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Fannypack72

How severe are my scars? Treatment Options?

Hi I am new here and wanted some advice about my scars. I am finishing up accutane but the initial breakout left me with substantial scarring. I had really bad hyper-pigmentation for a few moths but it has faded quite a bit now. Depending on the lighting and angle the scars can look relatively normal or quite severe. I think I have rolling scars but I am not sure. How bad are they and how much improvement can I expect if I am patient? 
Thanks!

Here are some photos in both good and harsh lighting - 

IMG_2614.JPGIMG_2609.JPGIMG_2607.JPGIMG_2600.JPGIMG_2599.JPGIMG_2605.JPG

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Yes you have rolling scars, they are superficial in nature.

You need 3 sessions of subcision with filler.

I would do (3) RF microneedling, there are many brands like Infini, Intracel, Intensif, secret, etc... You schedule these around your subcision.

I don't see any icepicks.

I would finish off with many medium strength tca peels (from a derm or med spa) or a sedated TCA peel with a (derm / plastic) that will get under the scars and resurface the texture - this is considered a deep peel. Regarding your PIH or Hyperpigmentation I would not treat until you treat your scars as this will bring some redness. Vascular laser is the best for this. Finally the body takes time to heal, please allow months in between treatments, ... many treat over 3 years as they have down time and money. 

You can start now with your subcision.

Read more about subcision and acid peels in the FAQ - top post of the scar solutions sub.

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Start with subcsion with buffer filler. I suspect you have some fibrosis or skin thickening (if your skin feel tougher or harder, this is a good indication of dermal or sub dermal fibrosis.) Infini will not have the solenoid strength to penetrate tight bundles of scars, neither does Intracel. Instensif RF does, (super strong solenoid motor), but power is weak, PD or pulse duration limited to 200 ms, and energy is non insulated. Solution? Old fashioned low density but high power (> 100 mj) CO2 laser - not any fractional CO2 but FDA, TGA approved and tested lasers. Like always, combination treatments will be best. At the end, filler - PRP. This is because your scars are softer, and integration will be better. 6-8 sessions, 70% improvement with the correct specialist. All the best. No TCA CROSS indicated. No picks like BA mentioned. 

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12 hours ago, beautifulambition said:

Yes you have rolling scars, they are superficial in nature.

You need 3 sessions of subcision with filler.

I would do (3) RF microneedling, there are many brands like Infini, Intracel, Intensif, secret, etc... You schedule these around your subcision.

I don't see any icepicks.

I would finish off with many medium strength tca peels (from a derm or med spa) or a sedated TCA peel with a (derm / plastic) that will get under the scars and resurface the texture - this is considered a deep peel. Regarding your PIH or Hyperpigmentation I would not treat until you treat your scars as this will bring some redness. Vascular laser is the best for this. Finally the body takes time to heal, please allow months in between treatments, ... many treat over 3 years as they have down time and money. 

You can start now with your subcision.

Read more about subcision and acid peels in the FAQ - top post of the scar solutions sub.

Is it safe doing subsicion right after finishing off accutane?

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Thank you for your responses I really appreciate it! I will definitely take all of this into consideration and will start looking at options for subcision soon. 

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Subcision and filler are fine.  Just don't do any ablative / resurfacing procedures like chemical peels, dermabrasion, or laser.   The old recommendation was to wait at least 1 year after accutane to do ablative procedures, but frankly I don't think you need lasers.  You need the indentations to be raised and restore volume.

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