Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
silkentress

Suggest scar treatment

Recommended Posts

BB1B9283-EBC1-425C-824A-9ED7202FE6E2.thumb.jpeg.494ae8b5503089ba220c943728eedeaa.jpeg8410B1CF-5FA8-4F22-8B5E-5282D7DE0FDD.thumb.jpeg.8f613e4b3b33f0cd13c6174e405e8a3d.jpeg6041DFCF-D070-4779-8605-BD877DCF0A6D.thumb.jpeg.f73c3d9b5602d6c4984792733cbfedaa.jpeg8CFDAED9-97A3-4F65-9C0C-E80DFAD14430.thumb.jpeg.8f2056c4905d82c311dcbe98677259a3.jpeg35 year old female suffering from acne scars. In a span of 15 years I have had the following procedures on and off.
Erbium yag :2 treatments while on accutane which gave me a rolling scar on my right cheek.
TCA Cross 90 % : 5 Treatments in a span of 4 years.
Suture Excision : 2 deep boxcars 
Dermarolling 1mm : 3 treatments 
Subcision plus dermapen with PRP : 1 week ago.

I am trying to get rid of these scars but have hardly noticed 40 percent improvement in a span of 15 years. Previously i had deep boxcars whose borders have improved due to TCA cross. I have been looking into Infini and Co2Re. I have two dermatologist in Pakistan offering these treatments.I need someone’s advice on whats the best mode of treatment for my kind of scars, and how many treatments at what depth and level of Infini do I require? The practitioner offerinf infini doesnt look tht experienced. Theres one offering Scarlet RF and Hitone Rf too. Out of all three RF devices, which one gives the besr results and is safe? Hitone is by AMT technology and is korean made. Unfortunately, dermatologists here arent very experienced in performing subcision. I am not tht satisfied with the results. Ill have to look for an experienced doctor performing subcision here. I know its not the device but the doctor but unfortunately my choices are very limited in this country. 

Edited by silkentress

Share this post


Link to post
Share on other sites
@silkentress

Hi there, Thanks for posting

I see surface box cars, rolling, icepics, hyperpigmentation - PIE/PIH - reds / browns. 

Erbium on Accutane, risky!
Any improvements from the TCA Cross treatments? I can see you doing paint on TCA, multi layer, same treatment only to the bed of the scar on several areas. 
I don't see dermarolling doing much in your case, but could be used between treatments at home for collagen stimulation.

From the bruising I see in the picture, they should have done much more extensive subcision on you, ... missed many areas.

40% improvement is quite good, ... I feel of course you could get more. 

I see you needing much more subcision, ... not just the one area of bruising. PRP is fine. You will need several sessions. If you wish you can put a vial of sculptra throughout the cheek (not in one area) area under the scars as a spacer, but your already doing prp. 

I would do 3-4 sessions of Infini rf needling mixed between your subcisions. You cannot go too shallow with Infini or you will get hyperpigmentation issues. They need to stay in the mid-deep dermis. 1mm, 1.5m, 1.75mm, 2mm. If they go shallow have them do a test spot first to see how your skin responds before doing the whole face at another time. Inifni is fine, ... you just need on whatever device insulated needle in your skin type.

You have box cars, they need to do 3-7%co2 - CO2RE with the highest power. They will angle the laser to just hit the border of the box cars (pits). Several treatments will be needed.

I would do a fully ablative erbium resurfacing just on the box cars if you can find someone who will do this on your ethnic skin type and has experience. Otherwise fly to Lim, ... as you have done do many treatments before.

Please use daily retin-a/tretinorin/differin and a konjac and arbutin cream (ingredients) for cell turnover and to prevent hyperpigmentation. 

You may do at the end for discoloration reds and browns several sessions of picosure. 




Treat as you have time and money, 3 months apart all treatments, you can microneedle one month between dr treatmetns at home, everything is optional. 

Share this post


Link to post
Share on other sites
4 hours ago, beautifulambition said:
@silkentress

Hi there, Thanks for posting

I see surface box cars, rolling, icepics, hyperpigmentation - PIE/PIH - reds / browns. 

Erbium on Accutane, risky!
Any improvements from the TCA Cross treatments? I can see you doing paint on TCA, multi layer, same treatment only to the bed of the scar on several areas. 
I don't see dermarolling doing much in your case, but could be used between treatments at home for collagen stimulation.

From the bruising I see in the picture, they should have done much more extensive subcision on you, ... missed many areas.

40% improvement is quite good, ... I feel of course you could get more. 

I see you needing much more subcision, ... not just the one area of bruising. PRP is fine. You will need several sessions. If you wish you can put a vial of sculptra throughout the cheek (not in one area) area under the scars as a spacer, but your already doing prp. 

I would do 3-4 sessions of Infini rf needling mixed between your subcisions. You cannot go too shallow with Infini or you will get hyperpigmentation issues. They need to stay in the mid-deep dermis. 1mm, 1.5m, 1.75mm, 2mm. If they go shallow have them do a test spot first to see how your skin responds before doing the whole face at another time. Inifni is fine, ... you just need on whatever device insulated needle in your skin type.

You have box cars, they need to do 3-7%co2 - CO2RE with the highest power. They will angle the laser to just hit the border of the box cars (pits). Several treatments will be needed.

I would do a fully ablative erbium resurfacing just on the box cars if you can find someone who will do this on your ethnic skin type and has experience. Otherwise fly to Lim, ... as you have done do many treatments before.

Please use daily retin-a/tretinorin/differin and a konjac and arbutin cream (ingredients) for cell turnover and to prevent hyperpigmentation. 

You may do at the end for discoloration reds and browns several sessions of picosure. 




Treat as you have time and money, 3 months apart all treatments, you can microneedle one month between dr treatmetns at home, everything is optional. 

Share this post


Link to post
Share on other sites

Thanks for replying. I posted a reply but it didn’t get posted so i am posting it again. I just saw that I posted in 2009 too but didn’t get replies from anyone.

I have done 4-5 TCA cross 80% over a period of 4 years and have seen scar bed rising. I may do one or two more.I think the improvement from cross is 40 percent. The erbium i got only softened the edges of boxcars.

I agree with the subcision part as the dermatologist looked inexperienced and since I didn’t have a choice i had to suck it up. She was constantly worried about giving me haematoma. You mentioned filler as a spacer but she didn’t inject any spacer and just spread PRP on the face witj the dermapen.

I need to know when the spacer should be placed after subcision. Its been 12 days since i got subcision done. Is it to be injected Immediately after subcision or after the swelling is down after 3-4 weeks? Do u think my scars would have Re tethered by now?I have option of getting sculptra done as a spacer but i dont know when it should be done. I understand its for collagen stimulation and ideally done 4 weeks before Infini. 
I forgot to mention tht my last TCA cross was 15 days before my subcision. On the 8th of November itll be a whole month. The redness that you see is because of TCA cross. 

A clinic is offering me infini + picosecond laser. Is it ok to do picosecond after Infini  ?

I have the following list of treatments in 3 months intervals.
1. A proper subcision...spacer HA or sculptra
2. Infini
3.subcision
4. Infini
5.Co2re
6.Co2 re
7.picosecond 


 

Share this post


Link to post
Share on other sites
@silkentress I missed your post sorry about that busy busy.

Ok good, derm is inexperienced with sub, .. .find someone who can be more aggressive under the scars. She should not be worried about a hematoma, easy to resolve and or drain. She should learn cannula subcision if she is freaking out about this.

You need a spacer with subcision, weather filler - HA, prp, 1 vial dilute sculptra etc. Some people do Chinese cupping on the scars at home for several weeks but it can make bruises. 

12 days if fine, ... she can do the filler now. But I don't see her doing that much subcision so perhaps find someone who will do all the scars and not a tiny space, ... not worth filler there alone.

I don't think your scars were done properly with sub from the beginning and as such would find someone else to be more aggressive. 

Yes you fill when the swelling goes down.

"A clinic is offering me infini + picosecond laser. Is it ok to do picosecond after Infini  ?" this is fine.

Plan looks ok you need multiple subcisions 3 months apart, multiple tca cross, rf needling spaced between subcisions, co2 is optional towards the end. multiple picosure.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×