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xander_33

Acne Scarring / Treatment

Just to give some background on myself. I have been struggling with acne for close to 8 years now, experiencing severe breakouts. These days the acne is under control ever since my dermatologist decided to put me on Accutane, a couple years ago. Since then I have been dealing with the aftermath of those acne breakouts leaving hyperpigmentation and scarring across my body and face. Scars ranging from keloids to icepicks, boxscars, and rolling scars. The keloid scarring pertains to my back, shoulders and chest primarily but my main concern right now is to treat the scarring that is on my face.

Pictures: (Tried to pick the best angles/light conditions to accurately visualize my acne scars)


Left Cheek:                                                                                               Right Cheek:
scar1.thumb.jpg.069f833cc8da01a0f2da0074f8825fe3.jpgscar2.thumb.jpg.a09618d70eb34aa9e6469ee84c13ba7c.jpg

I am looking for some guidance and tips from this community on how to treat my acne scarring. Financially, laser resurfacing treatment isn't a viable option for me at this time, also I am skeptical about it's efficacy and potential to cause more damage to my skin. I was looking into dermarolling/TCA cross and other methods. Dermarolling caught my eye due to the results I have seen across the internet and the extensive research that is published on microneedling procedures. Additionally, dermarolling is relatively cheap and can be done at home. As of late I have adopted a skin care routine that I have strictly followed these past couple of weeks. Slowly I am seeing improvements on the overall look of my skin but the actual scarring is prevalent and deep.


The medications/topicals that I am using currently are:

Tretinoin .025%

Moisturizer/Facial Cleanser Cerave

Salicylic acid / exfoliate

Edited by allen_33

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Is not to bad. I had scars like yours. Mine got better with subcision, and i also wont to do filler later on. Contact a doctor who knows about scars. A mod on the forum can probably answer better than me. 

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1 hour ago, newbie1 said:

Is not to bad. I had scars like yours. Mine got better with subcision, and i also wont to do filler later on. Contact a doctor who knows about scars. A mod on the forum can probably answer better than me. 

How many times did you go in for subcision? Also how much did the treatment cost, if you don't mind me asking?

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@allen_33 "Financially, laser resurfacing treatment isn't a viable option for me at this time, also I am skeptical about it's efficacy and potential to cause more damage to my skin." - Ok You can do TCA Cross on your icepicks, and some subcision cheaply even if you have to do one or two a year for finances. 

** Please Note I offer to acne scar suffers a "more" "customized" (private) consultation than the above general advice. Analysis, answering questions, ongoing support by Private Messaging. Feel free to message me there. Be patient as I can get over 100+ of the worst acne scar cases to help, it "may" take me up to 48 hours to respond.

Checkout the main scar treatments sub, find the FAQ pinned on top there, goto the bottom, there are Dr's or call around and ask who does cannula subcision or nokor subcision (needle type) to dermatologists and or plastic surgeons, consult a few before you decide who you like, even if you have to pay as treatment is expensive, better like them. Ask how many subcisions they do a month and if they treat your skin type. If they just do laser run they will just blast you and not solve your issue.

___________
Disclaimer: Information and support is not meant to diagnosis, treatment, or cure any health or mental condition and is not a substitute for professional face to face medical care  (consult with a few Dr's and pick your favorite one). Posts are for informational purposes only, please consult your personal health care practitioner before engaging in anything discussed. 

 

 

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@beautifulambition In my case what would be the difference between using Cannular or Nokor needle for subscision, is one cheaper? I know it might be hard to tell from just the photos but how many sessions do you think I might need? Due to my budget, I am looking to tackle each issue with my skin, one at a time. From what I have gathered so far subcision will likely show the most scar improvement overall compared to any other treatments, correct me if I am wrong. Once that scarring is taken care of, like you said, I could move onto TCA/RF needling. The icepicks are noticeable but what bothers me the most about my skin is the texture. On days where I have used tretinoin the night before and moisturize I am pretty comfortable with the appearance of some of my scars. The scarring on my right cheek looks noticeably worse than the left cheek in those pictures due to angle/lighting but it is actually my left cheek that I am most insecure about. I am sort of having trouble differentiating which scars of mine are rolling, boxcars, icepicks or just a combination of them.

Important detail I feel like I should add is I am in the Southern California area and plan to book a consultation with Dr. Rullan to see what would be the best course of action.

Edited by allen_33

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@allen_33 Cannular subcision would be better, you have widespread scarring. Cost does not matter, that depends on the doctor. I have heard some needing 3 to 6 sessions of subcision, it depends on how you heal. Ok Budget- do one or two subcisions a year if you can. Subcision will help you. Well it's not taken care of, you could mix your rf needling and tca cross between subcision sessions. Long process. Ok goto Dr Rullan great. He can do cross and subcision in one session (That's how he does it), He does not do energy devices so do that at a med spa.

BA

 

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@beautifulambition

Here are some more pictures with different angles and lighting. Granted I have moisturizer on here, the scars look more shallow.

scar5.thumb.jpg.a2087f714c685b6ef058230c0d7d89dc.jpgscar6.thumb.jpg.d15cbc94fa983cb3762ad980d2aff19c.jpg

If I did consecutive subcisions would I get fillers after each one, also which type of filler would be the best for my scarring? Sorry for bombarding you with questions. At the end of the day I will likely defer to the doctor's recommendation but I thought this would also be a good opportunity to educate myself. 

If you think subcision would yield the best results I will follow the treatment plan you laid out for me. Does subcision improve only rolling scars or can it improve boxcar scars as well? Reason I ask is cause It looks like I have a lot of boxcars/icepicks that could be touched up which would improve the overall appearance. Does it matter the order in which I get these treatments, like if I were to get microneedling/TCA/Acid peels done now?

Lastly I am a pretty anxious person and while there has been many success stories there has also been a few cases where these treatments have not made a difference or have even damaged the patient's skin further. Regarding subcision, do I run any GREAT risk of my superficial scarring getting worse due to a complication in the procedure or healing process? I have heard Dr. Rullan can be aggressive.

 

Edited by allen_33

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If I were you , from my experience stay away from lasers . You have really good surrounding skin tissue , I ruined mine with laser. I also wouldn't do peels or tca . Imo . I mean you can if you want to but tca messed my skin up more too. I'm not a poor healer really.  I'd try fillers if I were you. I'm going to try them soon.  Good luck and keep us posted.  Don't let this ruin your life and keep you from living. 

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@allen_33 No you don't have to get filler after each one, ... some you can do Chinese cupping (Amazon), or you can subcise with filler still in the cheeks without a issue. Please wait at least 3 months between subcisions. Some only subcise when they need a top up in filler (so longer). You have scars all over so I would do over dilute Sculptra, thoughrough the cheeks under all the scars. It's not a volumizer, ... it will make new collagen, when you do your rf needling it will stimulate more collagen as well. Latter on in the subcisions, you can do ha filler to the individual pits, only if you wish, but not until several are done.  

Subcision can improve both rolling and box cars, especially cannular subcision, but you also need several other things as subcision alone won't do it. As I laid out in the plan above. Energy devices work best for box cars as well. Your most severe scars are box cars, not icepicks unless were talking about the tiny pores. 

You mean the rullan special with tca cross and subcision people often do, that is fine, do you manual stuff first. He does not do good laser or rf needling, ... find a med spa by you to do rf needling once you do the subcision and sculptra. 

Frankly any time we touch the skin there can be side effects right. It depends how you heal. Subcision will not harm you, tca cross will make some of the scars wider, but the point is to make them wider, and after many procedures we then do a acid peel or laser resurfacing (rullan just does peels, erbium laser resurfacing you would get elsewhere).

Subcision is relatively harmless. Do several Rullan treatments, if you are not getting enough improvement, discuss with him exscisions wich are surgical closures, this really depends how you heal but is effective. I would do the rf needling between the Rullan apts. 3 months between all appointments.  There is nothing to be afraid of with Rullan. If anything you need to see what works best for you to heal. The ones who did not do well, had poor healing or did not do enough treatments. Many start with him, then do energy devices closer to home - elsewhere. 

You have Ethnic skin so be prepared you will need more treatments as they don't want to go to hard on your skin type. Use the differin/tretiorin nightly and the whitening cream as I said above.

 

 

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@beautifulambition Could Dermapen/traditional microneedling be an alternative to RF needling, to stimulate collagen production after subcision+fillers? There is a spa nearby that offers Dermapen facials that I wanted to get done before coming here for help. Also if fillers are not necessary after each subcision, would it be best to get it on the first session or later sessions? Would it be a fair statement to say that not getting fillers with your subcision defeats the purpose of getting subcision done in the first place? As it helps prevent retethering of the scars, stimulates collagen production, and volumizes the skin for a better overall appearance. On that note does each filler work the same by providing a spacer for collagen to form under the subcised area?

I feel like TCA cross will be my final treatment if I ever do decide to get it done. My priorities seem to be treating the Boxcar scarring/pits/rolling scars as like you said those are my most severe scars.

So 3 months between subcisions. How long between subcisions and microneedling?

@floridagirl1991 

That is a good point you bring up regarding the surrounding skin tissue. This speaks to my concerns about possibly damaging my skin further through these abrasive treatments. Over the years I have sort of just learned to live with my skin and the mental burden has become an integral component to my life and my identity. I appreciate the advice and kind words, it means a lot.

The struggle and pain that many of us have endured throughout our lives, as a result of acne is incredibly disheartening. This condition can be extremely debilitating, disfiguring and I wouldn't doubt has a strong causal link to depression and other mental illnesses. 

I saw your thread and I wish you the best of luck in treating your scars. It seems like you have exhausted your options but skin rejuvenation is a long and grueling process. Fillers have shown tremendous results in restructuring the underlying skin tissue and inducing collagen formation, look to get that done definitely. 

Edited by xander_33

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@xander_33 No one is like laser, the other is like well manual needling. One you do at home, the other you don't. I would never goto a spa and get normal microneedling. Rf needling sure if they were good. Anyone can dermastamp at home. When you get filler is up to you, ... you can do Chinese cupping instead if you wish. Probably at the beginning and the end. No many don't get filler, but there is a high rate of tethering or saying it's not doing much as they don't do this step. We are not volumizing at all, we are using it as a spacer. Volumizing is using HA filler towards your last subcision in the individual pits. You don't even need that much for a spacer. 

IT depends what your talking about, rf needling 3 months apart, or any dr treatment, at home, just a month apart, you can do this while waiting. 

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