@AndreaVisentinHi There, thanks for providing the pictures that helps.

Your a great candidate for subcision + filler!

Non-ablative laser's literally do nothing for scars, ... pigment yes. Never start with laser treat the deeeeepest problem and that is the pits and linear atrophy. Ah sensitive skin, and reds, this is why they did non ablative laser for the discoloration.

Epiduo is fine, test spot if you need on a small area, use nightly, if you can only do it once or twice a week that is ok.

You have atrophy: Rolling scars, Linear scars, and some box cars, textural scarring, and some hyperpigmentation.

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Disclaimer: Information and support is not meant to diagnosis, treatment, or cure any health or mental condition and is not a substitute for professional face to face medical care (consult with a few Dr's and pick your favorite one). Posts are for informational purposes only, please consult your personal health care practitioner before engaging in anything discussed.

36 minutes ago, beautifulambition said:

@AndreaVisentinHi There, thanks for providing the pictures that helps.

Your a great candidate for subcision + filler!

Non-ablative laser's literally do nothing for scars, ... pigment yes. Never start with laser treat the deeeeepest problem and that is the pits and linear atrophy. Ah sensitive skin, and reds, this is why they did non ablative laser for the discoloration.

Epiduo is fine, test spot if you need on a small area, use nightly, if you can only do it once or twice a week that is ok.

You have atrophy: Rolling scars, Linear scars, and some box cars, textural scarring, and some hyperpigmentation.

* I would do 3-8 sessions of cannula subsision to your scars, this will help you most, ... they can do a bit of filler after or you can do Chinese Cupping (Amazon) for a whole month (with cupping yes you bruise, so be prepared if you take this route, you can vary the suction strength, wear a concealer over the area like dermablend). A buffer keeps things from re-tethering.

* I would do rf needling to your scars, ... this helps rolling / boxcars(4 sessions or more)

* CO2 laser if you need a boost in low density and high power setting.

* For texture we lastly do Sciton fully ablative laser resurfacing, notice I said ablative, non-ablative with do nothing for your scars. Jplasma, or a Deep Chemical Peel is good. OR several TCA peels, or a deep peel on the scar areas only. You have sensitive skin discuss this aspect with the Dr you goto, talk about steriod shot to the hip, doing a test area, and aftercare. This works once you raise your pits, but there is down time.

* buy a dermastamp(you might already have one) and stamp them monthly (you treat with the Dr every 3 months - above things regardless of what they tell you, the body is incredibly slow to heal and they want $$$$ quickly). So once a month you dermastamp or derminator (google it), andyou can alternate with do glycolic peels at home. Treatment for many takes 3 years, everything is optional.Treat as you have time and money (for some that's only 2 things a year), many take 3 years to treat, it's a slow process again with most of it related to how you heal and what works best for you, do more of that.

* For redness we do pulse dye laser, or something like picosure, picoway. Laser resurfacing (Above) and Q switch is used if the pigmentation is not responding after several treatments. Alternatively you can try first peels for discoloration or hyperpigmetnation.

* This is a must for your skin type and discoloration to do nightly(note you already have epiduo so you have the retinoid taken care of and the hydroquinone parts)

Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), The Ordinary Granactive Retinoid (if you can't get the above). Cureology(USA) & Yoderm(USA) provides online prescriptions with customized skin care creams for your concerns, those in UK Dermatica provides the same thing. Apply a moisturizer when your face is dripping wet. Wait 5 minutes for it to dry, and then apply the tretinoin. This cuts down on irritation, you can also skip days of application (one or two days a week) if it's irritating and you need to build up %. This provides skin turnover - new collagen. To prevent (reds & browns from all Dr-treatments to ethnic skin or to work on current skin discoloration), try PCA hydroquione free gel for Hyperpigmentaion (Amazon) or Cureology/Dermatica includes this in their products if ordered. Using this prevents hyperpigmentation from treatments. Hydroquinone has side effects for some people, natural options are better with ingredients like: kojic acid/Konjac, Alpha Arbutin, Niacinamide by The Ordinary is great for large pores, discoloration, and inflammation. The Ordinary, Cerave, Eucerin (QV Skincare in AUS), Dr Sam Bunting Flawless Cleanser, La Roche-Posay (sensitive), and Acne.org's products are all great options for moisturizers and cleaners without fragrance / dyes / allergens. The Three most important things one can use are: Vitamin A skin turnover (retinol, retinaldehyde, retinoid), Vitamin C Serum which makes collagen, and a sunscreen (zinc oxide physical for sensitive skin - DRMTLGY Active Sunscreen, Elta MD Physical).

Checkout the main scar treatments sub, find the FAQ pinned there, goto the bottom, there are Dr's or call around and ask who does cannula subcision or nokor subcision (needle type) to dermatologists and or plastic surgeons, consult a few before you decide who you like, even if you have to pay as treatment is expensive, better like them. Ask how many subcisions they do a month and if they treat your skin type. If they just do laser run they will just blast you and not solve your issue.

 

Thank you really a lot for your reply.

I wanted to do some subcision treatments before starting non-ablative laser ones, but the fact that the only doctor who did subcision told me that that treatment wouldn't work, even if I know it was the best, made me fell to the laser surgeon's arms. Also, the former onetold me to just get fat in order to smooth the scars lol. Acne scars in my country ( Italy ) are super rare, so even surgeons are kind of ignorant about the issue.

Anyways, I thank you again and I really wish you the best. If I could pay back the favour somehow, I'll do it!

BTW Dr. David Lim cited you in an Instagram story weeks ago. He said you've got more knowledge about acne than him!