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malia02

Severe scarring, bad texture and hypopigmentation. Need help. Please reply!!!

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Hey, I need really your help. I suffer from severe acne scarring. I had done several treatments to reduce my acne scarring:
 in 2005 laser (ablatif CO2) and Excision (I think it was that, I trusted the surgeon)
in 2007 laser (ablatif Erbium Yag)
in 2016 laser (ablatif CO2) + subcision
Now I am very depressed. I am suffering from bad texture, acne/rosacea, acne scars (atrophic and hypertrophic) and hypopigmentation (from laser). Right?
What type of scarring do I have?
Should I go for fillers, TCA, TCA cross, subcision or punch elevation and dermabrasion?
Or should I treat my acne/rosacea with accutane first?
Can I take it or do another treatment when I had my last CO2 laser treatment (totally ablatif) in January 2016?
Please help!!! I  am so depressed...

Edited by malia02

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How much improvement have you had from these treatments? I can't really see enough active acne for you to take accutane, have you had acne for years that you have not been able to treat effectively with topicals and such? For treatments I think subcsion + suction, microneedling, and chemical peels would be ideal for you. Fillers would also likely be very effective for your scars, they are just expensive if you go the temporary route and permanent fillers have some uncertainty associated with them.

If you have not already seen Mr.matt's blog take a look: http://www.acne.org/messageboard/topic/232731-man-in-the-mirror-pre-and-post-subcision-photos/

Edited by PCT14

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Thank you for your advice.
I do get pimples and lumps because of my acne/rosacea but less than before. I struggled the last 45 years with skin problems. I never got accutane but metro (cream). In my youth,  a cosmetician picked all my pimples so I got  all my scars.

I was so stupid. I haven't taken pictures in the same light. Now the scars are a bit shallower but wider. In certain light they are less
noticeable than before. But my skin remains looking very bad because I have a lot of scars which are deep and wide.

Do you think I have completely destroyed my skin?
What type of scars do I have?
What about my texture?
Other advices?

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I agree with PCT14's good advice. Multiple subcision + suction treatments with or without fillers (maybe at final treatment depending on improvement achieved from subcision alone), microneedling (Derminator, dermastamp), possibly chemical peels once scars are level. Also, a dermatologist can inject any hypertrophic scars to flatten them. A prescription for topical retinoids (retin-a, tazorac) might be a good idea for active acne and between treatments to help promote collagen and faster healing. Once scars are raised up I think the hypopigmentation would be best covered with a light layer of mineral makeup powder (less irritating to rosacea than stuff with lots of chemicals). I think these treatments can give you more improvement and more immediate results than multiple laser treatments and are also less invasive/risky than punch elevation + dermabrasion, which would create new scars from the punch elevations. I don't think I see any scars that would need TCA cross so if it were me I would stick to lower strength peels like 10-35%(max) TCA, lactic, glycolic. Best wishes and keep us posted. :) 

Edited by Ommmmmm

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I don't have much experience with fillers other than I would personally never get permanent filler. I would post a question with your pics on RealSelf for that or find a reputable professional and get their opinion on which filler. 

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Fillers. Check out Restylane Vital. First try filler to raise them (juvaderm voluma), along with subcision at the same time (ask doctor if he can remove the threads that pulls scars down it is not always called subcision - you are a great candidate for this treatment), then a course of 3 treatments of Restylane Vital. Start using Retin-A. 

Good diet, with meat (my mistake was going vegan). Exercise (actually good for scarring and mind). 

You can always grow your hair to hide it a bit. This close it will obviously look bad but from normal distance I bet it doesn't look as bad as you think. 

Please seek psychological help as well. Everyone can benefit from this. Scarring can be treated but mostly it is our perception of not being accepted that drives the need for such expensive treatments. But, I have done a lot, but the more I do the more I am starting to accept my battle ground of a face. 

Good luck! 

 

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31 minutes ago, beautifulambition said:

I have skin just like yours but with bigger rolling scars.

you need Subcision done followed by filler to lift up the car areas.

Voluma which is for cheek augmentation is good and its a Hyluranic Acid Filler that can be reversed, lasts 1- 2 years to see if you like the filler route. I am not a big proponent but arteflle / bellafill is a semi permanent filler with micro beads, it cannot be corrected once done, as we age they can migrate a bit and chance of grandulomas, some people on this site do micro silicone injections but this must be done by someone with thousands of procedures experience and a little micro injections at a time (Same side effects as Bella....). If you are in Europe Ellanse E is great and lasts 4 years.

Filler is your best option at this point (it's all we have if we are fat deficient and atrophic), subcision to untether the scars, and some tightening of the areas possibly with Infini RF . Secret RF / Intracel 

All these procedures are on realself.com to read the reviews

https://www.youtube.com/watch?v=veyJWYAYri8

Have you done the procedures you are recommending? Any results from any of your treatments?

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@beautifulambition What about subcision + suction? I heard some people got +90% results from that, but I'm not really buying it. Everybody has their own agenda... I guess I'll believe it when I see it.

Edited by EquippedJar

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4 minutes ago, beautifulambition said:

Filler is the better option than suction. Every time I did suction it tethered down again right after I stopped and the bruise healed. It works for some, you could try. I have no agenda, not trying to sell you anything, I understand your scars they are like mine - just trying to help, Filler would give you the biggest change, but only if they un tethered it. I have done a shitload of procedures look under my username, filler is the only thing that was the most improvement. 

The disadvantages of filler is it is not permanent (unless you go that route) and it is expensive, also it's dependent on the experience of your injector with acne scars. I posted a white paper weeks ago on vertical filling technique for acne scars ;-P
I didn't mean you had an agenda. I mean doctors, businessmen, etc. I think I'm going to follow the suction 'protocol' for two weeks, but starting on the very first day. I don't see any harm in starting earlier. Then I think I'll do TCA to finish the few icepicks off. In your experience, does subcision work for all types of rolling scars, or just tethered scars? There seems to be conflicting information on the internet as always.

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22 hours ago, beautifulambition said:

I have skin just like yours but with bigger rolling scars.

you need Subcision done followed by filler to lift up the car areas.

Voluma which is for cheek augmentation is good and its a Hyluranic Acid Filler that can be reversed, lasts 1- 2 years to see if you like the filler route. I am not a big proponent but arteflle / bellafill is a semi permanent filler with micro beads, it cannot be corrected once done, as we age they can migrate a bit and chance of grandulomas, some people on this site do micro silicone injections but this must be done by someone with thousands of procedures experience and a little micro injections at a time (Same side effects as Bella....). If you are in Europe Ellanse E is great and lasts 4 years.

Filler is your best option at this point (it's all we have if we are fat deficient and atrophic), subcision to untether the scars, and some tightening of the areas possibly with Infini RF . Secret RF / Intracel 

All these procedures are on realself.com to read the reviews

https://www.youtube.com/watch?v=veyJWYAYri8

Thank you very much. You have helped me so much.  I'll have an appointement tomorrow with a doctor. Beautifulambition, you would go for Juvaderm Voluma because Artefill and Ellanse E are  both semipermanent and too dangerous? Sorry for my English.
Do you think it's too early to get subcision + filler because I had traditional ablative CO2 treatment and subcision in the end of January?
I will ask for retin-a, I have never used it: How is it used? On my pimples/lumps in my chin overnight or on the scars? Or is it used on the whole face? What can I do for my texture? I have also lots of ice picks on my chin and forehead  but my main concern are the scars on my cheeks.
I have purchased a red light device. Do you think it helps?

One last but very IMPORTANT question: My daughter  has been suffering also from acne for the last 18 years, she is so tired of having acne and scars. She has tried everything, topicals, antibiotics, good diet etc. Now she is on antibiotics again and on spironolactone (and birth control). She has mild acne scars. She's soooo terrified of getting scars worse and getting scars like mine.  Should she ask for Accutane tomorrow? On the one hand, she's terrfied of getting scars from Accutane, on the other hand she's terrified of getting scars worse from her acne which will probably never be cured only with spironolactone and without Accutane. Any eperience/advice? Thank you in advance.

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5 hours ago, malia02 said:
Thank you very much. You have helped me so much.  I'll have an appointement tomorrow with a doctor. Beautifulambition, you would go for Juvaderm Voluma because Artefill and Ellanse E are  both semipermanent and too dangerous? Sorry for my English.
Do you think it's too early to get subcision + filler because I had traditional ablative CO2 treatment and subcision in the end of January?
I will ask for retin-a, I have never used it: How is it used? On my pimples/lumps in my chin overnight or on the scars? Or is it used on the whole face? What can I do for my texture? I have also lots of ice picks on my chin and forehead  but my main concern are the scars on my cheeks.
I have purchased a red light device. Do you think it helps?

One last but very IMPORTANT question: My daughter  has been suffering also from acne for the last 18 years, she is so tired of having acne and scars. She has tried everything, topicals, antibiotics, good diet etc. Now she is on antibiotics again and on spironolactone (and birth control). She has mild acne scars. She's soooo terrified of getting scars worse and getting scars like mine.  Should she ask for Accutane tomorrow? On the one hand, she's terrfied of getting scars from Accutane, on the other hand she's terrified of getting scars worse from her acne which will probably never be cured only with spironolactone and without Accutane. Any eperience/advice? Thank you in advance.
Have your daughter do a test on her zinc levels. There is an easy test involving swirling a zinc solution in your mouth for a bit. Look it up online. I found out I was extremely zinc deficient after a year of overdosing magnesium for nerve pains (magnesium competes with zinc). I took zinc supplements and within a month all my cystic acne was gone. None of the odd pimples I get every now and then never leave a mark and go away within days. I don't know if zinc would get rid of all your daughter's acne, but it couldn't hurt, as long as she's dosing safely. Maybe even take her to a trustworthy nutritionist to get everything sorted internally while you're at it.

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Thank you.

Do you know what can be injected to remove the hypertrophic scar?

I thougth that if my daughter's acne would be hormonal, spironolactone and birth controll would help. Spironolactone is for hormonal acne, isn't it? Should she go to a gynecologist to have a blood test of her hormones? She has already done a blood test to find out if she has a deficiency of zinc, magnesium etc. And a test of the thyroid. Everything is ok. She is very, very thin. I think the reason why she suffers from acne is a histadelic metabolism. Her body produces more toxins than normal and ingests less vitamins and minerals than normal. Therefore, she takes various supplements: zinc, several minerals, opc, vitamin c, msm, alpha lipon acid, sam-e, map...But her acne doesn't disappear completely, I think accutane is the only way.

If you have bad experience with accutane (e. g. accutane causes acne scars),  please let me know.
 

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8 hours ago, malia02 said:

Thank you.

Do you know what can be injected to remove the hypertrophic scar?

I thougth that if my daughter's acne would be hormonal, spironolactone and birth controll would help. Spironolactone is for hormonal acne, isn't it? Should she go to a gynecologist to have a blood test of her hormones? She has already done a blood test to find out if she has a deficiency of zinc, magnesium etc. And a test of the thyroid. Everything is ok. She is very, very thin. I think the reason why she suffers from acne is a histadelic metabolism. Her body produces more toxins than normal and ingests less vitamins and minerals than normal. Therefore, she takes various supplements: zinc, several minerals, opc, vitamin c, msm, alpha lipon acid, sam-e, map...But her acne doesn't disappear completely, I think accutane is the only way.

If you have bad experience with accutane (e. g. accutane causes acne scars),  please let me know.
 


Hey Malia,

I have some pretty bad experience with accutane being an indirect cause of pretty much all of my scarring. But the thing is, everyone reacts different to medication, I just had really bad luck. I would never tell anyone not to take it, but you do have to keep in mind that it is a possibility you might end up worse off. Is it a risk worth taking? It very well may be. You have to decide for yourself.
 

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On 7/5/2016 at 7:47 PM, malia02 said:

Thank you for your advice.
I do get pimples and lumps because of my acne/rosacea but less than before. I struggled the last 45 years with skin problems. I never got accutane but metro (cream). In my youth,  a cosmetician picked all my pimples so I got  all my scars.

I was so stupid. I haven't taken pictures in the same light. Now the scars are a bit shallower but wider. In certain light they are less
noticeable than before. But my skin remains looking very bad because I have a lot of scars which are deep and wide.

Do you think I have completely destroyed my skin?
What type of scars do I have?
What about my texture?
Other advices?

Have you considered collagen or other fillers? Seeing your skin I can tell that you are not young, maybe hasnt worked ideally because of that? Decrease in collagen,etc etc and since you have tried lasers, excision, subcision, maybe fillers that are not permanent can aid :)

OOops didnt see the rest of the helpful messages, sorry! Btw spirolactone shouldnt be taken lightly... it was the reason for the worsening of my scars since it broke me out like crazy... the moment I stopped with it the acne went away. Take into account that I had all the tests done and it was prescribed by a doctor...  Edited by fleurverte

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Hey guys, I need really your help once again. Last week, I had an appointement with a dermatologist. He suggested me to do the following treatments in this order:

1) Skinoren for my skin texture/orange peel texture/hypopigmentation
2) Nd-Yag Laser to remove my redness and telangiectasias on my face and to make the hypopigmentation less visible
3) Lipolysis to remove fat which hangs down on my face (cheeks/chin)
4) Microneedling +  PRP
5) Subcision + Filler (Voluma)
6) Iso (low dose for my rosacea/lumps)

He said that I should first concentrate on removing my telangiectsias and my fat hanging down because these treatments would give me an improvement in my face. Removing acne scars, especially when they are already  treated 3 times by ablative laser, is more difficult. I have a lot of scar tissue. I don't trust laser and invasive methods anymore. I am worried about getting Nd-Yag  Laser and lipolysis. What do you think about it?
I don't know where to start with my skin.
Does it make sense to do microneedling + prp before doing subcision + filler?
Can I do anything for my hypopigmentation? Are my pigments permanently lost?

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Too many things on that list for me to offer much help. I would think you should first address the issues that bother you the most. You've tried laser a number of times, if you are worried about it then don't do it.

As for the microneedling and subcision steps, I think they would have the same effect in either order. Microneedling is not known for having a big effect after one treatment, you will probably need multiple. It is something out can perform at home, less the prp, if you are interested.

Lipolysis does seem to be the main one you need to make a decision on, not sure if you will find any help regarding that treatment here.

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ok, my doc said that he doesn't use juvederm voluma to treat acne scars. Juvederm Voluma is too thick and it's injected too deep into the skin. @beautifulambition: Have you tried voluma? :Which filler gave you the best reult? Should I search for another doc who would do voluma? I don't know what to do :( Another hope is gone....
 

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Thank you BA. I think that he uses various fillers that can be reversed (different fillers of juvederm, belotero etc.). Although I am 61 years old, I still get pimples. My skin is very greasy. Should I go for accutane? Then I will have to wait another year to do fillers. Or can I go for subcision and filler and start accutane shortly afterwards? The doctor doesn't offer v-beam for my "broken" blood vessels. I think that if I do v-beam, I will do it only on my nose where I have many big "broken" blood vessels. I am terrified of getting more hypopigmentation due to another laser (although it's v-beam). Do you know if there is a risk of hypopigmentation?

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