I'm 32, Asian male with acne of various kinds since I was around 11. I've mostly had whiteheads and cystic acne, the latter doing the worst damage. It has led to this horrible atrophic scarring and some ice pick scarring.
Pics: https://imgur.com/a/FOzCsx3
As you can see I still deal with active adult acne, but I'm not waiting for it to stop anymore. I've learned (much too late) about microneedling as an option and I'm actually going for my first treatment soon (with PRP). The doc also suggested a chemical peel in the fall because it's too hot right now (live in GA).
But I'm open to all ideas. It would mean a lot to me as an OCD person to get ideas for a detailed game plan to attack this scarring.
- Right now what I've got is microneedling at least month apart.
- I've read it's best to pair procedures and alternate. In my case that would be a chemical peel, TCA specifically. But not TCA cross as it's too harsh?
- I've also been recommended hydroquinone to deal with hyperpigmentation (should've been started before procedures, but I'm not waiting) and tretinoin to allow the peel to work more effectively.
Thanks in advance for any help.
Well I just got back from my first microneedling + PRP. That was something else. The numbing cream didn't work on me, either because they didn't use enough or didn't wait long enough (about 10 minutes), I don't know, so I felt every single bit of it, especially on the forehead. She didn't go over my whole face, as I've seen in every video I've seen of it; only went over the problem areas. She injected the PRP before the procedure. I asked if she would use different sized needles for different ares, but she never changed them. It was just a simple plug in pen. I wonder if the needles are even sterilized between uses.
Overall pretty disappointing first session at $500.
She agreed on alternating microneedling and chemical peels. She said we'll do a Jessner's peel for me instead of TCA because of my skin tone.
I asked about subcision and hydroquinone and she said no to both.
Does not sound like a scar specialist, more of a general derm. By the way the did treatments, etc...
Your scars are deep.
I would have done subcision with filler. 4 sessions of this. With Sculptra would be good as they are wide spread.
I would also do rf microneedling. Not Normal microneedling. 4 sessions of this spaced 3 months apart between your subcisions.
You need multiple sessions of paint on or spot peel (placing 3 layers of acid when it dries in the scar bed) on many of your larger pits, and tca cross on the icepicks.
You might also need co2 3-7% density and the fullest power if they are suborn (you can start with rf needling or this).
Finally a resurfacing with a erbium laser fully ablative for the texture.
Treat as you have time and money. Space things apart 3 months to heal.
Picosure towards the end is great for your skin type and discoloration.
BA
PS. That is just silly about retin - a / differin / tretinorin and konjac and albutin cream nightly. You do this to prevent discoloration in your skin type and help the skin. It's OTC.
On 8/17/2018 at 10:48 PM, beautifulambition said:Does not sound like a scar specialist, more of a general derm. By the way the did treatments, etc...
Your scars are deep.
I would have done subcision with filler. 3 to 4 sessions of this. With Sculptra would be good as they are wide spread.
I would also do rf microneedling. Not Normal microneedling. 3-4 sessions of this spaced 3 months apart between your subcisions.
You need multiple sessions of paint on or spot peel (placing 3 layers of acid when it dries in the scar bed) on many of your larger pits, and tca cross on the icepicks.
You might also need co2 3-7% density and the fullest power if they are suborn (you can start with rf needling or this).
Finally a resurfacing with a erbium laser fully ablative for the texture.
Treat as you have time and money. Space things apart 3 months to heal.
Picosure towards the end is great for your skin type and discoloration.
BA
PS. That is just silly about retin - a / differin / tretinorin and konjac and albutin cream nightly. You do this to prevent discoloration in your skin type and help the skin. It's OTC.
Thank you so much for the response.
I'm not sure where I'd find a scar specialist, but I am switching to a derm that does RF microneedling. They do a three treatment package. With the first treatment they would have also done PRP, but I already got that done with my other derm last month (2nd post).
I know you help many people so you can't be too detailed, but I'd like clarification on some things that are confusing me:
- In your suggestion for CO2 are you saying I should start with either but try to do both? I'm trying to minimize treatments obviously so I want to do the one that's most beneficial.
- With your PS I'm not sure what you're saying is silly and what you're suggesting instead.
Thanks