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Black*Falcon

Had An Appointment With Dr. Rahimi Rahimi But Not Sure If I Need Mixto, Please Comment.

What's up everyone? I'm new as a member, but I've been on this site for awhile (probably 'bout 3 months?). I'm Asian and I'm in my early forties and I had acne during my late teen and early twenties that was pretty stubborn at the time. It probably looked like what scottjlee went through but never got the scars treated. My scars are now shallow for the most part (since they got filled in naturally over time), and haven't had to worried about them 'til recently. Maybe it's been gnawing at me from the back of my mind for years, but I probably chose to block it out.

Long story short, I went and saw Dr. Rahimi this week and he told me I had two options: MixTo one time deal (which would end up being $3k- from what I gathered from other people who went to see him, it probably includes a second touch up session and pre-op) or 5-7 sessions of the cool touch (at $400 per session, which would end up being $2800 if I got all 7 ses done). This is probably because my scars are shallow and they don't look that bad unless you're right up against my face. As he was busy, I didn't get to spend too much time with him, but I got the gist of what he was offering.

One of the reasons I went to see Dr. R is because of DRaGZ. His photos and testimony of Dr. R's care and professionalism sort of won me over to go see him. I really do believe that it's the doctor that can work miracles, not necessarily the technology. Of course, if Dr. R only had antiquated technology from the 80s to work with, I'm sure he probably wouldn't stand a chance with the latest and the greatest that's out there. From my research, the best technolog out there for resurfacing skin seems to be fractional ablative laser.

When I was at Dr. R's office, what really sold me was seeing Zonia, the office manager/patient counselor's face. She told me that she had pretty bad scars before she had some work done and her face looked pretty dang flawless for someone her age. However, with that said, I am not completely convinced if the procedure will get rid of all my scars, especially the ones on my nose, which I will post pics of.

I recently told my friend that I was probably gonna get some work done on face and he was like "why, bro?" I tried to show him my scars but he didn't think I needed it. So I'm kinda on the fence, at this point, about getting it done. I'm hoping I can get some feedback, especially from the ones who've had fractional ablative laser surgery done. At this point, I'm not sure if I'm a good candidate (hyper pigmentation?) and if my shallow scars will disappear from the procedure. Thanks for your thoughtful comments in advance and I look forward to them!!!

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Edited by Black*Falcon

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Thanks for the comment, dudley. I'm sort of concerned about my nose area, wondering if the pitted scar can be fixed with the laser. At this point, I am definitely thinking of having it done, and if I do, I will chronicle my journey.

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Did Rahimi say your nose scars could be fixed with just laser alone? If so, did he say how many treatments it would take? Nose scars are difficult treat. You might see some improvement but I don't think you'll see much from just laser.

I also think you need to be realistic. Your shallow scars are not going to disappear from laser treatment. They can only be improved.

Did Rahimi recommend subcision on your scars as well?

If I were you, I'd ask for a spot treatment, and then give it a couple months to heal before deciding on whether to proceed. He spot treated one of my scars for free during my consultation. While I saw good improvement at first, that improvement faded at around the 3-4 month mark. Even the sharp edges to my boxcar returned. It faded enough that I chose to use another doctor with a different laser. I think he's a great doctor though who cares about his patients, but he is definitely not the only one. I would go on a few consultations, if I were you. There are some great ones listed on Realself.

Just my 2-cents.

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Inspired, your comments are much appreciated and valued, since I know they come from your long line of experiences with various types of treatments.

In my earlier post, I don't think I went into detail my feelings and thoughts about our initial consultation, so I will now attempt to do that here. As much as he's beloved by many members on this site, I have to say that my meeting with him wasn't what I expected it to be. First off, it was a bit short and curt. I think the impression I gave him was that I was on the fence about getting the procedure done. I didn't go into the office looking for a remedy that was urgent. For this reason, he told me "to think about the procedure," and to do further research on both cool touch and Mixto laser online. He did show me before and after pictures of his patients who had the procedure done. Yes, their scars were a lot worse than mine, and the after pictures looked great, but I only got to see the skin exposed from the scabs getting peeled off. This meant that the after photos were taken perhaps few weeks after the treatment, maybe a month. LIke what you pointed out Inspired, I wanted proof that it was gonna last more than few weeks or even few months. I tried to ask him detailed questions about subcision, specifically, questions surrounding the efficacy of subcision over laser, since a good number of members on this site have swore by the true results of subcision over, laser, chemical peels, and other forms of scar treatment. And I have pored over enough literature to understand the science behind subcision, which in a nutshell is cutting off the tethering fibers that hold down the upper skin and thus releasing the skin from forming the indentation. That logic behind subcision made a lot of sense to me. And I wanted Dr. R to explain it and the science behind fractional laser in detail but he simply said that "the combination of the two procedures will give you the best results." I'm sure he's right, yet I just wanted a 5 minute explanation of how the combination of the two was superior to subcision alone. I feel like he placed more emphasis on the laser than subcision, since when I did mention subcision, he said that he'll include it with the laser treatment at no cost. I think he's a great doctor from what he has done with many of his patients, including DRaGZ, yet I got the impression that I needed to get on with his program of the subcision and Mixto combination. I don't have a problem spending $3K. I just don't want to spend that kind of money for my kind of scars, which are a bit shallow that will get little or no results down the line. I wish he could have scientifically explained in detail how the laser would get rid of my shallow scars so that I would be convinced logically.

Anyway, he didn't go into detail how he would treat my nose scars. And yes, I have read that the skin on the nose works a bit differently than on the rest of the face, so I have great skepticism about the subcision/mixto combo getting rid of my nose scars. I did see on youtube a subcision done on a patient's nose, where the doctor stuck the norkor needle and made fan motions until the "snaps" were heard. It was remarkable. Now I don't know how effective that particular subcision turned out, since no after pictures were shown on the video. But, I do now know that subcisions can be performed on the nose, which I previously thought was not possible. So, in short, Dr. R didn't tell me how he planned on fixing my nose scars. He simply stated that the subcison/mixto combo was the way to go for me.

Inspired, I believe you got Deep FX done over the summer, which I've seen the pictures for. And I know you recently had Total FX done, so I'm curious as to how that's gonna turn out. BTW, can you tell me who you got the Total FX done with? If you're not comfortable sharing it in the post, please send me a PM. Thanks.

Edited by Black*Falcon

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Dr. Rahimi was very caring during my consultation. He spent a good amount of time with me. However, I did not get technical with him during consultation, like I've done in consultations with other doctors. At the time, I believed in his ability to work miracles and went in a bit blinded by the hype on this forum. I have received private messages from three people on this forum (who have not posted about their experience with him). They expressed feelings similar to your experience about their consultation with him. One of them proceeded with treatment and went the CoolTouch/subcision route in the end. After exchanging messages with other members and reviewing Rahimi's online photos, I also began to question whether I would get permanent results with MixTo. I did keep an open-mind for a long time though.

I have never heard of Zonia or a patient coordinator at his practice. Is she new?

I don't believe in promoting a doctor on this forum. I will send you a private message with his name. Just please keep in mind, I'm not endorsing him. I think he's an awesome, caring doctor with excellent credentials. He is honest as well, and won't promise you a percentage of improvement. In fact, if you ask him for how much improvement you can expect, he'll tell you that the expectation is unrealistic. That is actually one comment that sold me on him. He would only say, the hope is for significant improvement. He is only one of two doctors that I consulted with, out of over a dozen, that were bluntly honest with me and would not give me a percentage range for possible improvement. I really appreciated it. Dr. Rahimi said I would see 50% improvement from my spot treatment and to contact his office in two weeks to schedule my procedure. I did see 50% improvement after two weeks but I did not contact him because I knew I couldn't judge my results after 2 weeks. Sure enough, the results slowly faded over the next few months.

In the end, I think you have to decide whether you are willing to risk the money on the possibility of minimal improvement. How much do your scars really bother you? Are you willing to take a chance on "improvement"?

Btw, most of my close friends also don't understand why I'm putting myself through scar treatment. They don't think I need it either. At the end of the day, I'm doing this for me and am grateful I still have their support, even though they disagree with my reasoning.

Edited by *Inspired*

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hello blackfalcon,

As you know, I have recently done a procedure with Dr Rahimi. I sort of agree but disagree with *inspired* most recent post. In reponse, I do agree with her that this shouldnt be the place to promote doctors simply due to the fact that this is all virtual and that anyone online posting can actually be an employee of the doctor to promote him or her self. This is why I was SO skeptical with Dragz, I even Private messaged him, because read in between the lines, it seemed like he had some incentive to promote Dr. Rahimi. And to be quite honest and frank with you, Dr. Rahimi did ask me to write reviews online about his performance/treatment. And I have, and they were the honest truth. I have even been posting photos of myself to prove my results. I am only 8 days post mixto so I cannot truly judge if it actually worked or not. All my scars actually have returned after 8 days, but they have minimally improved, but it is way to early to judge since the main source of healing from CO2 fractional lasers is not from the LASER itself, but the damaging of the tissue to reproduce collagen growth of the scars. There has actually been evidence of this on one of my scars that wasnt that deep, near my lower lip, it was a true scar where there was a discontuity of skin. I have seen a growth of skin in that scar after the laser, which is quite exciting to see. But for my other deeper scars, unfortunately, has not been the case. But I know I must be patient and I can truly judge in about 3-6 months.

The reason why I sort of disagree with inspired's post is that she only had one spot treatment, and so she cant really judge the efficacy of Dr. Rahimi or the mixto laser (this is in all due respect to inspired, no offense, i appreciate your guidance and your help for all the advice)

Anyways, Simply put, the only reason I found out about Dr. Rahimi and the only reason I went to him was simply because of Dragz and the results that he has posted on his blog. If I was scammed, I was simply scammed. But I was not an idiot, I also did mixto research as well (realself) and many doctors (albeit, they probably only had the mixto so they were kind of self-promoting themselves) said the mixto, fraxel repair, and totalfx were all in the same. yes they have different features, yes they might go at different depth levels, but overall, they performed in the same type of concept. you should go on realself and research yourself. so after some thorough research of the mixto, and following dragz thread as well as many other people that did the mixto (you'll find a recent post by jbird12 I believe who did the mixto this past year and was pleased with her results) ....you will find they were pretty satisfied with their results with the mixto. All in all, you need to ultimately do research on all of the latest CO2 technology such as mixto, fraxel repair, and totalfx before you come to a conclusion. But to be quite frank with you, your acne scars aren't even that deep...so you probably do not need more than a minimum of 1-2 CO2 laser treatments to clean it up (and I believe any types of the CO2 fractional lasers will be suffice).

But in regards to your nose scar, that is much harder to treat, and I recently read a thread of somebody that performed a CO2 fractional laser CO2 and had some negative side affects (you should try looking up that thread, I cant recall which one it is), but the nose is defnitely more sensitive than the regular facial skin.

To be honest with you, if you can be patient like maybe 6 months, Ill have my 2nd mixto with Dr. Rahimi in about 3 months, and probably in 3-6 months afterwords, Ill be able to judge the mixto and will post my results on this site. I have been doing such a detailed thread because I want people to understand what works and what doesnt work, so they dont make the same mistakes as I do, if assuming, the mixto was a mistake. If it was, Ill wait on inspired's results, and if I am truly not happy with my results of the mixto, I will move on to the totalfx (if inspired is happy with her results and thinks it is worth it). Another side note, since your asian, you should be aware of the hyperpigmentation issues with CO2 lasers as well as permanent side affects of potentially going into deep with a laser (pass the

Subcutaneous layer which causes permanent hypopigmentation (permanent whiteness of skin))

Anyways like I said, if you can be patient, maybe 6 months - 12 months, or wait for *inpsired* results, you can truly decide which laser is for you. But as you can tell, me and inspired are not trying to promote any doctor, but trying to help future fellows with acne scars on the best course of action to take (whether it be which type of laser and who to actually go see for that laser).

anyways best of luck on. Ill keep you posted.

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Hmmmm... I don't think you were scammed by Dr. Rahimi, and wasn't trying to give that impression at all. I think you took my comment about promoting the wrong way. I have a personal reason why I don't want to mention doctors by name on this forum at this point. Dr. Rahimi also asked me to post about my experience on this forum, and encouraged me to make a thread about my treatment if I had MixTo in the end. To be honest with you, I regretted saying anything because of the three people who contacted me afterwards, saying they met with him based on my comments. One of them sounded pretty upset. The other got little improvement after multiple treatments. I don't want to sway anyone on a doctor or technology. I think that's a personal decision. I am also not a doctor and would never tell anyone they'd see great improvement after a couple treatments. How do you know that will happen?

I will say again that I think Dr. Rahimi is a good, caring doctor. However, there were many factors that played a part into why I chose another doctor and laser. My first Deep FX treatment was a spot treatment of just my scars. I had 50-65% improvement to most of my scars after one treatment. I can only compare what I've experienced. I can't judge my latest treatment at this point. When it comes to investing another $3000 in my face, I simply couldn't move forward with MixTo. I don't know why I feel like defending myself on this.

Dragz appears to have had good improvement. I think that's awesome for him. I don't think everyone is going to have the same experience, and having been disappointed by treatments in the past, I believe in proceeding with skepticism and caution.

To the OP, Just be thorough in your research. When you find the right doctor and treatment plan, you will know. However, I still say you must be realistic. Expect improvement, not eradication. Don't base your decision on my experience. Everyone will respond differently.

Edited by *Inspired*

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I'd just like to say that I think your skin looks beautiful, BlackFalcon, despite the scarring. Your scarring is mild and you certainly don't *need* scar treatments. It really depends on how much it disturbs you and what you can live with yourself. I'm pleased to know your scarring has filled in to an extent over the years. :) I hope the same happens to me. Please do keep us updated if you decide to go along with treatments, and best of luck!

And thank you, Inspired, for telling us that the initial improvement of 50% with the Mixto spot treatment faded later on. It's important to have realistic expectations when going in for invasive treatments like laser.

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BlackFalcon, it would be wise to continue your education on the different lasers. I have been a little removed from the discussion, but if memory serves me correctly Mixto is less intense than either Fraxel Re:pair or DeepFX. Doctors will advocate whichever laser they have so a patient must do his own homework - choose the treatment and then find the doctor. This is different than the traditional approach to medicine and requires more education on the patients part.

http://www.acne.org/messageboard/index.php/topic/252527-laser-link-o-rama/

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Hello:

I'm gonna try to respond to the last three posts from inspired, slee3, and austra. And despite the differing comments from several members who've had different experiences, I would just like to thank all of you for your two cents. It really means a lot to me as I don't feel so alone in dealing with this issue.

In post #6 inspired wrote:

>I have never heard of Zonia or a patient coordinator at his practice. Is she new?

The title on her business card reads "Patient Counselor Administrator." She came into the patient room with Dr. R for my consultation. When Dr. R had to leave, since there were many patients waiting outside, Zonia stayed behind and answered all my detail questions. One thing she did was to show me her cheeks which she said used to have a lot of scars. I went right up to her face and inspected them. They looked almost flawless. Granted, I didn't ask her to stand in a certain way so that the strong sunlight would hit the surface of the cheeks, but the room was strongly lit by the sunlight coming in from the window only few feet away and her face in general looked great. However, she told me she got the CoolTouch done, not the Mixto, even though she told me the Mixto was a "better deal" in the long run. I don't think she's new. I vaguely remember her telling me she's been there for 9 years or so.

>Btw, most of my close friends also don't understand why I'm putting myself through scar treatment. They don't think I need it either.

I think acne scars, for me at least, remind me of my past when I was going through a lot in my life. I remember stressing out all the time about school, my dad's death, and my future when my skin started to break out. I really didn't know how to control my stress then and I believe the stress more than anything contributed to my acne. Getting rid of my scars is a way for me to erase that part of my past. I don't want to be reminded of that part of my life, which still makes my stomach turn when I think about it. So there's a deep psychological component to my quest for smoother skin. My skin actually is smooth, but it LOOKS coarse from a certain angle, and it really upsets me at times. So, inspired, I can relate to your quest for smoother skin as well.

In the end, I think you have to decide whether you are willing to risk the money on the possibility of minimal improvement. How much do your scars really bother you? Are you willing to take a chance on "improvement"

These are all great questions I need to be asking myself in the months ahead as I slowly gather information and shop around.

In post #7 slee3 wrote:

As you know, I have recently done a procedure with Dr Rahimi. I sort of agree but disagree with *inspired* most recent post.

Hey slee3, I totally value your differing opinion. I really mean that dude. I think that's the great thing about this message board, that we can all agree to disagree. I've seen your pictures and I was blown away by the dramatic improvement. I do believe that the Mixto does a great job of improving deep pitted scars. Most of your small but pitted scars have vanished. Awesome! I've noticed that your deepest scars got improved but I could still see some remnants of the scars, which I think is normal and can be treated in a follow up session. I think Dragz has pretty much mentioned the same idea.

But in regards to your nose scar, that is much harder to treat, and I recently read a thread of somebody that performed a CO2 fractional laser CO2 and had some negative side affects (you should try looking up that thread, I cant recall which one it is), but the nose is defnitely more sensitive than the regular facial skin.

Yep. I personally think subcision or some kind of procedure involving a knife will be required. I don't think laser alone will get rid of those scars. I'm gonna try to look for that thread about fractional laser and its side effects on the nose.

To be honest with you, if you can be patient like maybe 6 months, Ill have my 2nd mixto with Dr. Rahimi in about 3 months, and probably in 3-6 months afterwords, Ill be able to judge the mixto and will post my results on this site.

This is very true. The old saying goes, "good things come to those who wait." I really could wait until you and inspired post your pics after three months and decide for myself which option would be best for me.

Another side note, since your asian, you should be aware of the hyperpigmentation issues with CO2 lasers as well as permanent side affects of potentially going into deep with a laser (pass the Subcutaneous layer which causes permanent hypopigmentation (permanent whiteness of skin.

Yes, this is something I definitely have to be cautious of. I did ask Dr. R about both hyper and hypo pigmentation and he said the Mixto shouldn't have any side effects on my Asian skin. But yes, I still have to be very careful and get some test treatments done before I go with the works.

In post #8 Inspired wrote:

Hmmmm... I don't think you were scammed by Dr. Rahimi, and wasn't trying to give that impression at all. I think you took my comment about promoting the wrong way.

To slee3 & inspired: I want to thank both of your for your honest and caring input about your experiences with Dr. R. I really mean that. Although you two differ on your opinions about Dr. R, I think you both make compelling arguments. So the fact that you're not saying the same thing is doing me a lot of good. I'm staying objective and cautious.

To the OP, Just be thorough in your research. When you find the right doctor and treatment plan, you will know. However, I still say you must be realistic. Expect improvement, not eradication. Don't base your decision on my experience. Everyone will respond differently.

I think Inspired has inspired me to be skeptical with both intelligence and a much needed dose of vigilance. There's a great deal of salesmanship doctors have to employ in order to stay at the top of their game, so I know that it takes real skills as a patient to separate the baloney from the truth.

In post #9 Austra wrote:

I'd just like to say that I think your skin looks beautiful, BlackFalcon, despite the scarring.

Oh, that's very sweet of you. I appreciate that. We crazy scar bearers are suckers for any compliments to our skin. :P

Your scarring is mild and you certainly don't *need* scar treatments. It really depends on how much it disturbs you and what you can live with yourself.

As I have mentioned in my earlier comment, there's a psychological component to my wanting to get rid of the scars, mainly my difficult past when I had acne. But you're right, my scars are not deep or bad enough that I "need" scar treatments. I totally agree. Maybe I'm just a vain mofo. lol

I'm pleased to know your scarring has filled in to an extent over the years. smile.png I hope the same happens to me.

Yes, your scars do fill in over time, but very slowly. I also try to stay healthy by eating right and taking supplements. Plus, I exercise regularly, which helps greatly.

Please do keep us updated if you decide to go along with treatments, and best of luck.

Will do, and thanks!

Wow... That was both exhausting and fun, responding to all your posts!!! Thanks for your input. I know we're all trying to help one another. Your knowledge and share of your experiences are much appreciated.

BF

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Thanks for the link Dudley. Yes, I agree that I need to do more research on the different types of fractional laser. I know I need some sort of ablative laser for my shallow scar, but not sure if FX Total is superior over MixTo. I will post my research results in the coming weeks and months as I uncover more info. Thanks for your support!

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Treatments like subcisions, excisions, and lasers are never as straightforward as they're made out to be. In fact some of these treatments left me significantly worse off. Like others have said, being Asian will considerably complicate things. For example, I've heard doctors claim that pretreatment with hydroquinone and Retin-A will greatly reduce post laser hyperpigmentation. While most doctors subscribe to this, some studies have shown that it has made no difference in incidences of PIH. I think that hyperpigmentation is in fact almost a certainty with lasers if you are Asian, so be prepared for that. I am pretty fair skinned, but the PIH has been an ongoing issue for me post Mixto. I don't think you will have any PERMANENT side effects, but there will almost certainly be 3-4 months of blotchy hyperpigmentation. If you work in a professional environment and you're a guy, your options for disguising it will be very limited. The ladies can cake on as much makeup as they want, but even that won't cover it in some instances. I'm not discouraging you from getting treatments, but I just want you to really consider if you can handle the lengthy recovery for possibly minimal improvement.

Edited by blahblah82

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The hydroquinone/kojic acid is not for PIH. It's to prevent possible PERMANENT hyperpigmentation.

Really, the best way to cover it up is cream-based hydrocortisone. It goes on like lotion, but it immediately calms the redness down in a matter of minutes. It also helps to use a sunblock that has anti-inflammatory properties as well.

That being said, though, your scarring is very, very minor. You have something akin to something dermatologist refer to as "orange peel" texture, and, in fact, doing ablative laser resurfacing can possibly actually have the side effect of an orange peel texture, which is precisely what you're trying to get rid of in the first place!

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Hey Black Falcon. I understand this can be an emotionally raw topic for many of us, especially those with really prominent scarring (myself included). That said, if someone told me to pay $10K and guarenteed my AFTER pictures could look like your CURRENT pictures, I'd willingly do it. Honestly your scarring is very minimal. I have spent this past year sinking an obscene amount of money into all manner of scarring treatments. I can honestly say that I have literallly tried almost every method of scar treatments available in the market. You really need consider if you can handle the prolonged downtime from any scar treatments of any true significance. I'm 31 and Asian as well, and I think you look younger than I do (didn't get the good asian aging genes).

It has been an emotionally taxing experience for me that I've kept mostly private and have not shared on this board. I give major props to all of you who are willing to memorialize your pics on the internet in an effort to help others.

Treatments like subcisions, excisions, and lasers are never as straightforward as they're made out to be. In fact some of these treatments left me significantly worse off. Like others have said, being Asian will considerably complicate things. For example, I've heard doctors claim that pretreatment with hydroquinone and Retin-A will greatly reduce post laser hyperpigmentation. While most doctors subscribe to this, some studies have shown that it has made no difference in incidences of PIH. I think that hyperpigmentation is in fact almost a certainty with lasers if you are Asian, so be prepared for that. I am pretty fair skinned, but the PIH has been an ongoing issue for me post Mixto. I don't think you will have any PERMANENT side effects, but there will almost certainly be 3-4 months of blotchy hyperpigmentation. If you work in a professional environment and you're a guy, your options for disguising it will be very limited. The ladies can cake on as much makeup as they want, but even that won't cover it in some instances. I'm not discouraging you from getting treatments, but I just want you to really consider if you can handle the lengthy recovery for possibly minimal improvement.

Hey blahblah82:

Thanks for your comments. I'm sorry your scarring has set you back, financially and self-esteem wise. I feel you dude. It's not easy. As far as looking younger, I know that using acne products can sometimes cause wrinkle-like texture to your skin. I've had that happen to me when I was using them. So, I've stopped using altogether and really focused on getting rid of stress in my life. I'm not saying you should do the same thing. It's just that the medication sometimes create this texture that makes you look older. My way of combating acne was from the inside. I know that there was a lot of stress when going to school and after. I made a conscious effort not to stress which induces unhealthy hormones and chemicals in your body. I sought therapy and other kinds of psychological and spiritual treatment to help me become healthy from the inside. So, however your skin may look right now, I would like to say that it will get better as you become more healthy, which I feel you are doing!

I understand that it's hard for you to share your photos with others at this point. I totally understand it. However, when you are ready, you should consider sharing them. It really helps to get feedback from other people. I thought my scars were absolutely unsightly but after what people have said, I'm gaining a better understanding that I've been harder on myself than anyone else. A lot of how we feel is developed from bottled up feelings. I know I resorted to keeping a lot of my frustration and even anger combating acne to myself for years. That caused a lot of psychological damage. I think that's why a forum like this is so wonderful since we're able to realize that acne and scarring is simply part of life and part of nature.

Yeah, hyperpigmentation has certainly been one of my biggest concerns. The idea that I go into get a skin treatment done and to come out with another skin problem is simply uninspiring. From what I've gathered from my research, it seems that fractional laser's tiny "hits" are small enough that it doesn't cause the same problems the previous lasers did. The old CO2 lasers from the 80s and 90s, simply "burned" the skin layer in a very undiscriminating way, and I think that caused a lot of problems. I read that the old lasers were not usually recommended for anyone who didn't have super fair skin. I'm not completely up on fractional laser technology, but from what I can gather, the smaller beams I guess dissipate the burning which causes less hyper and hypo pigmentation. With that said, I know that some people have gotten both types of pigmentation problems from fractional laser treatments. It happens. I think it's up to the doctor to understand how to use the laser with different skin types and different individuals. Personally, I believe that the more experience a doctor has with a particular skin type (i.e. olive skin type, Asian skin, African American skin, etc) that are prone to hyper-pigmentation, he/she will better understand how to avoid it in the first place. Experience trumps pretty much any in depth study or theory based on other people's analyses. And in that regard, I think Dr. R has had quite a bit of experience with hyper-pigmentation prone skin type. But, you're right, I do have to consider if I'm willing to suffer through long and arduous downtime and plunk down thousands of dollars for a very minimal improvement on scars people are saying are not that bad to begin with.

The hydroquinone/kojic acid is not for PIH. It's to prevent possible PERMANENT hyperpigmentation.

Really, the best way to cover it up is cream-based hydrocortisone. It goes on like lotion, but it immediately calms the redness down in a matter of minutes. It also helps to use a sunblock that has anti-inflammatory properties as well.

That being said, though, your scarring is very, very minor. You have something akin to something dermatologist refer to as "orange peel" texture, and, in fact, doing ablative laser resurfacing can possibly actually have the side effect of an orange peel texture, which is precisely what you're trying to get rid of in the first place!

Yeah, the "orange peel" texture aptly describes what it looks like, especially when harsh lighting hits my face. I was hoping that when the skin layer gets burned off, the uneven skin texture would smooth out. That has been my logic so far. But I guess you're saying that there's a chance that the laser can also create an uneven texture. Hmmm interesting. This is good to know. Something to definitely consider. I will certainly bring this up with the doctors in my future consultations. Thanks for your input!

Edited by Black*Falcon

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At this point, I'm wondering if I should get a derma roller and start my scar treatment from there. I do need more time researching the laser treatments, especially with all these side effects that can make my skin look even worse. And since my scars are shallow, maybe I just need to use a derma roller first and see how that works out for me. Has anyone used derma roller for their skin?

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The hydroquinone/kojic acid is not for PIH. It's to prevent possible PERMANENT hyperpigmentation.

Really, the best way to cover it up is cream-based hydrocortisone. It goes on like lotion, but it immediately calms the redness down in a matter of minutes. It also helps to use a sunblock that has anti-inflammatory properties as well.

That being said, though, your scarring is very, very minor. You have something akin to something dermatologist refer to as "orange peel" texture, and, in fact, doing ablative laser resurfacing can possibly actually have the side effect of an orange peel texture, which is precisely what you're trying to get rid of in the first place!

Firstly, I didn't know hyperpigmentation could be permanent! I hope that's relatively rare. Secondly, I assume you know that cortisone does thin the skin in long-term use and may prevent collagen formation. So do you think this effect is so minimal that cortisone is worth using nonetheless? My doctor also told me I could use cortisone for hyperpigmentation after TCA cross, but he said it may have an effect on collagen remodeling, and I decided not to use it.

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Permanent hyperpigmentation is a pretty rare occurrence with ablative fractional lasers, but still a possibility. It was all but guaranteed in the old fully ablative CO2 days with anyone other than white people.

Hydrocortisone affects your dermis about a fraction as much as topical tretinoin does, and topical tretinoin barely affects acne scars at all.

And you don't need to use hydrocortisone for a long time. Just 1-2 times a day for two weeks or so after you've finished peeling, and whenever you feel it's necessary.

Edited by DRaGZ

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@ blahblahblah82 Ok, I know it's not very manly, but why not use concealer if you're a guy if the PIH is just temporary? The best concealer isn't supposed to be visible. I use a mineral foundation called Bare Minerals and it's usually a perfect match for my complexion (not as much in the summer months now that I have a tan).

Also is it true that these Mixto reviews could be a scam? I was getting pretty excited reading the reviews of this laser on Realself thinking I had found the answer.

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