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Unless you have severe, widespread, and scarring acne, The Regimen is normally my suggestion for the most effective acne treatment.

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Indented forehead scars + more

MemberMember
0
(@ola-123)

Posted : 07/31/2020 4:18 pm

Hello everyone!

I need help in deciding what to do mainly with my deep post-cystic acne scars located mainly on forehead but also cheeks and chin, basically, my whole face. I battled the biggest acne outburst last summer and autumn, the scars formed around September of last year. I used 0.025 tret for 3 months and now I use isotret 0.05 gel since half of January (I can't get anything stronger in my country). I rarely get any new acne now, will be getting my 5th dermapen session next week and probably will get the last - 6th one in next 3 or 4 weeks. I asked derms about prp before but they weren't that entusiastic about it, so I didn't do any of this. Now I wonder what can I do after microneedling, because the autumn/winter is coming and  I want to do something more stimulating. I've read a lot and idk what to do tbh. I started with dermapen, because I am scared how my skin will behave with anything more aggresive - my skin is acne-prone (duh), sensitive, oily, vascular, prone to erythema, allergic, thin & pale. Example - niacinamide breaks me out instantly, 15% L-ascorbic acid serum breaks me out literally overnight (luckily, now that I use TO acorbyl glucoside solution, it's somehow ok), aloe & glycolic acid peeling pads - same story, the glorious vinegar acid solution - irritation of a lifetime. Before dermapen, last year I've done a few IPL sessions and I swear, 3 days after each one, I would get little red dots around my eyes. It took less than 2 weeks for them to dissapear. Person doing the treatment was shocked, they didn't have a patient like this before. The only case I got the dots after this, was when I cried aggresively and a lot, so I conclude that this is something vascular - my veins basically saying 'nope' to any kind of pressure/energy (?)

  • I wondered about subcision, but one derm told me it works on boxcar scars, and mine are rolling ones & also I have thin skin, so we don't really know what will happen, especially on forehead, and any new scar is a big no-no. 
  • I had the proposition to try TCA + microneedling, but I am really scared of acids, because they are the sole reason for the aggresive acne outburst (azelaic, shikimic and probably  glycyrrhizinic acid). TCA CROSS, as far as I know, is probably not for me, because I have almost none of the ice pick scarring, but I would be really eager to try it, since it's applied just on scars, not whole face, which in my case is really reactive.
  • CO2 ablasive laser - it gives promise of bigger improvement than plain fractional lasers but the thing that won't let me rest is the risk of the grid pattern staying with me forever. All I know the answer for it is using lower power, but will I achieve the same results as the 'normal/higher' settings? 
  • PRP - is there any point in doing this, when the scars are almost a year old at this point?
  • RF microneedling - I plan to do in the spring/summer next year, since I know it's not that aggresive. Also, derm told me that it doesn't give that much of an effect.
  • And in the end, when there will be no more prospects of improvement, I want to get fillers.

All I want to know is what order will be the best in my case, also - the configuration of treatments - subcision + TCA, subcision + CO2, subcision with filler or not, when the prp would come into play? I'll really appreciate any kind of help from anyone experienced, or with skin similar to mine. I hope the photos attached will be sufficient.

 

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MemberMember
4
(@rockyracoon)

Posted : 08/03/2020 5:34 pm

Hey, I definitely think the first thing you should look into is subcision preferably with a spacer as your primary modality before anything else. I don't think this is something any doctor can do, especially considering how tricky the forehead is, so I'd do a lot of research beforehand. I'd recommend sending BA a private message or posting your pictures on RealSelf for an expert's opinion. :) 

This video might be helpful! 

https://www.instagram.com/p/BWbP0rmAg8Y/


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