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how should I treat these scars?

MemberMember
0
(@huzcat022)

Posted : 05/10/2016 9:28 pm

hey guys, I've been stalking this forum for a while and just now joined in order to ask some questions.

 
I've been dealing with pretty severe breakouts for the past two years and it's left me with what I see as significant scarring. I've had acne since I was 13 and I've been on a topical erythromycin-benzoyl peroxide gel from then up until now. I was on doxycycline for a year and only stopped taking it about a month ago- I'm pretty sure it thinned my skin and left me with the scarring that I'm seeing now because I used to heal very well before this point. I've been on birth control for about a month and a half and have seen a reduction in my acne but not to the extent I had hoped so I'm starting accutane in three weeks. 
 
basically, I just wanted to get advice on my scarring- I'm not sure what kind of scarring it is or how deep it is. my friends and family say they don't see scarring but I think they're lying to me to make me feel better lol. I wanted to know if you guys think the scars will improve significantly while on accutane, and if not, what treatments I should do to reduce them, or if I'm an absolute lost cause haha. 
 
I have OCD/BDD so I know it's possible that the images i'm seeing in the mirror are over-exaggerated in my head, but I'm having a really difficult time right now. I feel extremely ugly and disfigured and it's really exacerbating my depression and mental health problems 🙁 
 
so here are some pictures of me in no makeup with relatively good bathroom lighting 
 
thanks for listening to me whine 🙂 

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MemberMember
311
(@quanhenry)

Posted : 05/11/2016 6:25 am

It looks like your acne is settling down, but every spot needs to be flattened out before you get to work on the scaring. They look like shallow boxcar scars, which are treatable. Peels are a good starting point, they can smooth the surface and fade red marks. Microneedling is popular on this board, though I havent tried it yet. Lasers like Fraxel are effective, but you will want that to be your last step.

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MemberMember
13
(@naimur97)

Posted : 05/11/2016 10:39 am

I see you've got a variety of scars ranging from icepick to rolling to boxcar.Your scars are quite shallow(most of 'em).Combination treatments of multiple sessions would be need to achieve around 70-80% improvement,which is frickin great.Totally agree with the other two replies.Start with less aggressive treatments before going for the big guns.But it's going to be expensive since it's gonna be a trial and error method.That's why many people saves money and plunge right into laser resurfacing.First goal for anyone treating acne scars is to treat the deepest ones.You can look into subcision for the deeper ones,though it's not quite necessary for you.
And the redness might just be PIH,which would go way in about 2-3 months.If the redness is persisting(around 9-12 months or even more)then it might be post inflammatory erythema,i.e PIE.For PIE V-beam is gold standard.Again multiple sessions would be required. IPL also helps but would require more sessions and longer downtime(as i've heard).Plus IPL is also said to be a tad painful(no idea why).
And finally don't go for acne scar treatments with active acne.If you are still getting breakouts then you might consider taking accutane.First treat acne and then the scars.
Good Luck

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MemberMember
252
(@robertitoo)

Posted : 05/11/2016 10:51 am

Vbeam is yet to be mentioned....Go with Vbeam. You're a perfect candidate: red scars, active acne and a few indents. Vbeam will not only mitigate your red scars, but will cease acne from forming for quite some time. Vbeam can also reduce the chances of indented scarring by absorbing the inflammation

Myadvice.: try oil cleansing, get a series of vbeam done and use sunscreen religiously. If you're adamant about your decision on accutane then my work here is done.

Naimur97 liked
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MemberMember
0
(@huzcat022)

Posted : 05/11/2016 2:37 pm

5 hours ago, beautifulambition said:

Ematrix which is RF, it is great on active acne. Infini is also good to shrink the pores. Or Superficial Botox to shrink the pores which are causing your acne. You might need a food panel to see if your allergic to anything, could be hormonal. Accutane might be a option to get the acne under control. Even a nice salicylic peel and facial wash would be good for you. If you don't want to undertake those you can get a facial done or goto a dermatologist. Treat Acne first, then scars. Vbeam / IPL would be great for the redness. Retin A topical would be great for your skin.

thanks for the advice! 🙂 I do think some of my acne is hormonal but I'm sure some of it is just regular bacterial acne as well...I have severe food allergies, always have, since I was born, but I avoid all the foods i'm allergic to. I've always thought using retin-a might be good but I had a bad allergic reaction to epiduo (and I'm pretty sure it's kinda the same thing???) so I've been pretty cautious. 

8 hours ago, QuanHenry said:

It looks like your acne is settling down, but every spot needs to be flattened out before you get to work on the scaring. They look like shallow boxcar scars, which are treatable. Peels are a good starting point, they can smooth the surface and fade red marks. Microneedling is popular on this board, though I havent tried it yet. Lasers like Fraxel are effective, but you will want that to be your last step.

I've read a bunch about microneedling! would it be best for me to get it done professionally or use a home dermaroller? 

3 hours ago, Naimur97 said:

I see you've got a variety of scars ranging from icepick to rolling to boxcar.Your scars are quite shallow(most of 'em).Combination treatments of multiple sessions would be need to achieve around 70-80% improvement,which is frickin great.Totally agree with the other two replies.Start with less aggressive treatments before going for the big guns.But it's going to be expensive since it's gonna be a trial and error method.That's why many people saves money and plunge right into laser resurfacing.First goal for anyone treating acne scars is to treat the deepest ones.You can look into subcision for the deeper ones,though it's not quite necessary for you.
And the redness might just be PIH,which would go way in about 2-3 months.If the redness is persisting(around 9-12 months or even more)then it might be post inflammatory erythema,i.e PIE.For PIE V-beam is gold standard.Again multiple sessions would be required. IPL also helps but would require more sessions and longer downtime(as i've heard).Plus IPL is also said to be a tad painful(no idea why).
And finally don't go for acne scar treatments with active acne.If you are still getting breakouts then you might consider taking accutane.First treat acne and then the scars.
Good Luck

I'm glad to hear that you think they look pretty shallow- I'm really hoping that the redness will subside and they'll look less deep eventually!! 

3 hours ago, Robertitoo said:

Vbeam is yet to be mentioned....Go with Vbeam. You're a perfect candidate: red scars, active acne and a few indents. Vbeam will not only mitigate your red scars, but will cease acne from forming for quite some time. Vbeam can also reduce the chances of indented scarring by absorbing the inflammation

Myadvice.: try oil cleansing, get a series of vbeam done and use sunscreen religiously. If you're adamant about your decision on accutane then my work here is done.

so does this mean that you think I should skip accutane and go straight to v-beam? or get v-beam after accutane?

I don't know if this photo helps any more, but this is my skin with pretty heavy makeup on (layers of foundation and some translucent color correcting powder) in the angled natural lighting of my car!! 

image.jpg

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MemberMember
311
(@quanhenry)

Posted : 05/12/2016 6:57 am

@huzcat022

Dermarolling is kind of an outdated technique. If you do it at home you should invest in a mechanical dermapen like the derminator. Clinics charge a ton for the treatments, which are safe to do yourself if you do the research.

Vbeam is magic for red marks and slow down acne, but I think chemical peels work nearly just as well for hundreds less, and can be done at home.

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MemberMember
3
(@glownshine)

Posted : 05/13/2016 7:16 pm

Save your money and buy a derminator.

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