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tartan123

Best treatment for my acne scar?

Background:

Asian male

I suffered severe cystic acne when I was in college. My acne is pretty much under control now after several rounds of accutane.

Previous Treatments (not much improvement):

Ablative Co2 laser resurfacing 

Infini RF Microneedling x3 

Venus Viva x2

Bellafill + subcision x2

I am thinking of trying TCA cross with Dr. Rullan. What are some other treatment options for my scar type?

Here is my left cheek

IMG_20190109_080118.thumb.jpg.b39c8a2452b0ef496cc1fa41790bbfda.jpg

IMG_20190109_080138.thumb.jpg.cdf3de32c206e2f9420fe82705988e38.jpg

 

Here is my right cheek

IMG_20190109_080145.thumb.jpg.065d71f4d92a063d7da215e5b8c2aa81.jpg

IMG_20190109_080130.thumb.jpg.7c89981b08bf8d1393df6da1f6ffe228.jpg

 

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2 hours ago, tartan123 said:

Background:

Asian male

I suffered severe cystic acne when I was in college. My acne is pretty much under control now after several rounds of accutane.

Previous Treatments (not much improvement):

Ablative Co2 laser resurfacing 

Infini RF Microneedling x3 

Venus Viva x2

Bellafill + subcision x2

I am thinking of trying TCA cross with Dr. Rullan. What are some other treatment options for my scar type?

Here is my left cheek

IMG_20190109_080118.thumb.jpg.b39c8a2452b0ef496cc1fa41790bbfda.jpg

IMG_20190109_080138.thumb.jpg.cdf3de32c206e2f9420fe82705988e38.jpg

 

Here is my right cheek

IMG_20190109_080145.thumb.jpg.065d71f4d92a063d7da215e5b8c2aa81.jpg

IMG_20190109_080130.thumb.jpg.7c89981b08bf8d1393df6da1f6ffe228.jpg

 

don't you have any pics from the time when you hadn't had any treatment yet? It's weird that you didn't have good results after all those treatments; after all your scars are very mild. 

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@tartan123 Thanks for posting

You have ethnic skin so it's more sensitive to treatments and gentler settings are used.

I see surface box cars and rolling scars, textural, with some icepicks.

Good idea see Rullan for Cross. Several treatments are needed.

Ablative Co2 laser resurfacing - I don't see this working for you as the scars have not been taken care of.

Infini RF Microneedling x3 - shocking this did nothing, but your scars were not prepped for treatment, you had not raised the scars first.

Venus Viva x2 - worthless

Bellafill + subcision x2 - You have surface scars so I do not see this doing anything for you.

IF cross is not successful you may need excisions to the box cars and surface scars. 

Typically co2 is not done ablative in cases like this, ... it's only done to the individual box car and angled to treat the walls of the scar.  

I would in your case do picosure laser, find a local med spa if needed, as it stimulates collagen and helps with the discoloration.

Please use differin or tretinorin or retin-a nightly with a cream having the ingredients kojic acid and licorice for whitening, you can find this on Amazon. This will prevent discroloration. 

 

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3 hours ago, Toni94 said:

don't you have any pics from the time when you hadn't had any treatment yet? It's weird that you didn't have good results after all those treatments; after all your scars are very mild. 

Unfortunately, I didn't take any quality pics with similar lighting before receiving any treatments. It's hard to compare before and after with different lighting. 

3 hours ago, beautifulambition said:

@tartan123 Thanks for posting

You have ethnic skin so it's more sensitive to treatments and gentler settings are used.

I see surface box cars and rolling scars, textural, with some icepicks.

Good idea see Rullan for Cross. Several treatments are needed.

Ablative Co2 laser resurfacing - I don't see this working for you as the scars have not been taken care of.

Infini RF Microneedling x3 - shocking this did nothing, but your scars were not prepped for treatment, you had not raised the scars first.

Venus Viva x2 - worthless

Bellafill + subcision x2 - You have surface scars so I do not see this doing anything for you.

IF cross is not successful you may need excisions to the box cars and surface scars. 

Typically co2 is not done ablative in cases like this, ... it's only done to the individual box car and angled to treat the walls of the scar.  

I would in your case do picosure laser, find a local med spa if needed, as it stimulates collagen and helps with the discoloration.

Please use differin or tretinorin or retin-a nightly with a cream having the ingredients kojic acid and licorice for whitening, you can find this on Amazon. This will prevent discroloration. 

 

9

Thanks for the suggestion. I plan to get several sessions of Cross and then I plan to go back to RF microneedling.

 

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@tartan123 When did you do the Infini RF microneedling? and how often? I am considering to do several RF microneedling treatments and its depressing for me as well that it did not really do much for your scars. You scars are very shallow compare to my scars.. Personally, looking at your scars, I think you are perfect candidate for RF microneedling.. it is very shocking and frustrating :smileys_n_people_57:. Did you see any improvements in overall face quality? like texture, tone, pores, pigmentation, etc? 

 

@beautifulambition I know it is always right and better to do manual treatments first before you do any RF microneedling, chemical peels or laser treatments but looking at these pictures, I see those scars are pretty shallow and some of his scars seem they are the best scars to be treated with Infini RF. What could be the factors causing no improvements after 3 sessions of Infini? To me, these scars (or maybe some) seem shallow and Infini RF seems to be the best treatment for him. Are those scars still too deep to be treated with Infini? His scars are comparatively very shallow and if Infini did not improve his scars, I guess RF microneedling would literally do nothing for my deep pitted scars.

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@Gimozzi Sometimes I feel like I am fighting a never ending battle of comparisons, analysis of what went wrong, and freak outs. Please read the below, I have pasted it several times this week. Your not like anyone else on these forums. I cannot over-analyze every choice, health concern, and action done in your life. It all depends on how you heal. Before someone thinks I am cold and callus, I have helped you for months through private message, I Get your frustration. You had a poor procedure by a general derm, slower healing type from your skin type, and dealing with acne - getting it under control. Even low dose Accutane slows your healing. Now you have decided to go for RF needling before manual work. These are all your choices as this is your plan for treatment. 

Please Read he is going to Dr Rullan a top acne scar specialist for tca cross and treatment, and he is continuing rf needling, none of these treatments are a 1 time and we have magical good skin type of thing. He knows that it takes time and healing is slow with lots of treatments. If is scars do not respond He has two choices: 1) Do nothing 2) Punch excision or Punch float and resurfacing (cutting and lifting). I told you the same thing.Do not compare you haven;t even had enough tca cross sessions or even several sessions of rf needling. This is a long and drawn out process. It;s best if you find a therapist as I feel it's effecting you emotionally and no one deserves to suffer with scars inside and outside, that is half of the battle. 

Bluntly - some people (very rare you would know this sensitivity - in your case I think it's also the Drs you have to treat locally), will have very little improvement without cutting - surgery (weather face-lift or excision (cutting out the scars). I can only lead you on what I know works. There are so many other factors (read below), if you have a poor DR or Poor healing then I cannot change that but I can suggest you see someone better.  

Don't give up the fight before you even have begun. 

___________________________________________________________

Copied Several times this week (general advice):

We are not your Drs' goto a board certified Dr for help, ... if you want get 3 opinions and choose the one you like best. Your cases have nothing to do with each other or anyone else here, everyone is a individual with a different story. 

No scar case is the same, we are not clones, one person could do a million procedures and not be you, your all different ages, ethnic backgrounds, healing capabilities, plans for treatment, outcomes, different surgeons (they treat differently as well), etc, we could go on and on. The point being is never compare yourself to someone else. Sure you can learn from their experience but do we really know every single detail about what was done and why - no.  If someone heals poorly or had a poor Dr they typically hang around here. 

 Without knowing all the details of your scar work to analyze where things went  wrong I can give generalized advice. 

Let's go over some reasons why treatments may fail: auto-immune conditions, smoking, poor health and healing, poor treatment techniques by the Dr's, not doing enough treatments, expecting the skin to be glass smooth and instead having gradual % of change over a few years of treatment - many only get 50%, Doing energy work first and blasting the face thus loosing fat and collagen and complaining it got worse, re-occurring acne and scarring in different places, stress, antibiotics, anti depressants, hard drugs, alcohol and the liver, poor gut health, use of bad products that strip or hurt the skin, microneedling causing more scars when they have poor healing, excessive acid peels taking away layers of the skin. A big one is patients being cheap and not doing enough mls of filler, .5ml is not going to be enough filler for excessive scar work or fat loss. If subcision was done in the past with NO filler then yes it will do nothing, If you goto a general Derm and they are clueless this is also a big one, they can make things worse. Scar treatment is often over years time with excessive time of healing, it's not quick, so mono or singular treatments will not do it for your individual scars. Some people cannot do energy devices like laser - it will literally scar them... can't do microneedling ... can't do peels, all that is left is subcision and filler or invasive face lifts. Also the order treatment is done is very important. We don't pave a road correct before the potholes are fixed. When Dr's just laser they often are not fixing the pits.

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@beautifulambition Thanks for the advice again,BA.  I was not freaking out or anything, it was just frustrating to see someone saying there is no improvements after all these treatments, especially Infini RF microneedling. I understand that everyone heals differently and there are many other factors affecting healing. I just wanted to hear what you think on this. 

I am sorry that I tend to rely on your opinion in every scar/treatment related topics and I truly appreciate all the support and advice you provided for months.

I know I am struggling physically and mentally, but I can feel it that it is slowly getting better as I am slowly and compromisingly accepting the reality.  Although there are not much options available for me, I will pursue the treatment plan which I think is the best as I have to make my own decision and I have to be fully responsible for my choices.

Again, thank you so much for your advice, BA

Have a great day!

Edited by Gimozzi

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14 hours ago, Gimozzi said:

@tartan123 When did you do the Infini RF microneedling? and how often? I am considering to do several RF microneedling treatments and its depressing for me as well that it did not really do much for your scars. You scars are very shallow compare to my scars.. Personally, looking at your scars, I think you are perfect candidate for RF microneedling.. it is very shocking and frustrating :smileys_n_people_57:. Did you see any improvements in overall face quality? like texture, tone, pores, pigmentation, etc? 

@beautifulambition I know it is always right and better to do manual treatments first before you do any RF microneedling, chemical peels or laser treatments but looking at these pictures, I see those scars are pretty shallow and some of his scars seem they are the best scars to be treated with Infini RF. What could be the factors causing no improvements after 3 sessions of Infini? To me, these scars (or maybe some) seem shallow and Infini RF seems to be the best treatment for him. Are those scars still too deep to be treated with Infini? His scars are comparatively very shallow and if Infini did not improve his scars, I guess RF microneedling would literally do nothing for my deep pitted scars.

I did RF micro-needling late last year. I did 3 sessions 6 weeks apart.

Maybe some improvements but its hard to tell because I didn't take any before pictures in proper lighting. 

Edited by tartan123

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