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sunshinefunshine

Help! It's Time For Treatment Of My Scars After Accutane, But What To Do? (Pics Included)

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Hi!

I've suffered from cystic acne ever since I was 11 years old. I am now 21, and finished Accutane in September 2013. Since that time, I've been using Skinoren cream. It has helped immensely with the redness, but I am obviously left with huge, sunken scars on my face.

I recently went to the dermatologist, and he recommended a TCA peel. He said I can do several of those, but the skin will never look 'normal'. I have one scheduled for September of this year. My question is, will this do anything at all for my scarring? I know my scars are severe and numerous, and I had always thought that subcision or some type of laser would be the best option for me.

I live in Finland, and I wonder if the reason that nothing else is being recommended for me is because there isn't any other option here or something. When I lived in the US, I went to a dermatologist who said that laser would be the best option for me and my scarring, but this was when I had active acne on my face and 2 years before it was cleared.

I really, really need help. My derma in Finland says that I could have a million dollars and there's essentially no fixing it, just making it a bit better. I feel so let down. I always thought I had a chance of looking somewhat normal. I guess that this isn't true. Am I being told the truth? I have an unlimited budget to spend on my skin. I could literally spend 25,000 euros on it if I had to. I am willing to do anything, and it just doesn't seem right that a TCA peel is my only/best option.

(I am white, with very, very fair skin. I don't know if that means anything at all.)

Thanks in advance for the help!

Pictures of my horrific scars in the strongest lighting I could find:

post-390301-0-50146100-1397596082.jpgpost-390301-0-06124100-1397596072.jpegpost-390301-0-19576200-1397596057.jpeg

post-390301-0-19576200-1397596057.jpeg

post-390301-0-06124100-1397596072.jpeg

post-390301-0-50146100-1397596082.jpg

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I have the same type of acne scars with you ans they are so red if I'm outside. My both temples also destroyed by rolling and box scars and little on my forehead and I have big boxcar on the left and right of my nose. Since you have light skin, I think you have many options to improve your appereance. I've never done ablative treatment such as laser, as for no money and asian skin (light brown). I have just done microdermabrasion 7 times (my little knowledge about acne scars) and my acne scars never fade even causes more scarring. I do not know exactly what you have to do. But I have been on line to seek any treatment for 2 years more. I think tca peel never make you satisfied. Because it uses lower concentration of tca acid. You should ask your doctor about tca cross for your ice picks (?) as it uses higher concentration but it can make your scars worse if not doing properly. And I heard laser (fraxel repair) works great for light skin type. Again, I have never did ablative treatment.

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I have the same type of acne scars with you ans they are so red if I'm outside. My both temples also destroyed by rolling and box scars and little on my forehead and I have big boxcar on the left and right of my nose. Since you have light skin, I think you have many options to improve your appereance. I've never done ablative treatment such as laser, as for no money and asian skin (light brown). I have just done microdermabrasion 7 times (my little knowledge about acne scars) and my acne scars never fade even causes more scarring. I do not know exactly what you have to do. But I have been on line to seek any treatment for 2 years more. I think tca peel never make you satisfied. Because it uses lower concentration of tca acid. You should ask your doctor about tca cross for your ice picks (?) as it uses higher concentration but it can make your scars worse if not doing properly. And I heard laser (fraxel repair) works great for light skin type. Again, I have never did ablative treatment.

I agree that I'd be more satisfied, but I worry because I am going to the dermatologist 'expert' clinic here, and they act like a TCA peel is the absolute most extreme thing that they will do. I don't understand it at all. I guess I can ask about it, but I feel like I am talking to a wall. They initially wanted to do a salicylic acid peel! I asked whether they could do anything more, like subcision or something like a laser, and the response was that a TCA peel is the only choice. I just don't understand. If they don't have the right things to treat me here in Finland, why not just tell me?

I am at the end of my rope. I don't even know that concentration the TCA peel is. It's just like a general term here. This is so frustrating to me. I will be so angry if September comes around (even though the EU says 6 months post Accutane, they want to wait the ''American standard'' of 12 months) and nothing changes about my skin. I am a female, and living like this is torture. I wish people wouldn't stare at me. It hurts so much. :(

Edited by sunshinefunshine
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I think the dermatologist is being honest and upfront. The tCa peel will help with the redness by working to dry up the redness and the skin will start to shed and exfoliate. The red areas will turn brown, and the skin will start to peel, revealing fresh white skin underneath. If you remove the redness, your skin will look a lot better in overall appearance. The tca peel works on discoloration, and not the indent itself. It can also prevent future scars that existing inflamed red marks can cause.

For the correction of the indented scar itself, dermatology is limited in treatments... creams and pills can't fix an indented scar. However... plastic surgery can. Plastic surgery can be limitless depending on the creativity, the vision, and skill of the surgeon. I can't comment on the type of procedure you should have because your scars are different than mine and I'm not a plastic surgeon but the solutions are out there. If you find a plastic surgeon who believes he can help you with scar revision, don't treat the entire face... Instead treat one scar and wait to see the results. Treating one scar at a time is a safer bet in the case you don't get the results you want.

Edited by Searchandseek
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hi you could try some at home treatments for the scars like the dermaroller or stamp with the right serums like vitamin c retinol or i hear copper peptide is good,,it works for some people you can get the products online to, just do some research first tho so you know whats best for your skin!!

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Maybe this is a stupid question, but would punch grafting/dermal grafting work at all on my kind of acne scars? I have read about it, but I'm not sure I am a candidate because my scarring seems to be all over the place and not very localised. I don't have any super deep pits either, just a lot of shallow areas with raised scar tissue surrounding them.

I have tried dermarolling before and stuck with it for almost a year using as much as I could handle (1.5mm) and it has done nothing at all for me. My face looks exactly the same as it did. Skinoren is the only thing that has helped any aspect of it at all, and I have tried numerous collagen creams and facial regenerating creams as well as various scar treatments available in cream form.

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If you have an unlimited budget look into recell, it's a really amazing treatment.

I have read of this, but do I have to go to the UK for treatment? When going abroad, how long do I stay for the consultation and procedure? What about the after care? How do I find a reputable doctor to do the procedure whilst sitting here in Finland?

Edit: Also, does anyone know if something as simple as dermabrasion procedures would help me? My dad had acne scars similar to mine 30 years ago and claims he had a few dermabrasion things done and they helped him a lot, but I just don't see how.

Edited by sunshinefunshine
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If you have an unlimited budget look into recell, it's a really amazing treatment.

I have read of this, but do I have to go to the UK for treatment? When going abroad, how long do I stay for the consultation and procedure? What about the after care? How do I find a reputable doctor to do the procedure whilst sitting here in Finland?

Edit: Also, does anyone know if something as simple as dermabrasion procedures would help me? My dad had acne scars similar to mine 30 years ago and claims he had a few dermabrasion things done and they helped him a lot, but I just don't see how.

As far as I know, Recell is probably not available in Finland. You would likely have to travel overseas, and I'd probably recommend staying for about a week, assuming you can work out scheduling the procedure ahead of time. That way you wont have to travel back to Finland, right after the treatment, as your skin will probably be quite red. Usually Recell is combined with another procedure like laser or demabrasion (Laser would probably be better). I'm by no means an expert on Recell but if you want to chat about treatments or anything feel free to PM me :)

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I think you're going to have to do laser (Co2) or dermabrasion for the scars. TCA peel will help with the color...which will make it look better.

Will it ever be 'perfect'? Not likely. But don't give up on it looking better. It can be improved. Keep searching for a PS or derm until you find the right fit. They are not created equal. Good luck!!!

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You are right, your scars are not deep, just widespread over a large area. I think these would be amenable to resurfacing procedures like laser or dermabrasion. Dermabrasion is a very very aggressive procedure though, and has a lot of risk. Getting rid of the redness alone will improve the look of the scars.

How does your dad's skin look today after the dermabrasions? Does he still have visible scarring?

From your description (white, very fair skin) and your dad's past success with resurfacing procedures, I think it would be a reasonable place to start. I do agree though that you should wait a little longer. It sucks, I know. Or.... you could do a test patch and see how you heal if you are desperate to get treatment soon. The one thing I'll say though is making decisions out of a place of desperation rarely turns out well. Always proceed slowly, before you make a critical mistake in selecting a procedure and DOCTOR. We've seen a few disasters lately on the forum.

Edited by blahblah82
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I have the same type of acne scars with you ans they are so red if I'm outside. My both temples also destroyed by rolling and box scars and little on my forehead and I have big boxcar on the left and right of my nose. Since you have light skin, I think you have many options to improve your appereance. I've never done ablative treatment such as laser, as for no money and asian skin (light brown). I have just done microdermabrasion 7 times (my little knowledge about acne scars) and my acne scars never fade even causes more scarring. I do not know exactly what you have to do. But I have been on line to seek any treatment for 2 years more. I think tca peel never make you satisfied. Because it uses lower concentration of tca acid. You should ask your doctor about tca cross for your ice picks (?) as it uses higher concentration but it can make your scars worse if not doing properly. And I heard laser (fraxel repair) works great for light skin type. Again, I have never did ablative treatment.

I agree that I'd be more satisfied, but I worry because I am going to the dermatologist 'expert' clinic here, and they act like a TCA peel is the absolute most extreme thing that they will do. I don't understand it at all. I guess I can ask about it, but I feel like I am talking to a wall. They initially wanted to do a salicylic acid peel! I asked whether they could do anything more, like subcision or something like a laser, and the response was that a TCA peel is the only choice. I just don't understand. If they don't have the right things to treat me here in Finland, why not just tell me?

I am at the end of my rope. I don't even know that concentration the TCA peel is. It's just like a general term here. This is so frustrating to me. I will be so angry if September comes around (even though the EU says 6 months post Accutane, they want to wait the ''American standard'' of 12 months) and nothing changes about my skin. I am a female, and living like this is torture. I wish people wouldn't stare at me. It hurts so much.

Yes, Here's me too. Doctor didn't tell me if there's another option for me but advices me to have some microdermabrasion several times then after 7 times I realized it does nothing to my indented scars. I think they'll only offer you the treatments that are only available in their clinic. It may also they do not want to let you down by not telling you there's no right thing fixing your scars or they just do not understand nowadays technology as it changes frequenty. But I underline here that it's much difficult to improve acne scars than to treat acne itself.

I think if the clinic only offer you the tca peel, for me it sounds that it doesn't experience enough to improve indented acne scars. Just ask them if they have experienced to help the patient who has the similiar problem with you. If not, I'm doubt they can predict what your face will look like after. It's important to make sure that any one knows exactly what they do.

I guess any peel doesn't help the indented scars but may improve the skin tone. The laser and other surgery procedure absolutely can't be compared with superficial treatment as for those would wound the deep dermis so it the wound is hoped to do the healing in proper way to fill the loss tissue. That's actually only the theory but in fact it can also cause more scarring.

The dermatologist is likely to have lesser knowledge to overcome this scarring than a plastic surgeon since a plastic surgeon focused more in the aesthetic appereance. But you must find a good surgeon if you decide to do any surgery.

I know exactly how it hurts. Although I'm male but doesn't mean I have less emotional problem in this case. I do not have any advice how to handle this feeling but I hope You can find your own happiness.

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You are right, your scars are not deep, just widespread over a large area. I think these would be amenable to resurfacing procedures like laser or dermabrasion. Dermabrasion is a very very aggressive procedure though, and has a lot of risk. Getting rid of the redness alone will improve the look of the scars.

How does your dad's skin look today after the dermabrasions? Does he still have visible scarring?

From your description (white, very fair skin) and your dad's past success with resurfacing procedures, I think it would be a reasonable place to start. I do agree though that you should wait a little longer. It sucks, I know. Or.... you could do a test patch and see how you heal if you are desperate to get treatment soon. The one thing I'll say though is making decisions out of a place of desperation rarely turns out well. Always proceed slowly, before you make a critical mistake in selecting a procedure and DOCTOR. We've seen a few disasters lately on the forum.

What kinds of risk does a dermabrasion procedure entail? I am completely uneducated as to the risks aside from discoloration of the skin.

My father is about 1/2 Native American, so he has much darker skin than I do, but is still in the lightish skin tone range. He took a large risk having the procedure with his skin tone, and he wasn't told of the risk at the time (otherwise he says he wouldn't have done it). I guess he is fortunate to not have any discoloration issues. Overall, I'd say his skin looks quite nice, but it has a definite 'orange peel' texture and some unevenness but I don't see any rolling scars or much evidence of individual scars at all. He has a few crater like areas near the sides of his nose from blackheads, but nothing else that I can see.

This is maybe a stupid question, but am I at more risk of having discoloration at all because of my genetic make-up (having darker skinned ancestors) than someone who is 100% white and looks very similar to myself? (My mom is extremely light and blonde, and I myself am a redhead who burns in the sun and is as white as a piece of paper with freckles. I do, however, have brown eyes like my father.)

I am happy to wait until September to have work done if it is the safest choice. If I do get the TCA peel then, does anyone know how long I will have to wait to have a procedure like dermabrasion? Or if I have dermabrasion, is a TCA peel even necessary in the first place?

I am so lost about this whole thing, and thanks for all of the help so far!

Here's some daylight images of my scarring (sorry for weird blurring but I have some moles and stuff that are pretty distinctive and my goal is to remain anonymous):

Edited by sunshinefunshine
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http://dermatologue-arouete.com/content/traitement-des-cicatrices-acn%C3%A9-paris-dermatologue

Since you are in Europe, check out this French doctor's work. It's pretty incredible. He does surgical procedures (punch floats), then resurfacing.

Unfortunately they didn't present pictures showing their final results (one year later or so). I have no doubt that punch float and dermabrasion are among the few treatments that provide decent improvements, if done properly, but when I had a CO2 laser done in 1999 my skin looked good for months, after which it went back to what it was before the treatment. Their pictures are not conclusive, even though I believe those patients had good improvements.

Edited by marcosctb
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http://dermatologue-arouete.com/content/traitement-des-cicatrices-acn%C3%A9-paris-dermatologue

Since you are in Europe, check out this French doctor's work. It's pretty incredible. He does surgical procedures (punch floats), then resurfacing.

Unfortunately they didn't present pictures showing their final results (one year later or so). I have no doubt that punch float and dermabrasion are among the few treatments that provide decent improvements, if done properly, but when I had a CO2 laser done in 1999 my skin looked good for months, after which it went back to what it was before the treatment. Their pictures are not conclusive, even though I believe those patients had good improvements.

Here's someone's acne scar treatment history story I found (written in French but translated) with some pictures and a review of his experience with this doctor:

http://translate.google.com/translate?hl=en&sl=fr&tl=en&u=http%3A%2F%2Fforum.doctissimo.fr%2Fsante%2Facne-psoriasis%2Ffractionne-cicatrices-creux-sujet_176366_2.htm

(Scroll down until you start to see pictures.)

This person seems really happy with the results, but I am not sure I understand how long this process takes. I can't stay in France for months at a time. I wonder as well if even I need the punch floats because my scars are so shallow and absolutely everywhere, but I guess only an expert can make that decision.

Edited by sunshinefunshine
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Here's someone's acne scar treatment history story I found (written in French but translated) with some pictures and a review of his experience with this doctor:

http://translate.google.com/translate?hl=en&sl=fr&tl=en&u=http%3A%2F%2Fforum.doctissimo.fr%2Fsante%2Facne-psoriasis%2Ffractionne-cicatrices-creux-sujet_176366_2.htm

(Scroll down until you start to see pictures.)

This person seems really happy with the results, but I am not sure I understand how long this process takes. I can't stay in France for months at a time. I wonder as well if even I need the punch floats because my scars are so shallow and absolutely everywhere, but I guess only an expert can make that decision.

In this case the last picture was taken one week after his dermabrasion. I'd like to know how much of that improvement remained permanently. His skin was still very swollen.

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Here's someone's acne scar treatment history story I found (written in French but translated) with some pictures and a review of his experience with this doctor:

http://translate.google.com/translate?hl=en&sl=fr&tl=en&u=http%3A%2F%2Fforum.doctissimo.fr%2Fsante%2Facne-psoriasis%2Ffractionne-cicatrices-creux-sujet_176366_2.htm

(Scroll down until you start to see pictures.)

This person seems really happy with the results, but I am not sure I understand how long this process takes. I can't stay in France for months at a time. I wonder as well if even I need the punch floats because my scars are so shallow and absolutely everywhere, but I guess only an expert can make that decision.

In this case the last picture was taken one week after his dermabrasion. I'd like to know how much of that improvement remained permanently. His skin was still very swollen.

Should I be suspicious that I can't find any healed pictures at all? Why stop posting before your face has healed so that everyone cannot see the end result? I thought that was the purpose of these kinds of boards, so that we can see the results.

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You can opt to have dermabrasion done just on a small area. Two years later you can treat the rest, if the permanent results on the test area is ok. That's what I would do if I lived near France.

Should I be suspicious that I can't find any healed pictures at all? Why stop posting before your face has healed so that everyone cannot see the end result? I thought that was the purpose of these kinds of boards, so that we can see the results.

Edited by marcosctb
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I really, really don't want to travel to another country and take the time to have just a patch test done and then wait 2 entire years and have to go back again. I know I should be patient, but I feel like I have already waited forever. I tried creams for years to get rid of my acne, then antibiotics for years after that, then finally accutane (which took 12 months as I was on such a low dose) and now I am almost done waiting a year after my accutane in order to get treatment. I am really mad that I would have to wait another TWO (!!!) years to have any kind of improvement. I feel like I am living my whole life waiting for things to get better, and after ten years of this nightmare it just goes on and on and on. I would be thrilled with a 50% improvement of my scars. I wouldn't have another treatment done if I could just do something to make them halfway better. I don't want perfection, I want to feel at least a little bit normal.

I think it is the stupidest thing in the world that acne seems to be the only socially unacceptable disease in existence. If someone has cancer or is missing a leg or something else is wrong that they cannot control, is it okay to stare at them? No. If someone has some sort of facial deformity, it's not okay to stare at it, or ask them what it is, or what happened to him or her. But for some reason acne/scarring (which is just as unavoidable as any other genetic condition) is something that people feel fine to question you about or to stare at you for. You wouldn't judge someone for having breast cancer and scarring from an opertaion, but it's totally fine to judge someone for having less than perfect skin from no fault of their own.

What makes me even angrier is all the people that exploit people like me, who are already in a difficult position. Why make someone's life even harder than it already is by tricking them into wasting their money on something useless? My life is hard enough as it is, and having to try and figure out a way to make it better is much harder than I thought it would be. I'm in a very easy position to exploit right now and I know that. I (like many others) am desperate and obviously unscrupulous people are aware of this.

Anyway:

Does anyone know what complications can arise specifically from dermabrasion done wrong? What are the odds of something going wrong on such fair skin. I did the test of what skin class number I am and I scored a 3, to put me into the 1st, lightest category. I know there's no such thing as a 'quick fix', but I want it done ASAP.

I should probably also add that my parents live in California and I can go home for a bit and have treatment done there, but I just don't know what to do or where to go. I am so suspicious that everything seems like a scam and it seems like all the doctors are so self-promoting. I understand advertising and wanting to make a profit, but I just feel like I can't trust anyone about this. Imagine if any other condition were treated this way. My best friend has Crohn's Disease, and I can't imagine if trying to find treatment for it were anything like this maze of false information and people who want nothing more than money and have little to no motivation to help.

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I really, really don't want to travel to another country and take the time to have just a patch test done and then wait 2 entire years and have to go back again. I know I should be patient, but I feel like I have already waited forever. I tried creams for years to get rid of my acne, then antibiotics for years after that, then finally accutane (which took 12 months as I was on such a low dose) and now I am almost done waiting a year after my accutane in order to get treatment. I am really mad that I would have to wait another TWO (!!!) years to have any kind of improvement. I feel like I am living my whole life waiting for things to get better, and after ten years of this nightmare it just goes on and on and on. I would be thrilled with a 50% improvement of my scars. I wouldn't have another treatment done if I could just do something to make them halfway better. I don't want perfection, I want to feel at least a little bit normal.

I said 2 years because that's the time my face took to heal completely after I had a CO2 laser done. After 18 months more or less strange white marks (hypopigmentation) started to become visible on my forehead, and they got worse with time. I have to be conservative if i intend to be honest, because i know from personal experience that the healing process is slow after invasive treatments.

Maybe dermabrasion is different, though, because it doesn't have the heat damage. I don't know. What I have read over the years about dermabrasion is that the doctor must be almost an artist to get good results and that the procedure is risky. There was a user here called Animegirl who had many dermabrasions and she improved her scars a lot. She is not posting anymore, unfortunately. Some others had no improvement at all and some people ended up with new scars.

i would wait 2 years but I would try other treatments in the meantime, like TCA peels, fractional lasers, subcision, copper peptides, some more needling, etc. If nothing works and if the dermabraded area is ok I would have a full face dermabrasion done, as a last resort (after trying less risky treatments).

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This happens all the time. People come on here and blog about their procedure, then never update at all. I am led to believe that their initial excitement was ultimately tempered by less than ideal results or something that fell below their expectations.

Sunshinefunshine, I do not think you need to do anything surgical like punch floats. Your scars appear shallow enough that resurfacing may be enough.

Here's someone's acne scar treatment history story I found (written in French but translated) with some pictures and a review of his experience with this doctor:

http://translate.google.com/translate?hl=en&sl=fr&tl=en&u=http%3A%2F%2Fforum.doctissimo.fr%2Fsante%2Facne-psoriasis%2Ffractionne-cicatrices-creux-sujet_176366_2.htm

(Scroll down until you start to see pictures.)

This person seems really happy with the results, but I am not sure I understand how long this process takes. I can't stay in France for months at a time. I wonder as well if even I need the punch floats because my scars are so shallow and absolutely everywhere, but I guess only an expert can make that decision.

In this case the last picture was taken one week after his dermabrasion. I'd like to know how much of that improvement remained permanently. His skin was still very swollen.

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i truly think you will benefit from recell+fraxel repair+subcision combo which Ernesto had very successful results for his pitted scars or the fat stem cell graft with the celution device could do the trick also. unfortunately in most countries it's not approved but i believe both recell and celution are available in England and some other parts of Europe… heres a vid for celution

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This user had punch floats followed by dermabrasion with dr. Yarborough, in the USA (similar to the treatment that French doctor offers). She posted before and after pictures (pages 7-9). This thread documents her 5th dermabrasion, when she eliminated all of her remaining scars (it seems some small imperfections were left).

She was a real person, sharing reliable information and showing real results.

Edited by marcosctb
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