermaroller tests our patience all the time. It works, but it's so slow... and we will know if it works or not in some cases more than a year after we started.
After 11 months rolling my scars I see an overall improvement of about 20%.
