Pic would help

Hi. For the darker spots ''post-inflammatory hyperpigmentation'', ingredients like vitamin C, niacinamide, or alpha arbutin can help fade them over time. And for texture, gentle exfoliation you need to think about lactic acid or low-strength retinoids which can smooth things out... But Id avoid anything too harsh near your lips, that skin is delicate!.....As for treatments, retinoid use or professional peels can build collagen for long-term improvement...W

@wilamenaskincare Ive also been wondering about how to treat the more delicate areas near the lips, glad you mentioned that. Have you or anyone else here tried low-strength retinoids specifically in that area? Im curious how well-tolerated they are over time. Also, for building collagen, do you think microneedling is worth exploring for smaller scars, or is it more effective on deeper ones?

For low-strength retinoids near the lips many people tolerate them well if introducedverygradually buffering with moisturizer, using them 12 times a week. The key is avoiding the vermilion border, the actual lip tissue, and sticking to the surrounding skin......On microneedling, treatments like retinoids and microneedling work cumulatively, so patience is key. For the darkest spotsonthe lips, if theyre post-inflammatory a dermatologist might suggest gentle laser like Q-switched or topical brighteners safe for lip mucosa, but that area requires extra caution. W

@dan

Hello. I managed to take these two photos showing the same area from different angles. I suppose that whatever is useful for these scars, it would be useful for the rest of the face.

https://ibb.co/xqP0dzSX

https://ibb.co/whzYw1CV

Of course, the best would be to look at my skin directly, but the photos give you an idea.

I had hundreds of acne lesions. Most of them were like pustules, but because I had very oily skin, sometimes there were a lot of pus, and sometimes it was more complicated and there were furuncles or carbuncles. And occasionally I damaged the skin myself and complicated things with my fingers when I was a teenager.

For example, in this fragment of face, directly with your eyes, you could see like 15-20 scars. But there are at least two that you can see at a talking distance. Number 1 is a depressed scar (first, probably I damaged the skin myself when I was younger, and later a new acne lesion in the same place made the scar bigger).

Number 2 is a dot close to the lips, which seems like two dots close together, left by two pustules. In the second photograph it is seen as having a different color.

Number 3 is like a red tinted area in the skin immediately close to the lips. It is not very clear in the photo, and in reality is subtle.

I have more around the lips, in general like small dots from pustules. And I have a lot more scars in the cheeks and in different parts of the face, from dots to some depressions, if you watch closely and attentively. But, as a hole and not approaching too much, you dont see a lot of deep scars like some people have.

As I said, what bothers me more is around the mouth. And I know they are scars, the skin is deformed. So, in the best scenario, it would be nice to soften or reduce the scars in order to improve the general look of the skin, if that is possible and its worth it.

Also, just in case, I add that I took Accutane more than ten years ago and that changed my skin. It is much less oily now, and I dont know if it is less capable of wound healing.

@wilamenaskincare

Hello. Thank you for your answer! You can see the photos and more information in my previous post.

Does a retinoid gel have something to do with Accutane, in the sense of drying the skin, maybe permanently?

And I dont know really if it is about collagen, at this point, when the scars were settled years ago. The wounds are already healed and the skin is deformed. There is nothing to heal.

Maybe some sort of peeling or abrasion would help...? What do you think? Whats your experience? Are you a doctor or just someone with similar skin concerns?

Hi, I don't see any photos, but it does not matter. I'm currently studying everything about skincare... Ive learned so much through research, testing products, and staying curious. I share whats helped me in hopes it helps someone else.! I hope one day to be fully qualified and do this professionally.

Retinoids and Accutane can both be intense on the skin, but theyre not the same thing......Retinoid gels like tretinoin or adapalene are topical treatments that do dry out the skin, especially at first, because they speed up cell turnover. But that dryness usually improves as your skin adjusts! ..Accutane on the other hand, is way stronger because it works internally to shrink oil glands, and for some people, that can lead to longer lasting dryness. Everyones different. so always start slow, and moisturize well.

Youre right that fully healed, indented scars wont heal on their own anymore, collagens already done its best at the time.

Peelings can help a little by resurfacing, but for deeper texture, you might need stronger stuff.

Other options are Lasers and Microneedling, you really need advice from a qualified professional to know whats right for your skin. Everyones texture is different and so is the best treatment.... I hope this helps you in some way. W

A few things I'd say:

• Your scars are not noticeable really. I know they are to you because you're focused on them, but I dunno if anyone would really notice them. My first thought would be to approach this on a mental level and just become fine with small imperfections that make you who you are? That would be easiest. Love your tiny flaws kinda thing.
• If that's not what you're looking for and you want to improve the small imperfections, I wouldn't think retinoids will do much. Retinoids improve skin texture by about 20% and only short term (while you're using it). As soon as you stop it goes back to how it was. So retinoids can work a little bit in the short term, but that's about it.
• You could try scar treatments. Perhaps very localized treatment with fractional laser + PRP or microneedling + PRP. If you got a bunch of those treatments (like 5-10) you might notice a permanent improvement. Or a very localized filler might be interesting for these tiny imperfections. I'm not sure exactly which type of filler would be best, but an expert physician could probably point you in the right direction. I always like the sound of analogous fat transfer (your own fat). But again, I'm not an expert. You can research scar treatments more here.

@dan

Thank you for the information!

Yes, I know what you mean by focus. But I have bigger areas of scars on my cheeks. And these dont bother me. However, scars around the mouth are much bothersome, for some reason. The same happens with acne in this area. Also, one thing is to have one or two little dots, but if I have 10 or 15 all around the same area, it makes me investigate possible treatments.

I will have to forget about this idea if I see that the process is too difficult, risky or expensive, for example.

I find it incredible that I would need 5-10 very aggressive treatments like lasers in order to notice a permanent improvement. As I read somewhere that 2 or 3 were recommended for deeper and bigger scars, I supposed I needed less work for my more superficial scars.

At the same time, in the Acne.org page you showed me, laser, microneedling and other peelings really dont score too high in the reviews.

By very localized treatment, do you mean applying laser, microneedling or whatever only around the scars that I choose? Is that possible? More than ten years ago, when I asked a dermatologist about that, he told me that was not possible or convenient with lasers just because this area would have a different color than the rest of the face.

Do you know this kind of portable microneedling pen for self-treatment? What do you think?

Also, localized fat fillers seem interesting, if I find an experienced doctor who knows what he is doing and believes the filler would really work. It seems like a much more direct way to tackle the issue than lasers, for example.

@wilamenaskincare Thank you! The photos are in an external site, I just wrote down the links to them.

Posted by: @Similar

I find it incredible that I would need 5-10 very aggressive treatments like lasers in order to notice a permanent improvement. As I read somewhere that 2 or 3 were recommended for deeper and bigger scars, I supposed I needed less work for my more superficial scars.

Yeah, based on the studies I've read (I've read literally all of them) the before and afters only get impressive after more than 3 sessions. More like 6ish. Sometimes more. But...as I always say, I am not a real world expert on scar repair. I have only read the studies. I have to wonder if that's why they don't score well in reviews. Maybe people only get 1-3 sessions.

As far as localized treatment goes, I might be wrong about that one. If your doctor says the skin color will change, listen to him/her. Especially with darker skin, that can be an issue. But you said you have scars elsewhere anyway, so if you're getting laser, may as well get it everywhere right?

As far as microneedling at home, the at-home pens are usually much shorter needles so I don't think they do too much. Also, I personally hate the idea of self-administering scar repair treatments. It literally freaks me out. You don't ever want to fool around with potentially scarring yourself for life or doing something that backfires. If it were me, I would only, under any circumstance, ever, go to a licensed, experienced, very good doctor who's done it a million times. (Ok, hopefully I made my point loud enough 🙂

Lastly, yeah, I kinda like the common sense idea of a filler. Just fill those suckers in a tiny bit. And if you fill them with your own fat, less complications and what not. But again, I am not a doctor, and not a real world expert. Talk it over with a really good doc who can show you before and afters just like your scars.

@dan

OK, thank you. Are these studies available on the Internet?

I have to consider if an aggressive ablative laser treatment suits my needs and my type of scars. Because if the treatment itself can produce scars, I must evaluate the risk-benefit. I don't know if one or two sessions can improve or worsen my skin. I don't think I could do 6 sessions of an ablative treatment, for example. It seems too much! I would like to find a more simple and safe solution (and less expensive, too).

Also, if those lasers are applied on the whole face, according to the scientific principle or the marketing, collagen will be produced everywhere, not only in the scars. So how would the scars become less deep, if the whole skin is affected?

Maybe that is why you talk about localized treatments?

Are fillers only temporal?

I should find an honest and experienced specialist. If I go to one of those cosmetic centers, I suppose they will try to sell me something, but if I visit a couple of them, perhaps I could find someone more trustworthy.

And do you know if retinoid creams can eliminate permanently ''post-inflammatory hyperpigmentation'' , I mean reddish color near the lips? And Q-switched as @Wilamenaskincare mentioned?

References: You can see a list of all of the references on the scar treatments pages. However, they are not available to the public usually. My MDs have special access and that's how I end up being able to read the entire studies.

As far as your treatment goes, you are circling the answer, which is to find the right doctor. I always suggest people visit 2 if not 3 specialists and only go with someone when you're 100% comfortable. They absolutely MUST be able to show you a bunch of before and afters similar to your own scarring. If they don't have that, move on. If their suggestions change based on your whims, that's also a red flag. You want a confident doctor who knows what you need and has done it a million times and is sure it will work.

You actually make an interesting point when you say lasers increase collagen everywhere. Why wouldn't that just raise all of the skin? Very interesting point! I haven't gotten that question. If you get to talk to a doc about it and get answer, let me know. I attached what ChatGPT says cuz I was curious. But ChatGPT often hallucinates so you'll want to double check it.

Fillers: Some are temporary and some are permanent. Temporary is nice because if it goes horribly wrong when you get it, it fades away with time. Permanent is good because it's permanent, but you risk issues if its not done right. I like the idea of transferring your own fat because it's permanent but also as natural as it gets. BUT, I just like that idea. I don't have lots of experience with fillers in real time with real people. Very little. So do your own research on this.

Retinoids: You're Caucasian from what I can tell from your pics, so the marks (redness) should just fade with time pretty reliably. I don't believe retinoids help all that much with PIH as far as redness goes in Caucasian skin. They more help with the brown marks in non-Caucasian skin. Bottom line, I'd say if you're Caucasian, maybe focus on other stuff. The redness should naturally fade.

@dan Hello, thank you!

Yes, I am Caucasian, and my skin is fair. I have like 30 years of experience in acne, now I am 44, and I know that after a pimple, the redness usually fades. If the inflammation is intense and persistent, the redness can take a while to vanish, sometimes 3-6 months or more. But in this particular case, I am talking about a soft redness which has been present for more than 15 years. Perhaps this happened because it is right against the lips, and the skin there is more sensible or different? But, if this is the case, I don't know why this pimple left redness and not several other pimples around the lips I've had over the years.

Anyway, if retinoids don't help, maybe a laser, even a superficial one, could help make the color more even?

Thank you for the ChatGPT answer. It is possible I think that, for topics like this, ChatGPT usually sources information from official materials from laser manufacturers or cosmetic clinics, which are considered reliable. If, for example, someone or a group criticizes this treatment, the bot won't tell you about it. At least not right away, unless you explicitly ask about criticism.

I am not saying that this answer couldn't be true. But it is not impossible that doctors or specialists don't fully understand how the lasers work. Perhaps they damage the skin in a quite controlled way, and the skin heals, sometimes with improvement, and sometimes without visible change. I've also seen people on forums mention that they noticed their scars more after treatment.

I don't find wood-sanding analogy particularly clear. When we sand a piece of wood, we can immediately see the result and touch the surface to check if it's smooth. The healing mechanism after the laser seems random and unpredictable, it is far from instant, and it doesnt heal from an esthetic point of view (the healing mechanism is not watching the results from the outside). So, ChatGPT uses its language skills to defend the official information.

I am just trying to understand what I can expect from this treatment.

Anyway, thank you very much for taking the time to inform me about treatments. I will report back when I have updates. I am not in a hurry, and I have other things to take care of, so it might take time.

Yes, please let me know how it goes if/when you decide to treat it.

Pic would help

For small, superficial scars, gentle exfoliation and consistent skin-barrier care can help improve texture over time. Most treatments work gradually rather than instantly, and results depend on regular use. While improvements are possible, they tend to be subtle and build up slowly rather than giving dramatic overnight changes.