Hello all. I did a round of Accutane three years ago. I always had what I thought to be slight scarring on my face from acne. However, as of the past few months, I swear that the appearance of my scarring has increased. I have not had any prominent pimples on my face post-Accutane, yet I feel as if scarring has increased. I have had a cyst on my back that did, in fact, heal with NO scarring so I cannot decipher what is going on with my face.
What really messes me is (and I'm sure others who are in my position) is how benign my scars look in DIRECT lighting. The following pictures were taken on the same day OR after the former pictures posted.
<---- Yes, you can see an ice pick scar under my freckle, but I have had that scar since I was a wee one. There is also a more subtle ice pick scar to the left of that one, but that one has been there since BEFORE I noticed the increased appearance of the REST of the scars.
Where the heck are my other scars that showed up in the shadowy lighting? Occasionally, I get hopeful that I am just experiencing hyper-pigmentation from dry skin or something, but the shadowy lighting cannot be lying. Surely there is some pitted nonsense going on. But the scarring I am concerned about looks so different from my one prominent ice pick scar that shows up independent of the lighting I am in. If no one knew this context, I could arguably use these photos for a deceptive before/after presentation of some snake oil intended for acne scars.
I digress. Can someone please tell what scarring I have so I can determine the best treatment? I am thinking of reading up on the ins and outs of TCA cross.
For the first 3 images your scars are clearly rolling scars. I suggest subcision professionally or DIY micro needling and exfoliating them from time to time with a weak peel. And yes different lighting can play tricks on you, i don't know what to say regarding that. Otherwise you have great looking skin
hey man.
your skin is great! hardly scarred at all buddy! I would get on with life! lol!
how long did you do accutane for? do you have photos of before? do the red marks heal up and if so how long do they take to disappear? I had to stop accutane because of head aches. I have some scars too that were caused by accutane and the inflammation that resulted from some trapped pores that erupted on me.
Lighting is a bitch! Your scars are just really shallow. You have great skin. You do not need cross in my opinion. Doing that on your own, with nearly unnoticeable scars, runs the risk of more harm than good. Plus that's more for deep ice pick/boxcar scarring. You have some shallow rolling scars which respond well to treatment. I would go for TCA or lighter peels, but not a high concentration of TCA. I would max out at 25%, and would start at 12-15%. You can also dermastamp/roll it every 4-6 weeks. Your skin would be near flawless in a year if all goes well.
I know people on this site have used copper peptides after needling/peels to aid the healing. I know nothing about them though, just throwing it out there if you want to research that.
I have shallow scars that "vanish" in direct light, but my two boxcar scars still show like your icepick. I think it's just the depth, that's what I assume.
Lighting is a bitch! Your scars are just really shallow. You have great skin. You do not need cross in my opinion. Doing that on your own, with nearly unnoticeable scars, runs the risk of more harm than good. Plus that's more for deep ice pick/boxcar scarring. You have some shallow rolling scars which respond well to treatment. I would go for TCA or lighter peels, but not a high concentration of TCA. I would max out at 25%, and would start at 12-15%. You can also dermastamp/roll it every 4-6 weeks. Your skin would be near flawless in a year if all goes well.
I know people on this site have used copper peptides after needling/peels to aid the healing. I know nothing about them though, just throwing it out there if you want to research that.
I have shallow scars that "vanish" in direct light, but my two boxcar scars still show like your icepick. I think it's just the depth, that's what I assume.
Thank you for the reply. So you are basically recommending TCA chemical peels, as my skin would not benefit from TCA Cross. Point taken. I will definitely do that!
In the mean time, I have started using the DermaRoller at .5. In addition, I withdrew my life savings and invested in Vitamin C Serum. I am playing it VERY safe with the DermaRoller. My skin is highly sensitive. I just did it for the first time a few days ago, and seeing my skin with all these track marks and redness has not been easy on me. Furthermore, I KNOW many recommend using needles of 1.5 for acne scars, so upgrading is not something I am looking forward to, although it is likely necessary if I want the BEST results.
Some people roll every few days, some people wait months. I will have a waiting period of at least 6 weeks between each roll.
I appreciate the comments saying my skin does not look bad. It does make me feel better, but fishing for compliments is certainly not my motive. 
I am extremely uncomfortable in highly lit areas.
I think someone asked a questions about Accutane, but I don't remember the question, and I am on a mobile device so navigation is dreadful. I was on Accutane for 6 months. I was given it for my cystic acne on my back. The red marks healed excellently there, but my face is unpredictable. Some red marks last forever, others a month or so. Side effects were joint pain, excessive sweating, slight hearing changes, dryness in the worst of places, and dry eyes. The only side effect that persisted was eczema and hearing changes. It worked well enough, but acne started to return until I altered my diet (no dairy, gluten, processed food, ect). Hope that covered the question I am not sure I am replying to. XD
Its a shame you feel uncomfortable mate because your skin is in my honest opinion flawless.
reason i asked about accutane is because i did a low does for 4.5 months 20mg daily for light/mild acne on my face and back, but persistent... not a day would pass without a new spot. I am 27 years old. and just wanted to sort it out and cracked under the pressure.
I have since learned it wasn't the best decision in the world. When i stopped the treatment my clogged pores all turned into cystic acne and so now i have a lot of scarring and red marks from this mess... this was never the case before, my skin healed pretty rapidly. I WISH I never took it and just changed my diet and really tried that path more thoroughly. What dose did you take?
I hope you get to the place you want in your head with your skin but i truly think it comes from accepting yourself. There are honestly so many other things it could be or skin condition you could have etc but you look healthy and the skin is smooth. go and live your life and don't worry about the tiny tiny indents.
You say some red marks last forever, do you mean literally forever or just a figure of speech? I am wondering at what point I may seek professional help with the marks/scarring. I cant advice derma rolling, you need to be careful as that can damage the skin! perhaps go to a specialist. look into derma stamping/pen instead. you don't want to compromise good skin.
peace
ps i'll reply quicker next time
I was on 20 mg for one month and 40 mg for 5 months. As for the red spots, I think most have healed up. Some may be stubborn, but most of the time they fade completely. I would love to not stress over my skin, but I am paranoid that my skin is not healing the same since Accutane either. It's a tough call. I can look back at photos of me taken RIGHT as I got off Accutane, and I see the same cheek scars I have today. And I didn't even really have CHEEK acne when I went on it; that particular acne plagued me at its worst a few years earlier. This series of events SHOULD tell me Accutane didn't do anything to mess up my skin's healing process, but I am still skeptical.
Why now have I suddenly noted my acne scars more so? Is it a mental thing? Did they get DEEPER (a camera would have a hard time reliably detecting that due to lighting discrepancies, so it would take a long time to notice)? Are subtle zits I don't see causing it? I dunno. I am being EXTRA vigilant of every zit to see if they are leaving even the TINIEST of scars. . . But even if that is the case, the only sure-fire solution to preventing acne would be more Accutane, which may or may not be the culprit of a bigger issue! Talk about the perfect crime.
It is too short to worry about our acne scars!