On 3/2/2021 at 10:17 AM, Amanda Hall said:I'm extremely skeptical of the results that non-ablative lasers yield. Had that done by two different doctors and two lasers and I saw no changes. One doctor even had the audacity to say, "Your skin looks better!" at my next visit. Uhh, he didn't even take pictures and how would he know when my next appointment was months from my treatment! I had when doctors say this. I've had three doctors tell me my skin looks better after treatment. It's utter BS.
Infini treatment is extremely painful. You'll need Pronox if you do your entire face. Or some kinda sedative. Numbing creaming doesn't really do as much as you think. That's how much it hurts. When I did it the first time, it was more bearable. During my second time, it was ridiculously painful. I'm not sure if the doctor changed the settings (he probably didn't). Can't explain why it hurt way more the second time.
I'm in agreement. Dr. Lim's video about Infini and how he praises RFM led people down the wrong path. Maybe he was getting paid under the table by Lutronic and he was just spewing BS to hype up the machine and technology.
I've gotten Infini done twice and wouldn't do it again. Didn't see noticeable results. My scars are mostly boxcar so please keep that in mind - maybe if I had some shallow rolling scars, I would have seem some improvement.Recovery is not 3-4 days despite what every doctor will tell you. Infini also hurts like a .
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3 hours ago, Amanda Hall said:Infini treatment is extremely painful. You'll need Pronox if you do your entire face. Or some kinda sedative. Numbing creaming doesn't really do as much as you think. That's how much it hurts. When I did it the first time, it was more bearable. During my second time, it was ridiculously painful. I'm not sure if the doctor changed the settings (he probably didn't). Can't explain why it hurt way more the second time.
I totally agree. It's funny when you look up online all the clinics, docs etc say in their websites that it's tolerable, slightly uncomfortable blah blah but the actually treatment is quite painful and takes you by surprise. It was very uncomfortable for me even with lidocaine(from subcision) + topical anesthetic cream.
1 month in and yet to see any improvements. It might be helpful for skin tightening and aging etc, but I'm skeptical about its efficacy for acne scarring.
8 hours ago, Marumi said:It's very hard to believe. None of actual the papers you gave to Serius Lee later in the thread is about combining RF microneedling with a co2 laser.
I thought I put one in, my mistake. You're still completely wrong , and let me explain why. I have put in 3 papers showing the combination is safe and effective at the bottom of my post. One of them is a small split face study comparing fractional CO2 combined with RF microneedling vs fractional CO2 alone.I will update the original post above for future readers. I'm not BA, BA was and still is against combining treatments. Apparently trusting doctors means I must be BA?
8 hours ago, Marumi said:I base my opinion on the opinion of the doctors who oppose the RFM+laser in one go combination, the fact that there isn't a single paper about it, and the fact that even the doctors you mentioned cannot show a single photo of a patient treated with the combo, and there isn't a thread here about it either.
For the fourth time, WHO are these doctors? Where are you getting this from? Tell the forum or stop misleading people. I'm willing to listen to you if you provide facts or reveal an actual source, but instead you're just spewing nonsense again. The only data so far that has been shown for any doctor recommendations about it is 7 out of 9 who recommend the combination on realselfand the doctors who published papers saying it's safe. I've just posted 3 papers after google searching for 5 minutes, does this mean you're going to change your opinion now that there's papers?
8 hours ago, Marumi said:And please do share the paper that shows that RF microneedling+ablative laser is safe and superior to one of these treatments done alone?
See link #1 below. Are you going to shut up now because you don't know what you're talking about? What we really need is a study showing the combination is better than doing both treatments separately, but maybe I just need to google another 5 minutes. Two of the studies belowalready noted there were less side effects, but we don't know if the combination is more effective than separating them, although if we know patient satisfaction is high from the studies (and experience of realself doctors), I'm willing to take the risk.
8 hours ago, Marumi said:I have read all the scientific literature on scars years ago, and I keep up with the current meta analyses and reviews, and just want to wish you good luck trying to find me a study about the superior results of RFM+co2 lasers
Clearly you aren't doing a good job if it took me 5 minutes to find one. Stop talking now? For the good of the forum?
6 hours ago, Amanda Hall said:'m extremely skeptical of the results that non-ablative lasers yield. Had that done by two different doctors and two lasers and I saw no changes.
This happened to me too. Did non-ablatives 5 times and saw no change. It's upsetting.
6 hours ago, Amanda Hall said:Infini treatment is extremely painful. You'll need Pronox if you do your entire face.
Good god. I'm doing it tomorrow. Can't wait lol. You said you got no improvement - did you do subcision at the same time? I can't remember the doctor but I saw one on social media that said it's better to do subcision with RF because doing it without subcision can help strengthen tethering. In any case it seems to be hit or miss on this forum.
Studies of fractional ablative CO2 combined with RF microneedling
The first one is a small 2014 split face study comparing fractional CO2 on one side of the face vs fractional CO2 plus RF microneedling on the other side. The side of the face with the combination healed faster and had less side effects than the side with CO2 only. Small sample size but it still shows it MIGHT be better to combine.
Here is a seconda Turkish retrospective study of 72 patients showing safety and efficacy of fractional CO2 combined with microneedling RF. As mentioned by realself doctors, they anecdotally noted that the side effects of the CO2 laser seemed to be lessened (although they didn't directly compare to using laser alone, so not the best evidence scientifically). Interestingly, patient satisfaction was higher in darker skin types.
The third one is a 71 patient Korean study showing that you can treat fractional CO2 + microneedling RF in patients on Accutane safely and effectively.
On 3/2/2021 at 4:20 PM, GuyWithScars said:I thought I put one in, my mistake. You're still completely wrong , and let me explain why. I have put in 3 papers showing the combination is safe and effective at the bottom of my post. One of them is a small split face study comparing fractional CO2 combined with RF microneedling vs fractional CO2 alone.I will update the original post above for future readers. I'm not BA, BA was and still is against combining treatments. Apparently trusting doctors means I must be BA?
For the fourth time, WHO are these doctors? Where are you getting this from? Tell the forum or stop misleading people. I'm willing to listen to you if you provide facts or reveal an actual source, but instead you're just spewing nonsense again. The only data so far that has been shown for any doctor recommendations about it is 7 out of 9 who recommend the combination on realselfand the doctors who published papers saying it's safe. I've just posted 3 papers after google searching for 5 minutes, does this mean you're going to change your opinion now that there's papers?
See link #1 below. Are you going to shut up now because you don't know what you're talking about? What we really need is a study showing the combination is better than doing both treatments separately, but maybe I just need to google another 5 minutes. Two of the studies belowalready noted there were less side effects, but we don't know if the combination is more effective than separating them, although if we know patient satisfaction is high from the studies (and experience of realself doctors), I'm willing to take the risk.
Clearly you aren't doing a good job if it took me 5 minutes to find one. Stop talking now? For the good of the forum?
This happened to me too. Did non-ablatives 5 times and saw no change. It's upsetting.
Good god. I'm doing it tomorrow. Can't wait lol. You said you got no improvement - did you do subcision at the same time? I can't remember the doctor but I saw one on social media that said it's better to do subcision with RF because doing it without subcision can help strengthen tethering. In any case it seems to be hit or miss on this forum.
Studies of fractional ablative CO2 combined with RF microneedling
The first one is a small 2014 split face study comparing fractional CO2 on one side of the face vs fractional CO2 plus RF microneedling on the other side. The side of the face with the combination healed faster and had less side effects than the side with CO2 only. Small sample size but it still shows it MIGHT be better to combine.
Here is a seconda Turkish retrospective study of 72 patients showing safety and efficacy of fractional CO2 combined with microneedling RF. As mentioned by realself doctors, they anecdotally noted that the side effects of the CO2 laser seemed to be lessened (although they didn't directly compare to using laser alone, so not the best evidence scientifically). Interestingly, patient satisfaction was higher in darker skin types.
The third one is a 71 patient Korean study showing that you can treat fractional CO2 + microneedling RF in patients on Accutane safely and effectively.
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2 hours ago, GuyWithScars said:Good god. I'm doing it tomorrow. Can't wait lol. You said you got no improvement - did you do subcision at the same time? I can't remember the doctor but I saw one on social media that said it's better to do subcision with RF because doing it without subcision can help strengthen tethering. In any case it seems to be hit or miss on this forum.
No, I did Infini by itself. I've had subcision done as well but no improvement there. I don't have a huge number of scars and you have to keep in mind that boxcars are different for everyone. It's my opinion that acne scars are different than scars from accidents or such.
16 minutes ago, Marumi said:Just as I predicted, youhaven't found a single paper showing that the combination treatment (RFM+CO2 fractional laser)is safer andgives better results than RFM alone or CO2 laser alone. That was your initial question, this is what we are discussing about and what I asked of you.
This is NOT what we were discussing. We were discussing whether it was SAFE to combine them and if they gave good results, not if separating them is better which I've stated numerous times would be a good study to have but I couldn't find one in 5 minutes. Just as I thought you would do, the moment I give you what you ask for (show safety + that it generally works, and that it's most likely more effective than not combining), you move the goal posts. Since the beginning I've stated that it would be great to know if it's better to separate them vs combining, but we just don't know. What we CAN conclude based on what I've presentedis that it's safe to combine, that the authors of the small study concluded there were less side effects compared to CO2 alone (so plausible but not proven), that anecdotally the authors of the larger study felt in their clinical experience that the combination had less side effects (plausible but not proven), andthat anecdotally 7 out of 9 doctors recommend this treatment (shows that most likely it's a good idea but we don't have any other data on medical consensus). Keep in mind, I've googled for 5 minutes. These people do this every single day and you're someone who clearly is scientifically illiterate and who's only argument so far has been "you can't trust any doctor because I don't trust Davin Lim".
18 minutes ago, Marumi said:The 3 studies that you've linked are all of very very very low scientific quality not because of the small sample size of 10 people, not even because some are retrospective (=not reliable), but because they all lack a control group to compare your results with.
Cool, where exactly were you educated to judge the merit of scientific studies? One study was 10 people but the other two had 70 people. These studies have sufficient proof thatit's generally safe, which was my primary concern. My secondary concern was "does it give good results" and that was also proven. You don't need a control group if that's what you're trying to prove. You need a control group if you're trying to say X is better than Y. To show thatX is safe or X is effective, Y is unnecessary. The 10 person study showed that it MIGHT be better to combine them scientifically, but if you pair that with the clinical experience of 7 out of 9 realself doctors, it probably means it works better!
Does it give BETTER results than separating? Is it SAFER than separating? We don't know, two of the papers I showed came out in 2020 so who knows, it might come out one day. It's obviously not safer to do 3 treatments than 1 treatment, regardless of whether or not you separate. Is it riskier to combine v.s. not combine? Who knows, but if several studies + doctors have concluded it's safe, that's all I care about. For now, without others presenting evidence, we can only go by what doctors recommend and have seen in their practice. 7 out of 9 on realself recommend it and we have no other data here.
Even if one day they prove it's better to separate, as someone getting treatments that doesn't mean that combining is a bad idea because you're still improving your scars (and possiblymore than with CO2 alone). The only thing you MIGHT be losing by combining is money. If it turns out that combining vs separating is EQUAL (or better) than separating, then what you gain is TIME. Time meaning you get improvement faster AND you get less overall downtime because you're not having downtime multiple times, just once. So explain to me why it would be crazy to combine? When best case you get equal or greater improvement with half the downtime (and a discount from combiningtreatments), and worst case you might lose SOME money.
I will ask you a FIFTH time now, where are your doctors who don't recommend it? Oh right, it's because you don't have any. I forgot.
41 minutes ago, Marumi said:This is the kind of science funded by the laser companies to promote their products, just as they pay doctors and hire marketing teams to help as well.
Proof the study was funded by a laser company? Or just more conspiracy theories where Davin Lim and the other 6 realself doctors all secretly met in 2014 to find out how they can charge more? Not saying that doctors don't do shady things, but you should have proof if you're going to try to discredit a study
32 minutes ago, Marumi said:It's extremelyrude of you to tell me to shut up and move on just because I don't share your opinion and I can back up my opinion with arguments.
lol Telling someone to shut up because they don't share an opinion is one thing. Telling someone to shut up because they're misleading the public in the face of facts by saying experts don't agree with something or that there's no evidence proving something is a safe is a responsible thing to do. Oh, and then attempting to gaslight me and the public by pretending you were asking for other studies or to prove other end points. So I'll repeat: stop talking.
On 3/2/2021 at 6:38 PM, GuyWithScars said:This is NOT what we were discussing. We were discussing whether it was SAFE to combine them and if they gave good results, not if separating them is better which I've stated numerous times would be a good study to have but I couldn't find one in 5 minutes. Just as I thought you would do, the moment I give you what you ask for (show safety + that it generally works, and that it's most likely more effective than not combining), you move the goal posts. Since the beginning I've stated that it would be great to know if it's better to separate them vs combining, but we just don't know. What we CAN conclude based on what I've presentedis that it's safe to combine, that the authors of the small study concluded there were less side effects compared to CO2 alone (so plausible but not proven), that anecdotally the authors of the larger study felt in their clinical experience that the combination had less side effects (plausible but not proven), andthat anecdotally 7 out of 9 doctors recommend this treatment (shows that most likely it's a good idea but we don't have any other data on medical consensus). Keep in mind, I've googled for 5 minutes. These people do this every single day and you're someone who clearly is scientifically illiterate and who's only argument so far has been "you can't trust any doctor because I don't trust Davin Lim".
Cool, where exactly were you educated to judge the merit of scientific studies? One study was 10 people but the other two had 70 people. These studies have sufficient proof thatit's generally safe, which was my primary concern. My secondary concern was "does it give good results" and that was also proven. You don't need a control group if that's what you're trying to prove. You need a control group if you're trying to say X is better than Y. To show thatX is safe or X is effective, Y is unnecessary. The 10 person study showed that it MIGHT be better to combine them scientifically, but if you pair that with the clinical experience of 7 out of 9 realself doctors, it probably means it works better!
Does it give BETTER results than separating? Is it SAFER than separating? We don't know, two of the papers I showed came out in 2020 so who knows, it might come out one day. It's obviously not safer to do 3 treatments than 1 treatment, regardless of whether or not you separate. Is it riskier to combine v.s. not combine? Who knows, but if several studies + doctors have concluded it's safe, that's all I care about. For now, without others presenting evidence, we can only go by what doctors recommend and have seen in their practice. 7 out of 9 on realself recommend it and we have no other data here.
Even if one day they prove it's better to separate, as someone getting treatments that doesn't mean that combining is a bad idea because you're still improving your scars (and possiblymore than with CO2 alone). The only thing you MIGHT be losing by combining is money. If it turns out that combining vs separating is EQUAL (or better) than separating, then what you gain is TIME. Time meaning you get improvement faster AND you get less overall downtime because you're not having downtime multiple times, just once. So explain to me why it would be crazy to combine? When best case you get equal or greater improvement with half the downtime (and a discount from combiningtreatments), and worst case you might lose SOME money.
I will ask you a FIFTH time now, where are your doctors who don't recommend it? Oh right, it's because you don't have any. I forgot.
Proof the study was funded by a laser company? Or just more conspiracy theories where Davin Lim and the other 6 realself doctors all secretly met in 2014 to find out how they can charge more? Not saying that doctors don't do shady things, but you should have proof if you're going to try to discredit a study
lol Telling someone to shut up because they don't share an opinion is one thing. Telling someone to shut up because they're misleading the public in the face of facts by saying experts don't agree with something or that there's no evidence proving something is a safe is a responsible thing to do. Oh, and then attempting to gaslight me and the public by pretending you were asking for other studies or to prove other end points. So I'll repeat: stop talking.
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This is my last response to you because this back and forth needs to end. If anyone has made it this far, I'm confident that they'll see right through it with all the evidence I gave in this (9 papers & 9 doctors) vs you (0 papers, 0 doctors, 999 unbacked claims & conspiracy theories).
At no point have I said the results would be better if youcombined multiple treatments than if you did the same treatments but separated them. That question, which nobody seems to know the answer to,isn't as nearly asimportant as whether combining 2 or more treatment typesin 1 session is safe and better than doing 1 type of treatment in 1 session. And the answer is obvious that if safe, it's better to combine more than one if you have a mix of scars. This makes sense logicallyand in the implicit widespread consensus of acne scar experts that seem to promote combining treatments around the world.You have presented ZERO evidence of this being untrue. Zero. Also,all 9 papers I put outhad the experience that combining2 of the 3 we discussed (fractional laser, RF microneedling, and subcision) was safe. Here's #10 combining infini, subcision, and phenol which had 139 patients.Also safe.
9 hours ago, Marumi said:The studies you've found are considered low qualityscience by any standards, and you cannot draw any conclusions about how safe or effective the combonation treatment is based on these studies.
By any standards or your standards? It's funny that you complain a study is small, but then say "look at this other thread where 3 people say infini doesn't work well for them" and have no problem calling that evidence that infini doesn't help (and this is not me making any statement on whether or not I think infini by itself is effective, I have no idea). The studies I presented are good enough to bepublished in medical journals and are clearly validated by the only data we have about a doctor consensus on combining RF + fractional laser.Most likely scenario is that it's a good combination if recommended for your scar types and the doctor knows how to use the combination. Once again, where is your evidence that this doesn't work?
On 3/3/2021 at 3:51 AM, GuyWithScars said:This is my last response to you because this back and forth needs to end. If anyone has made it this far, I'm confident that they'll see right through it with all the evidence I gave in this (9 papers & 9 doctors) vs you (0 papers, 0 doctors, 999 unbacked claims & conspiracy theories).
At no point have I said the results would be better if youcombined multiple treatments than if you did the same treatments but separated them. That question, which nobody seems to know the answer to,isn't as nearly asimportant as whether combining 2 or more treatment typesin 1 session is safe and better than doing 1 type of treatment in 1 session. And the answer is obvious that if safe, it's better to combine more than one if you have a mix of scars. This makes sense logicallyand in the implicit widespread consensus of acne scar experts that seem to promote combining treatments around the world.You have presented ZERO evidence of this being untrue. Zero. Also,all 9 papers I put outhad the experience that combining2 of the 3 we discussed (fractional laser, RF microneedling, and subcision) was safe. Here's #10 combining infini, subcision, and phenol which had 139 patients.Also safe.
By any standards or your standards? It's funny that you complain a study is small, but then say "look at this other thread where 3 people say infini doesn't work well for them" and have no problem calling that evidence that infini doesn't help (and this is not me making any statement on whether or not I think infini by itself is effective, I have no idea). The studies I presented are good enough to bepublished in medical journals and are clearly validated by the only data we have about a doctor consensus on combining RF + fractional laser.Most likely scenario is that it's a good combination if recommended for your scar types and the doctor knows how to use the combination. Once again, where is your evidence that this doesn't work?
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On 3/1/2021 at 8:26 AM, Marumi said:Note that the doctors who seem to have predominantly good reviews here on the forum, and who people seem to go see for treatments, aren't the over hyped self promoting social media stars like Lim& co
Who are these doctors with predominantly good reviews on the forum? Whenever I look for preferred providers for acne scar treatment, I see Dr. Lim, Dr. Rullan, Dr. Weiner, Dr. Emer, etc. and those are all folks who are "social media stars". Please, if you can point me to solid doctors who aren't trying to rob people blind, I'd really like to talk to them about treatment!!! Thanks so much in advance for any guidance you can offer. I'm trying so hard to find a trustworthy provider and it is challenging, to say the least.
On 3/16/2021 at 5:58 PM, Tonitrus09 said:Who are these doctors with predominantly good reviews on the forum? Whenever I look for preferred providers for acne scar treatment, I see Dr. Lim, Dr. Rullan, Dr. Weiner, Dr. Emer, etc. and those are all folks who are "social media stars". Please, if you can point me to solid doctors who aren't trying to rob people blind, I'd really like to talk to them about treatment!!! Thanks so much in advance for any guidance you can offer. I'm trying so hard to find a trustworthy provider and it is challenging, to say the least.
To be honest, of all the threads I've read on acne scars doctors on the forum, I think Dr Rullan is the most trustworthy and has the best treatment plans for all skin types. Downside is he's pretty expensive. As for the other doctors you've mentioned I will only advise you to look VERY closelyat their credentials as not all of them are board-certified dermatologists or board-certified plastic surgeons. I recommend you check their Realself profiles and see their qualification under board certification.