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Treatment Recommendation (Pics Inside)

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Hi all, just came across this forum when I were looking up scar treatments. I am a 27 year-old Asian guy, been struggled with acne & scars since high school. Fast forward to now, the acne situation is mostly in check. I’m currently on a low dosage of Accutane (10mg/day) for maintenance. However, the scars really bother me. I am thinking of getting treatments, and was wondering if I can get some recommendations here. Thanks in advance.



Edited by hntt

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@hntt Hi there

You have mainly boxcars and icepick scarring.

Extensive TCA Cross has to be done for the icepicks and smaller boxcars. Several sessions are needed.

I can see subcision helping on some of the boxcars/rolling scars, 3 sessions are typically needed.

CO2 laser would be effective angled to just treat the borders of the box cars 3-7% density and the highest power. If your Dr does not do this get profractional erbium done. 

RF microneedling is great for box cars 3 sessions.

You have discoloration so picosure is great for that and collagen production.

In your skin type peels can cause hyperpigmentation so I would see a experienced Dr.

Retin-a/differin/tretinorin nightly with a konjac arbutin and licorice cream (some of those ingredients), this makes cell turnover and prevents further hyperpigmetnation. 

Treat as you have time and money, you have severe scarring, this will take some time to treat. I would do 3 months between all Dr's treatments even if they say sooner. Everything is optional. 

I have seen TCA cross and rf needling help a lot in cases like yours.


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100% agree with the above. The box car scars can be hard to treat if one does not have experience. DO NOT punch any of these scars out. They can be markedly improved with angled CO2 to the sides and base, or TCA painted. Now, the forehead scars- see someone good for this. MANUAL scar directed needling is best, 2-3 sessions with saline. Then last session with DILUTE vvv dilute Botox to relax the muscles. You can end this with fully ablative laser if scars are shallow enough. See the correct people, and your scars will be treated to good effect. Above all stay on the 10 mg Isotretinoin. Wish you well.

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Hi guys, really appreciate the replies. I am going to see a specialist in the next few weeks and update my journey here. Thanks again!

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A little bit update. To prep for the procedures, my current doctor took me off Isotretinoin (I was previously on a low dosage of 10mg a day), and had me taking some supplements instead (A, C, E, B6, biotin, zinc, etc.). It’s been 3 weeks.

@Obi wan when you said “Above all stay on the 10 mg Isotretinoin” – do you mean during scar treatment period as well? I understand that there is not a definite answer on this. According to latest research, some treatments can be done without the 6-month waiting period, but also everyone heals differently?

For scar treatment, I went to see 2 specialists.

One only recommended Pico, which didn’t really inspire a lot of confidence from me. From my understanding, scar revision is not what it is best for. They seemed to be quite dismissive when I brought up other options such as needling / PRP. 

Another one suggested to start with TCA Cross. They would add other types of treatment a month later, just to be safe from Iso / Accutane. I can start TCA next week. They also prescribed topical Tretinoin (0.05%) nightly to prep my skin. I think I will go forward with them. 




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