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Hi Everyone,
Long time lurker, and I finally bit the bullet to create an account and post. I need some advice for my pitted scars on my left cheek with active acne. For some reason my cystic acne loves my left cheek and crops up every 4 months or so for the past 2 years. I've had cystic acne all my life, and after different treatments it slowed down for the most part. Just my left cheek is active.
My wedding is next July and I'm trying to lessen the severity of the pit appearances. My dermatologist recommended me RF - Radial Frequency? Microneedling or Faxel treatement. They recommend Microneedling for me. It costs $3,600 USD for 3 treatments. This seems very high priced based on what I've seen, however I really trust and like my dermatologist and she's never been one to push me to do things I didn't like. Based on the comments I've seen , RF microneedling hasn't really worked for a lot of people, in fact ive seen it damage people ? What about Fraxel? Should I just go ahead with Inifini or fraxel - even if it helps a little?
I feel stuck with little options. Are there any other recommendations that are not aggressive like skin punching/surgery (both NOT recommended by dermatologist due to skin type) or subsicion or even dermarolling? I don't want to do any DIY stuff since I scar very easily - I'm prone to have keloids and raised scars. (If it's basic name brand creams - I'm all for it. Just nothing like aggressive such as 80% TCA peels at home) I'm also tempted to consult with other dermatologist, but it is time consuming and costly for several consultations. I just want advice on what has worked for people who have had not-too-aggressive treatments. Anything that has helped slightly improved appearance(10-20% improvement) would be good with me, I'm feeling desperate.
Provided below is my skin background alongisde the duration or year completed:
Skin background:
-Cystic Acne (all my life, I am 25 yo)
-3 Keloids scars from cystic acne on shoulders and shoulder blade (10 years old)
-raised white back acne scars ( 10 years old)
Treatments:
-regular monthly "light" chemical TCA peels on face and back , 10 - 30% depending on face or back ( 2015 - 2016 current dr)
-Steroid injections for keloids and cystic acne (2015-2016 current dr)
-Laser treatment, Genesis - Did not work ( 2014, at skin spa)
-Obagi Kit - Effective for forehead cystic acne , got rid of 80% of acne (2010, done at different skin spa)
-Birth Control, got rid of 5-10% of acne - stopped working after 6 months (2010 PC physician)
-Tetracycline, worked for 6 months (2008/2009 PC physician)
Provided below is a pic of my lower half of my face, apologies as i have makeup on, but you can still see my pitted scars.
I can't tell as the picture has makeup and is in heavy light. Please see the official faq below for how to take a scar picture.
If you have rolling scars which I cannot see the preferred treatment is subcision and filler
The FAQ has all the info under subcision.
If it is mainly a surface issue with very little fat loss you can get TCA peels done or laser.
Microneedle will do nothing for you, and Infini RF is typically for deeper scars. I just see some small texture irregularity in that pic.
If it is what I think it is to the right of the lips subcision and filler would help.
6 hours ago, Frasier said:Beatifulambition, how can you be so sure about microneedling wont do anything for her? Havent several people here had good results from that?
Because of scar type ... as Dr Lim Says. You must listen to the patient and their time period of desired treatment. Her main issue she reported were "rolling scars." She has a big event coming up. Microneedling without RF can take up to 3 years to see improvement (for 3k at a doctors office for Microneedle I can have my face filled with filler and it will look better). Scar work as you know is never one and done, It takes a combination of things. I microneedle and I also TCA, and I do laser and I do Infini, Sublative, etc... So I am not saying it's not beneficial. I am just listening to the patient and giving what I think could help most in her case. She has also tried a lot, so I can judge off that filler will give more of a improvement (she is predisposed to scar). Keep microneedling Fraiser, it's a excellent way to penetrate products like EGF as well.
Thank you for the perspective beautifulambition. I updated my original post with no makeup pics with diffetntt angles .
I definitely understand Infini would take a while, I guess I was hoping at least the first session would get rid of at least 10% of my scarring. Would you say it is effective , but just take a long time (3 years )? Subcision looks rather scary to me and I'm betting with my skin inwould scar more . I'll definitely look into filling and ask the dermatologist if I can go that route - are any negative effects with fillers ?
I see one issue on your right cheek / left brow. This needs filler to correct with subcision. Stretch and squish it between your fingers, does it look better?? You do not need traditional subcision just with the filler needle around the scars. Please make sure your doctor has experience with filler and acne scars. They can assure you that they will not doughnut filler around scars but subcise the tethers and make it look even. Ask how many they have done before. (Should be hundreds or thousands)
If you do infini rf, do not do any filler until the end of your treatment. Laser and RF melt filler.
I don't see that you need laser or Infini, you could do a TCA peel and fix some of the small textural issue, less risk. When you get into lasers and Infini and you have a prior history of scarring then you can create more issues with energy. Only have them spot treat the scarred areas. If you do decide to do Infini Insist on a test spot to test how you heal. One guy if you look back a few days ago was upset after fat loss. IT dissolves some scar tissue and takes months to remodel collagen (for some this does nothing - like laser, they still do filler and subcision in the end), be prepared that it will get worse before better and could cause more scars as you said, you get them easily.
I still think the best option for you is subcision of that right cheek and filler and a topical tca peel for texture. I know this will give you some percentage of improvement.
I cannot guarantee with Infini you will get what you want, we all heal differently, and we have auto immune like disease, after all we have scars.
PS. Please like if you found this helpful.
7 hours ago, beautifulambition said:I see one issue on your right cheek / left brow. This needs filler to correct with subcision. Stretch and squish it between your fingers, does it look better?? You do not need traditional subcision just with the filler needle around the scars. Please make sure your doctor has experience with filler and acne scars. They can assure you that they will not doughnut filler around scars but subcise the tethers and make it look even. Ask how many they have done before. (Should be hundreds or thousands)
If you do infini rf, do not do any filler until the end of your treatment. Laser and RF melt filler.
I don't see that you need laser or Infini, you could do a TCA peel and fix some of the small textural issue, less risk. When you get into lasers and Infini and you have a prior history of scarring then you can create more issues with energy. Only have them spot treat the scarred areas. If you do decide to do Infini Insist on a test spot to test how you heal. One guy if you look back a few days ago was upset after fat loss. IT dissolves some scar tissue and takes months to remodel collagen (for some this does nothing - like laser, they still do filler and subcision in the end), be prepared that it will get worse before better and could cause more scars as you said, you get them easily.
I still think the best option for you is subcision of that right cheek and filler and a topical tca peel for texture. I know this will give you some percentage of improvement.
I cannot guarantee with Infini you will get what you want, we all heal differently, and we have auto immune like disease, after all we have scars.
PS. Please like if you found this helpful.
Thank you beautifulambition! This very helpful, I will for sure ask all that you mentioned to my Dr !