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verdicchio22

What to do about Scarring?

Hey Guys,

I am a long term sufferer of Acne. I had severe cystic acne as a teenager on my face, back, shoulders and chest. I went on Accutane about 6 years ago and this helped to clear my cystic acne. I currently still have mild Acne on all areas with my back still being the worst.
My problem now is my scarring which I believe is severe due to the severe level of Acne I once had. I am now looking into treatments for my scarring as it is causing depression and some days I feel I just can't take it anymore. Everyone tells me my skin is not as bad as I think but I think they say this out of sympathy. 
I would like to know what people think about the level of scarring I have and what treatments I would benefit from.
I have an appointment with Dr. Chu in London on the 13th February and would like to know what to ask.

I have attached photos although the lighting is not great so doesn't show the full degree of scarring.
20180130_124530.jpg20180130_124442.jpg20180130_124505.jpg20180130_124519.jpg20180130_124434.jpg

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Can you tell me where your scars are I do not see any except the temples, perhaps I have trouble seeing it in the pictures. The temples could use some subcision. The forehead lines are a normal response in all human being and botox treats this.  IT looks like between your eyes is another muscle botox area. Scars make shadows with a flashlight. See the FAQ for how to do this, top of the scar solutions sub.

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Yes they are not very visible in these photos. I will take more with a flashlight later and post them. Can you see the large pores? I think they are scared pores? 
Also the raised scar on the right hand side of my face by my mouth?

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These pictures show it better although it is hard to get a good angle with the flashlight.
I have scarring all over my face with the worst being on the temples, cheeks and nose.20180130_190710.jpg20180130_190724.jpg20180130_190352.jpg20180130_190358.jpg20180130_185856.jpg20180130_190342.jpg20180130_190044.jpg20180130_190340.jpg

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Those divots are going to need subcision to start out with. I would say some you could get away without filler, but there are deeper ones which would really benefit from it (right by your mouth, near your ear.) You should start with that, and expect to need 3. Instead of filling, some areas could also be suctioned, but filler would be best.

Afterwards (or in-between, depending on your healing and free time) 3 infini RF to address left-over atrophy and skin irregularities. From there, many many TCA peels or erbium laser for texture!

For forehead lines if they bother you, botox would be best to address these

Edited by Petsme

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Thank you for posting those pics. See how things are different with shadows ;-) Petsme was right your biggest treatment will be several sessions of subcision and filler. I know Chu only does prp but you can do filler afterwards. See Eva's post on the second page I discuss PRP and Filler for subcision recently. 

For the bump, Chu can inject that with steroid and make it shrink down.

3 sessions of rf microneedling infini, intracel, vivance, intensif, etc... you can do and so the subcisions around. The body takes time to heal so please put some months between your treatments. 

You can do a few tca peels as petsme said at the end or one sedated peel or erbium laser resurfacing.

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A prime example of how angled lighting will always reveal the true depth of scars.   Thank you for sharing the updated pics.  I agree with the above.  Subcision and filler will help.    What is working in your favor, is that despite the fact that you have some deeper indentations, the texture of your skin is good (smooth, not ragged or exhibiting sharp edged boxcar scars).   These kinds of rolling scars look good when filled correctly because the margins are soft and blend into the surrounding normal skin.   If you have sharply demarcated boxcars, you can fill them but you still see the edges.  In those scars, the edges or "shoulders" of the scars need to be ablated / smoothed with lasers / peels / dermabrasion (the most extreme).  

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So how bad are my scars and will I be able to get a marked improvement on the appearance of my skin? 

If my scars are so deep why don't they show up in softer lighting?

Also how long do you think It will take to achieve results from the treatments?

Edited by verdicchio22

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No one can predict how your skin will react to a treatment.  There are treatments that are essentially "instant" like fillers, where you can see an effect almost immediately after the swelling resolves in a few days.   There are other treatments that rely on your body's ability to heal itself after intentional damage (peels, lasers, subcision).   Those take longer.  In general, expect to commit to several rounds of subcision and filler to see noticeable improvement.  

Edited by dazzed

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