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Simp

CO2 Fractional for acne scars (Exelo2?)

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I had co2 fractional treatment done by my dermatologist two days ago. I will have few more spaced 4-6 weeks apart and possibly fat transfer with subcision somewhere in between. The laser that I'm being treated with is called EXELO2 by Quantel. As I understand the higher the fluence the better the depth of ablation. As studies show, high fluence low density is better when treating acne scars. (https://www.researchgate.net/publication/47754413_Lower-Fluence_Higher-Density_versus_Higher-Fluence_Lower-Density_Treatment_with_a_10600-nm_Carbon_Dioxide_Fractional_Laser_System_A_Split-Face_Evaluator-Blinded_Study

Here are some statistics about different lasers on the second page chart: (includes ie. Fraxel re:pair, Exelo2: named Exel co2) http://practicaldermatology.com/pdfs/PD0610_residents.pdf

Now I am not an expert when it comes to lasers and I have only read few studies as well as I could understand. When it comes to my understanding, Exelo2 seems to be pretty good as a laser (of course your results depends on the person who treats you as he/she adjusts the settings). If someone here knows better about fractional co2 lasers and understand the chart above, could you tell me is Exelo2 good as a laser?

Generally what do you people on this site think of my treatment plan?
- 3-4 fractional co2 lasers (first one was done pretty deep, but from what I can say after 2 days from the treatment, I can tolerate much higher energy settings) 
- fat transfer and subcision for bigger scars
- possibly tca cross after fat transfer, subcision and all the fractional co2 treatments for smaller scars that are left over.

I will also post pictures and results after I can see possible improvement from these treatments.

 

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I would personally do lasers last. If you need subcision and fat transfer, it must mean you have some atrophic scarring and volume loss. It's a little hard to tell without seeing any photographs.

Beautiful Ambitious uses the analogy of would you resurface a road with numerous pot holes? It's a little bit like that with lasers, as they are designed to resurface the skin. Remember lasers were not invented for scars, but rather they were designed for wrinkles and fine lines.

Hard to tell without a picture, but I would do lasers last. Just my personal opinion. You and your dermatologist are free to do what you wish. All the best for treatments.

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@Simp Wow that is not good, co2 first and 4-6 weeks apart. We do laser last. You need manual work done on the scars. ScarRight is Right haha, do they pave the road before working on the potholes. Many derms are terrible they will blast you when you come through the door with laser, this is poor acne scar treatment. I can give you a plan for your scars, if you post pics with directional light or a flashlight. We should not even be concerned about the laser device, this is not how you treat scars. Sounds like a standard package derm, ... when they say pay up for laser it will fix everything. The order we go though treatments is very important. Also 6 weeks for laser. You know you heal for a year after you have co2 laser right, and must wait at least 3 months between unless they are doing very low settings. Why wouldn't you get fat transfer and subcision first - makes no since. I don't need to see studies on laser, I am a expert on the subject, anything you post is mainly made by a laser company to justify their device split face or not. 

Why are you coming here with charts and studies. Do what you feel is best if you don't want us to help you. I have helped thousands, possibly millions with all the lurkers. Acne scar work is not simply done with a laser. I get the cases when they have tried so many things and nothing else works ;-)

Your comparing the equivalency of treatments based of of marketing material, this is like comparing race cars based on specifications before ever driving them. 

IF you do laser first it cold be a complete waste of money, but it's your decision. We get many who have fat loss doing it this way as they hit rock bottom. But you do what is best, this is your treatment and many people have to learn that way.

Will take me 24-hrs to respond, I have 50 of the worst acne scar cases who have PM'd me for help.

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Dear @ScarRight and @beautifulambition I thank you guys for your advices and work for this community. However I am a man of science nowadays and what I've read from your posts and answers the treatments you usually recommend are proven to work on acne scars by studies. However co2 fractional laser has so many studies to back up it's claims on acne scars that I myself believe that co2 fractional is very sufficient long term treatment for acne scars (and no, not every study is funded by laser company etc. Some of the studies are done in universities funded by university itself and many studies show unbiased data from co2 fractional lasers and how well they work on acne scars). I believe that people who don't seem to get results are treated with too low fluency to show marked improvement. Fat grafting and subcision have shown better improvements with just one treatment vs 3 fractional co2 lasers on a study. Even though it is proven to work better than 3 fractional lasers in most of the cases, one study (done on rats so not really reliable honestly) shows that pretreatment of the fat recipient site with co2 fractional laser increases fat survival rate (same study was done with microneedling with similiar results). Hence i believe that by doing this one co2 fractional laser before my fat transfer could improve my results.I don't want to offend you guys but I really would like to see some data from you guys too because anecdotal evidence of individuals on this forum just isn't simply enough.. For example this thought that co2 fractional treatments spaced 4-6 weeks apart is worse than treatments spaced 3 months apart doesn't really have scientific proof behind it. All I could find about this topic was one study that showed co2 fractional treatment intervals on acne scars spaced 1 month vs 3 months apart seem to have no difference in results nor complications. (https://www.ncbi.nlm.nih.gov/pubmed/24018777) I believe when it comes to lasers and scar treatments it's the patient, (skin type and healing) practicioner, (right settings on the device, knows how to treat scars on your type of skin efficiently with ie. device, needle, or chemicals) and device (how versatile the settings are) that count to the results. In my opinion you can get superior results from tca, subcision etc when compared to co2 fractional if laser isn't done properly (too mild settings for example) but good lasers can also provide really good results on the right hands.

This is only my personal opinion and I don't mean to offend you. I'd like to discuss about these things with you guys so we can all learn something new. I believe that your methods would have really good results on my scarring, but sadly I live in Finland and I really don't have many options for treatments here. (maybe that will change as I'm planning to become dermatologist myself) If you can show me some data or studies that prove me wrong or can change my mind I would appreciate it. (It will benefit me)

Edited by Simp

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Most of the European poster's here goto Dr Emil in Denmark, a cheap Ryan Air flight away from Finland. Yes it is hard to find treatment in Europe or anywhere really. Lots of laser Dr's but very few specialists in this field. Most Specialists do not do fat grafting for acne scars (discuss this below). 

My thoughts:
* Realself.com would be a better place for you to ask a question(s). Most of the Dr's there are sponsored by a energy device company so you will get whatever brand they signed up with. 

* I would suggest you go on Youtube and watch Dr Davin Lim's videos. 
* As your not a Dr (at least I don't think you are), many Drs will be hesitant to discuss the devices with you in detail as they are not being compensated for their expert opinions. I suppose you can try to find a laser engineer.  
* Perhaps the Scarless healing mega- thread you would enjoy they are very into the idea of what if's.
* You seem set on your "data." There is nothing more I can add to the discussion in that case. It seems you already have your mind made up or you want someone to do the work / research to justify "your" point. 
* Do whatever scientific points of conclusion you have deduced. I support you (but disagree with you) if you want to get zapped by every kind of laser out there or are looking for XYZ brand so be it. It seems your energy device shopping, on who has the best specs, when that has nothing to do with acne scar work. 

* There are studies on all the items I have mentioned as advice. If you don't like them then your cherry picking what you feel is best and that's fine, lots of marketing materials out there. 

* "Studies are done in universities funded by university itself and many studies show unbiased data."  - Who donates to those universities, where do those scientists work.What pharmaceutical companies or medical device manufacture's do they have ties to. Do they get paid for speaking engagements for said device they did the study on. Were they given the laser to trial on patients in exchange for their opinion or data. Are they only using it hypothetically, or do they use it on patients so they need someone to pay for the treatment or they can hand pick the desired outcome (you throw out those who do not meet the desired goal). What other treatments were done that are not discussed, often the patient is given filler, or other treatments are done as well in conjunction with laser.  Did they take their pictures right after when their was swelling to hide things, was their follow up 6 months and then a year after. Was the magical outcome a outlier or statistical abnormality.  Was the laser on tiny surface scar issues or specifically filtered candidates, and not on the mass general population with variability of treatment. 
* I am not your Dr or paid to deal with providing you, as such debate with your provider treatment options. Laser specifications of why their toy is better than someone else's are pointless. 
* There is more to acne scars than lasers. They are a tool like a surgeon's scalpel. When they become the whole importance of treatment the patient is in for a huge let down as they bought into the hype (you just need another $$,$$$ treatment and you will see results they tell you, then another, or they are stacking multiple devices). 
* Laser does not get rid of scars, it softens them, the scar tissue is still there, ... bulk heating (laser) does not make fat magically grow or new skin appear. It is good for surface issues once the patient has responded and reached some improvement.
* Every company Alma, Cynosure, Fraxel, Syneron-Candela, Lutronic, etc... had split-blind white papers proving their device is the best, endorsed by the worlds Top Drs. Go into any hospital and the medical device they have purchased has scientific data behind it. But is it appropriate for your situation, I cannot say, and that is where the specialists' expertise is needed. Something can look great on paper and be terrible in real life.
* There are top Dr's in this field (we call them the top 1%) and they even disagree with how treatment should be done. One of them is Dr. Lim and while he has all the newest "toys" (lasers) he states manual methods should always be done first with the majority of improvement coming from them, then laser should possibly be used as a tool. Treatment is again customized to the patient's individual needs. Some never even use a laser. 
* I never said not to do laser, what I did say was to do manual methods (without a energy device) first, see what improvement you can obtain, then move onto a laser if needed.  Why would someone TCA Cross last? Cross makes the scar wider, "then" the laser deals with the texture. 
* Acne scar work is not based purely on specifications of lasers and their manufactured outcomes. If it was they would have solved acne scars decades ago. There is always some better energy device, laser that must be used or treatment protocol (but it never seems to live up to all the marketing material hype). Bad Dr's will base acne scar treatments on device manufacturer claims. They need someone like you to pay off their $100K to $500K new toy. They zap you and tell you that you need more. There are parts of treatment that are not physics alone, you have surgery (the surgeon has experience with his hands - Biology), Art of aesthetically using filler implant to improve the appearance. Patience Compliance and selection of a certain sub type that will respond to the treatment best. Chemistry and Pharmaceutical interventions. Clinical experience, when a specialist treats thousands of patients they gain knowledge that is valuable to treatment goals. Then you have the un-quantifiable which is your healing capability, that throws everything else out the window, ... this is why treatment must be customized to the client and not just shopping around for a energy device.
* Walk into any bad Dr and they will just zap you over and over again (as many treatments as possible) with a laser
* You mentioned getting fat grafting, so I am going with your treatment suggestion to help. I do not agree with fat grafting and have seen terrible results and side effects compared to fillers. 
* I published a book on the subject and have helped thousands here. A picture with directional lighting or a flashlight is needed to provide a plan for acne scar treatment.
* I often help those who have done every kind of treatment imaginable including the worlds strongest laser Ultrapulse, they do not reach the results they sought and they wonder what to do next as they are out of options. 

We had one gentleman who did 30 lasers treatments (he picked several he thought were best as well), with minimal success, everyone is different.There was a younger gentleman in the UK who had lasers over many years having bad scarring on this cheeks. While the texture improved the large scars were still there after all treatments. 

Quote

collage.jpg

Find a few dermatologist and or plastic surgeon's (even if you have to pay for consultation), pick the one your most comfortable with.

Quote

Should we be repeatedly wounding the skin when healing can occur for so long after energy device treatment, ... some even micro-needle every month and make new scars from over treatment damage. 

"When any wound is created, whether traumatically, or surgically, there is a wound healing cascade that is initiated. Multiple things occur underneath the skin that are not visible to the naked eye.  An infantile form of collagen is first formed and then as the wound matures, the body dissolves that collagen and lays down a mature form of collagen. Then this collagen over many months integrates in a stronger formation, similar to pick up sticks falling on the ground and then someone laying them neatly together in parallel groupings.  Inflammatory cells are also recruited into the area to keep it clean and new blood vessels form, microscopically, to bring in more oxygen that is needed for the new collagen to form.Typically there are biochemical and clinical changes in healing scars that are seen even up to 18 months after surgery, but this is why with Fraxel, that there is continual improvement in collagen build-up and even tightening possibly, for six months."

 

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I think lasers can work but there needs to be someone skilled at using it.  Someone who uses the correct setting and someone who hits the scars at a variety of angles as well.  At the end of the day though most acne scar studies are bogus because they are based on visuals and people often have swelling and pictures that are used in the studies and shown to other derms can be easily manipulated with lighting and shadows.  Fillers and subcision often give the best result and BA is correct about that.  However we haven't even seen your scars and if they are minor enough maybe you can go straight to laser.

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On 1/20/2019 at 5:46 PM, FromScarredtoFree said:

I think lasers can work but there needs to be someone skilled at using it.  Someone who uses the correct setting and someone who hits the scars at a variety of angles as well.  At the end of the day though most acne scar studies are bogus because they are based on visuals and people often have swelling and pictures that are used in the studies and shown to other derms can be easily manipulated with lighting and shadows.  Fillers and subcision often give the best result and BA is correct about that.  However we haven't even seen your scars and if they are minor enough maybe you can go straight to laser.

Beautiful Ambition is right on the money. I would prefer someone to tell me the hard cold truth. I have been lurking on these forums for a couple of years and the success rate of lasers on indented scarring is poor to say the least. It's a very risky procedure with side effects. Be careful. People have had their scarring made worse. Countless people who have posted on here come for help because lasers have either been ineffective and have done further damage.

The treatment plan originally stated is a matter for concern. You don't do laser before subcision, fat transfer, etc. Do lasers have their place? Of course, but only at the right circumstances and with a highly trained operator. You need several months to heal after a treatment. 4-6 weeks break between treatments is a recipe for disaster. Beautiful Ambition may have sounded blunt, but that is because he cares and he gets countless people messaging him asking for help, quite often because a dermatologist has done lasers at the incorrect setting and for the incorrect scar type. 

I wouldn't do a treatment plan with 4-6 weeks break even if you paid me for the treatment. Of course, you do not need to listen here. You are free to choose your dermatologist and treatment plan. I highly encourage you to search fractional lasers on the search button of this forum. Please do some research from actual members of this community.

Please also read the sticky threads in this forum. Lots of great advice and research. Take care.

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@beautifulambition @ScarRight @FromScarredtoFree I thank you all for taking your time to this topic. I’m not here to depate and I have left my view about acne scar treatments here. In summary I believe that fractional co2 done with correct settings is beneficial for acne scarring as I do believe that other methods are beneficial for acne scarring.

 

What you guys are saying really does make sense to me: filling intended scars up with subcision and fillers before resurfacing is beneficial. However my scarring is not that deep in most places. My scarring is mostly shallow rolling scars and boxcar scars which aren’t that visible in normal lighting and become evident from close distance or lighting from one direction only. I have few deeper and larger scars which I believe will benefit from fat transfer and subcision greatly.  I dont really feel comfortable showing pictures of my skin right now, but if I get results from the treatments I have chosen, (fat transfer and co2 fractional) I believe I will show you pictures from before and after. 

 

I have caucasian skin with moderate acne scarring and that’s why I believe fractional co2 with high energy could benefit most of my scarring greatly. Before I get my laser treatments I want to know what I’m getting (settings: fluency and density for example). When it comed to fat transfer, I also believe in my plastic surgeon who does fat transfers almost daily. He admits that I shouldn’t keep my hopes too high because fat transfer is extremely unpredictable. Sometimes he gets great results and sometimes almost no results at all. I know the risks and I’m willing to try fat transfer and see if it works for me. 

 

We people are different and some people benefit from fractional co2 lasers and fat transfers more than others. That’s the fact. We can’t decide for our bodies to receive the transferred fat for example. I personally believe that I will benefit from fat transfer and co2 fractionals. I will keep you updated about the procedures and results. 

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Just a little update.

Instead of doing fat transfer for my acne scars I have decided to try subcision with hyaluronic acid fillers first. This is because fat transfer is extremely expensive. I will try subcision with ha fillers first to see if I like the outcome with less investment, if I want and need something more permanent like fat transfer I will try it later. My mother (nurse) confidently agreed to do tca cross for my acne scars. Therefore my acne scar treatment plans have changed in order to save money. I still believe fractional co2 will benefit my scarring along tca cross, subcision and fillers. Total cost for my treatments will be around 2000-2500 euros (2200-2800 dollars), including 3 sessions of fractional co2 laser (1800e total), subcision with hyaluronic acid filler (400-500e) and tca cross done at home. 

 

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You state you mainly have shallow surface scars, hence why you want to do fractional lasers first. If this is the case, fat transfer might do more harm than good, not to mention it seems the fat gets absorb into the body eventually. Fat transfer doesn't seem to have a high success rate on these forums, especially for the cost involved.

Also, if your scars are shallow surface scars then subcision is probably not needed. Subcision is used for atrophic scarring that shows signs of tethering. Normally tethered scarring is not just surface scars. You did mention you have a few deeper scars, maybe these will benefit from subcision. Very difficult to tell without a picture.

You mentioned you're doing TCA cross at home. Do you have any ice pick scarring? This is where TCA cross can be effective.

Absolutely bonkers the order you are doing treatments. Laser should be Last. Subcision, if needed, should be done before lasers. Please update us on results.

Edited by ScarRight

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1 hour ago, Skin Pessimist said:

I'm guessing you have ice pick scars?

If he does, then fractional lasers will not work for these scars. Maybe he has a mixture of ice picks, rolling and boxcar scars. If he does have ice picks, then TCA cross can be beneficial for these.

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@ScarRight my scarring is mainly shallow to moderate rolling and boxcar scarring with few deeper scars, which would benefit from subcision and fillers (ha fillers or fat transfer are the only fillers worth considering here in Finland). Tca cross have been shown not to only benefit icepick and boxcar scarring but also rolling scars in a medical study. I believe I will try fillers for my deeper scars first and see if I like the results, if not then I'll probably have to try fat transfer in 2 years for possible permanent improvement which would cost 1500-2000 euros for my deeper scars. I have no icepick scarring present. The reason I got fractional co2 laser this early is because of my tight schedule for acne scar improvement before I start in the military. Co2 fractional laser will likely improve my scarring and hence improve the quality of my life. I sadly don't have that much time for waiting, arranging, meeting different doctors as you guys do. I did my research, made my decision and will try it out. Even if it isn't the absolute best way to treat my scarring, I believe it will give me some fast results and improve my mood.

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4 hours ago, Simp said:

@ScarRight my scarring is mainly shallow to moderate rolling and boxcar scarring with few deeper scars, which would benefit from subcision and fillers (ha fillers or fat transfer are the only fillers worth considering here in Finland). Tca cross have been shown not to only benefit icepick and boxcar scarring but also rolling scars in a medical study. I believe I will try fillers for my deeper scars first and see if I like the results, if not then I'll probably have to try fat transfer in 2 years for possible permanent improvement which would cost 1500-2000 euros for my deeper scars. I have no icepick scarring present. The reason I got fractional co2 laser this early is because of my tight schedule for acne scar improvement before I start in the military. Co2 fractional laser will likely improve my scarring and hence improve the quality of my life. I sadly don't have that much time for waiting, arranging, meeting different doctors as you guys do. I did my research, made my decision and will try it out. Even if it isn't the absolute best way to treat my scarring, I believe it will give me some fast results and improve my mood.

TCA cross for rolling scars? This is generally not the gold standard. Are these 'studies' peer reviewed? Subcision is probably better used here. 

Scar treatments take a long time. You should aim to do several treatments over 2-3 years. You should realistically aim to get 20-30% improvement from your fractional laser session. If you get more improvement, then great. However, you will never get rid of your scars. A realistic expectation is 50% improvement over a few treatments spaced out every 3 -6 months. If you get more, then that's fantastic. Many people don't get anywhere near that level of improvement. 

Very strange you came on here asking for advice and then straight out dismissed Beautiful Ambition relevant suggestions because you researched your treatment plan from 'medical studies'. What's the point really? Lasers shouldn't be done first and you can't rush your scar treatments.

 

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6 minutes ago, ScarRight said:

TCA cross for rolling scars? This is generally not the gold standard. Are these 'studies' peer reviewed? Subcision is probably better used here. 

Scar treatments take a long time. You should aim to do several treatments over 2-3 years. You should realistically aim to get 20-30% improvement from your fractional laser session. If you get more improvement, then great. However, you will never get rid of your scars. A realistic expectation is 50% improvement over a few treatments spaced out every 3 -6 months. If you get more, then that's fantastic. Many people don't get anywhere near that level of improvement. 

Very strange you came on here asking for advice and then straight out dismissed Beautiful Ambition relevant suggestions because you researched your treatment plan from 'medical studies'. What's the point really? Lasers shouldn't be done first and you can't rush your scar treatments.

 

@ScarRight Yes, TCA cross is usually done on icepick scars and boxcar scars. Here is a quote from the study: (which I will link below) Although in various studies best results with CROSS TCA are seen in ice-pick scars but since in our study we combined it with subcision, results were equally good even in rolling scars and boxcars scars. 
What we have to realize is that TCA was combined with subcision. This is what I am aiming for: I contacted plastic surgeon who does dermal fillers and tca cross for acne scars and asked if he could do subcision along with tca cross.

I understand and accept the fact that the scars are there and only thing I can do is to find the best possible practitioners to improve them.  However I don't really understand the reasoning behind spacing treatments 3-6 months apart. If you can prove that spacing treatments out every 3-6 months is more beneficial than doing treatments in 1-month intervals, I will believe you and thank you for correcting my understanding about acne scar treatments (anecdotal evidence from people online is not enough). At the moment the literature I have read has shown to me that doing treatments in 1-month intervals is just as beneficial as doing them in 3-month intervals for example.

If you read my starting post you can notice that I didn't come here for advice about acne scar treatments (not that they are not welcome). I came here looking for someone who understands more about the lasers and how they work on acne scars (meaning of fluency, density, power etc. when treating acne scars). I do admit that I asked for opinions about my treatment plans, which you guys did and thanked you and BA for your views about my plans for treating acne scars!

What is very strange for me on the other hand is that you straight out dismissed medical studies that I am willing to represent to prove my arguments. I understand and respect your opinions but not your negative attitude against medical studies, doctors on this field and especially me when all I am doing is sharing my understanding about treating acne scars and trying to get some conversations going on between different point of views. 

Now with all respect I don't really understand why you couldn't do one session of co2 fractional laser before getting other treatments. I personally don't see anything wrong with that since it improves the quality of my life fast since it was easily available. @beautifulambition is right on many points he wrote. Ba has really done research and knows his things but I disagree with him on some points. I still believe and probably always will, that fractional co2 in the right hands with right settings does wonders for acne scars (depending on the patients healing also). So i do agree that it isn't as simple as selecting a device, I think it's about selecting right practitioner with right equipment to treat your scarring. Cheers, thank you for your opinions! further conversation is welcome.

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22 minutes ago, Simp said:

@ScarRight  However I don't really understand the reasoning behind spacing treatments 3-6 months apart. If you can prove that spacing treatments out every 3-6 months is more beneficial than doing treatments in 1-month intervals, I will believe you and thank you for correcting my understanding about acne scar treatments (anecdotal evidence from people online is not enough). At the moment the literature I have read has shown to me that doing treatments in 1-month intervals is just as beneficial as doing them in 3-month intervals for example. @beautifulambition

 

Collegen takes 3-6 months to build up and develop when you have something like a laser done. Your skin needs time to heal. Where are these peer reviewed studies stating you can do scar treatments spaced four weeks apart? People on this forum have actually provided evidence in the way of photos, logs, etc. Are these medical studies peer reviewed? Or are they sponsored by the laser companies?

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Goto a Dr for proper treatment and advice!

Please stop trolling. We get one every few months. Thinking laser will slice dice and magically improve everything. always pushing laser to fix everything.

Notice the OP has nothing to add to the discussion, they did not come for help. Nor did they come to converse with acne scar patients (they instead wish to "lecture"). Posting links to subjective laser power settings means nothing, Dr. Lim would lol at that (so many other factors to treatment besides my power is bigger than yours).

Who says something like this "(meaning of fluency, density, power etc. when treating acne scars)." Go read a study if you want that, no need to waste everyone's time here.

It means they either A) Want a Laser Engineer to talk to or B-)Think they can come here to talk to a doctor.

You can find a white paper for anything if you want to prove a point. What do you think a thesis is, it's a idea or opinion that they "try," to prove. Doctor A may say laser is the best thing ever and here is my study to prove it. Dr B says no no no Filler is the best thing ever and here is my study to prove it. At the end of the day what this poster says does not matter.

The data we have at this site is much more valuable to a acne scar patient and has been endorsed by the worlds top 1% of acne scar Dr's, do your homework if you truly know about acne scars.

Are you a Plastic, Derm, pissed off derm who did not make the list, equipment manufacturer, disgruntled person who was treated with some physiological issues, or some kid in a basement of his mommy's house. Who knows.

You don't goto a support forum for Darwin's Evolution theory and this person knows that. They keep saying "prove it," and man of "science." Then goto a board certified Dr, ... why waste your time on a acne support boards.  IF you did this to any subject matter expert / author who had a book on Amazon they would think your rude and ignore you. 

There is absolutely no point of him/her being here other than to sew seeds of discord and put out false information. We have the sucess stories we don't even need to acknowledge them, ... what will be next is false pictures they obtained to prove sucess. The whole story of going into the Army, wanting a quick treatment, and a mom that does these treatments at home sounds a bit far fetched to me. Why tell us after all, other than to waste our time. You want quick treatment OP go get it. You don't like what we say here, next - move on. But that is the point right, to get a negative response. OP you love laser great, go get them.

Why do you suppose there are sooooooooooo many studies of laser, saying they are wonderful, magical, etc. Because Laser companies want to sell lasers, colleges want funding for studies, hospitals want $$$$$$$$$$ and Derms have a business $$$$$$$$$$$ and desire those speaking fee Dollars or selling those machines. Now look at studies of Subcision, hardly anything, because,... manual methods are not quick&sexy, they don't bring in the big dollars . All about Mullah. 

I am not going to prove anything to you, the burden of proof is on yourself, you will be doing this to your face not me. If you were open minded to research and study these boards have tons of it, otherwise again, what's the point?

...month apart treatments, laser is wonderful, his ""mom" will do his treatments, costs is too much but he will make do as he needs a quickie, upset of the cost of treatments.

 If someone does not want to listen and is not respectful of my time, have fun do whatever you want, ... 5 treatments at once cool, study says to cut out all areas of your face (really is a study that says this) nice, or use leaches to get rid of acne scars in the south Asian countries (split blind study). Whatever order you decide your own plan, ...cool as well, but this site has a psychological component of the mentally challenged who thrive off the insane asylum mentality of sewing discord.

I will not be helping someone who actually does not need some help, there are so many excited to get treatments that actually work after "laser(s)" were not effective.

Goodluck

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16th-century depiction of the universe, with earth at the center
By Evan Horowitz GLOBE STAFF  

When a group of scientists discovered in 2011 that some particles travel faster than the speed of light, it shook the world of modern physics. The announcement drew widespread media attention and seemed to upend one of the bedrock theories of 20th-century science, special relativity. There was just one problem: It wasn’t true. It had all been a result of mismeasurement, in part from a loose cable.

This may be a particularly glaring example of research gone wrong, but it’s not the only example. In fact, there are good scientific reasons to think that lots of published research is actually false. In 2005, a research professor named John Ioannidis published a much-cited paper titled: “Why Most Published Research Findings Are False,” in which he showed how the pressures of academic life, the small size of many scientific studies, and the preference for unexpected findings mean that even premier journals are surprisingly likely to publish findings that just aren’t true.

Here’s a breakdown of why, exactly, so much research turns out to be wrong and how we should treat new findings when they come out.

How do we know studies are false?

One way we know studies are false is that they get disproved by larger or better studies. Early studies on a B vitamin called Niacin, for instance, suggested that it could help reduce heart attacks by raising so-called “good” cholesterol. Years later, a more comprehensive experiment found that it actually had no impact on heart attacks.

Drug companies face this problem all the time. They read about cutting-edge discoveries being made in academic labs, but when they try to reproduce the experiments, they can’t. Scientists at a German pharmaceutical company who tried to reproduce the results in 67 published studies told the readers of Nature that they only succeeded one quarter of the time. Likewise, the American company Amgen found they could only replicate the results for 6 out of 53 published cancer studies.

 

 

Is it because of fraud?

Not really. To be sure, there have been some colorful and high-profile cases of fraud in recent years, including a Harvard animal researcher who monkeyed with his data, and a Korean scientist who tricked editors into letting him review his own paper. Ultimately, though, these kinds of incidents aren’t a big reason that so many studies prove to be false.

 

 

Then why are they wrong?

Imagine you’re a budding young cancer researcher trying to make your mark by investigating whether watching movies about cancer actually causes cancer. And let’s say, for the sake of argument, that it doesn’t. People who watch cancer movies are, in fact, no more likely to get cancer than anybody else.

Does this mean your research will all come up negative? Not necessarily. You may pick people for your study who aren’t good representatives of the population at large. Just by chance, you could end up with an unusual number of folks who like cancer movies and get cancer. You might get a false positive, meaning your study would show a link between cancer and cancer-movies even though they’re not really connected.

Of course, if you take all the appropriate precautions, it’s extremely unlikely that you’ll get this kind of false positive. But it isn’t impossible. Remember there are thousands of cancer researchers conducting similar studies. And with thousands of studies, the likelihood that one of them will produce a false positive increases dramatically.

If you’re the researcher who gets that false positive, you have no reason to doubt your findings. In fact, if you check your math, you can prove that your experiment, considered on its own, was extremely unlikely to lead to false results. What is more, with such surprising and original results, you have a great pitch for the journals, even if it’s entirely based on a fluke.

The larger the study, the easier it is to get false positives. 

Does this mean I should stop trusting scientific findings?

Not at all. But it does mean you need to treat even very high-quality research with a certain skepticism. Here are some tips:

• Pay attention to the size of the study. The larger the study, the harder it is to get false positives. It’s the difference between flipping a coin 10 times, where someone might get all heads by chance, and flipping it 1,000 times, where the odds are much lower.

• Be especially cautious if it’s the first such finding. Later corroborations and broader literature reviews are less likely to be misleading.

• Trust your prior beliefs. The more unlikely something seems, the less you should trust it. If you find yourself thinking, “I guess I was totally wrong about that,” you might want to say, instead, “I guess I should be a bit less sure than I was before.”

Ultimately, though, we all get taken in by new and promising findings, even the editors at top journals. Early results, though, are just the first phase in a research process that involves future studies and broader efforts at replication. For that reason, many of the breakthroughs and discoveries we hear about will end up being disproved, and what looked like an important step forward will often turn out to be a misstep. 

There is less consistency in medical research results than people realize, but the problem is often in interpretation of the results. One of the problems with medical research is that medical researchers do not understand statistics well or real life clinical experience to back up these theories.

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@ScarRight I posted the study above but here it is once again only from different source that shows us the sponsor of the study (Aarhus university hospital) : https://onlinelibrary.wiley.com/doi/pdf/10.1002/lsm.22165

@beautifulambition You seem to have no respect towards other people and their views/opinions..

No i'm not a troll, are you? You are here to help people? great! Let me give my opinion to people and you can give yours. If you are calling my information false, then prove it, prove me wrong. All you have against my view is words, opinions, anecdotal evidence and ''top acne scar practitioners *support*'' (your opinion and mindset). You really don't seem to welcome opinions that differ from yours, right? You need to support your arguments with more than just words, insults and assumptions about other people (like you made assumptions about me. Is this how you protect your glory on this site?).

Okay so I'm done talking about this with you kindly since you are not capable for that. If you call my information false, then prove it false. If you assume I'm a troll, I will assume that you are man of words not man of science. You seem very defensive about your view of point and use words and insults to claim your view right and my view wrong. I believe in science and medical industry. If you have no other proof than words and anecdotes I ask you to leave this thread alone (as you said you would do).

However I will update about my treatments and results here or on another thread (pictures included later). 


 

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What's the point of asking for advice and then ignoring it?

 

There's plenty of evidence to support waiting three months between procedures. You can easily find peer-reviewed studies or even dermatologists recommending similar wait times between procedures. Why? It takes time to stimulate collagen.

Edited by Skin Pessimist

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@Skin Pessimist

This is one of the reasons I made this post. You said there is evidence and studies supporting this idea, great! Now if you’re kind please link me those studies since I haven’t been able to find any. I made this thread to see opinions like this BUT backed up with links to studies and evidence.

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48 minutes ago, Simp said:

@ScarRight I posted the study above but here it is once again only from different source that shows us the sponsor of the study (Aarhus university hospital) : https://onlinelibrary.wiley.com/doi/pdf/10.1002/lsm.22165

@beautifulambition You seem to have no respect towards other people and their views/opinions..

No i'm not a troll, are you? You are here to help people? great! Let me give my opinion to people and you can give yours. If you are calling my information false, then prove it, prove me wrong. All you have against my view is words, opinions, anecdotal evidence and ''top acne scar practitioners *support*'' (your opinion and mindset). You really don't seem to welcome opinions that differ from yours, right? You need to support your arguments with more than just words, insults and assumptions about other people (like you made assumptions about me. Is this how you protect your glory on this site?).

Okay so I'm done talking about this with you kindly since you are not capable for that. If you call my information false, then prove it false. If you assume I'm a troll, I will assume that you are man of words not man of science. You seem very defensive about your view of point and use words and insults to claim your view right and my view wrong. I believe in science and medical industry. If you have no other proof than words and anecdotes I ask you to leave this thread alone (as you said you would do).

However I will update about my treatments and results here or on another thread (pictures included later). 


 

BA is the expert here. He shouldn't have to "prove" his knowledge on each thread he posts on. Getting into a big debate and exchanging peer-reviewed studies and insight from dermatologists is time consuming and detracts from BA helping others.

 

There are pinned topics explaining many of the things BA is telling you. There are peer-reviewed studies included on those topics. If you want to understand why BA is recommending subcision first, read the pinned topics.

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@Skin Pessimist That doesn't allow you to be rude and disrespecting towards others and their opinions. Everyone has to ''prove'' their argument if they want to be convincing. As I have said above many times, I understand ba's recommendations but disagree with him/her on certain points he/she has said on this thread. What I don't understand is his/her behavior. If you start an argument I ask you kindly to show me studies and evidence. Otherwise I unfortunately can't believe what you are saying. The responsibility to prove one's point lies on the person who claims something.

Edited by Simp

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1 hour ago, Simp said:

@Skin Pessimist That doesn't allow you to be rude and disrespecting towards others and their opinions. Everyone has to ''prove'' their argument if they want to be convincing. As I have said above many times, I understand ba's recommendations but disagree with him/her on certain points he/she has said on this thread. What I don't understand is his/her behavior. If you start an argument I ask you kindly to show me studies and evidence. Otherwise I unfortunately can't believe what you are saying. The responsibility to prove one's point lies on the person who claims something.

BA is here to help people, not engage in a scientific debate. BA has volunteered countless hours helping people on the forums. He's also a moderator. I can see why he'd be annoyed at someone disregarding his advice straight away. You're also portraying BA as anti-science.

My Q: Are you looking for advice or seeking to debate the effectiveness of different procedures? It's clear your preference is set. Nobody can convince you to change your mind. You never provided pictures either. Showing pictures of your acne scarring is the best way for BA to give personalized advice.

BA's reasoning for going with subcision first for rolling scars is explained in-depth in the pinned Q&A post. You're supposed to read it before posting topics. Had you done so, you'd already understand why BA recommends that order. There's also YouTube videos where Dr. Rullan or Dr. Lim explain these topics in-depth. Those two are highly respected in their field.

Edited by Skin Pessimist

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Skin Pessimist, it is now clear that this guy is a troll. All the information and evidence you seek is all found on the sticky threads. Obviously this person has not bothered to read any of that information. Normally its money hungry dermatologist that push fractional laser as first line treatment, not the patient. Hmm....

Edited by ScarRight

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@Skin Pessimist The thing is, as I have said many times above, I understand BA's perspective and recommendations on most things. I don't understand ba's attitude against lasers and people who believe in lasers on right hands and settings. It's sad but true that some people like me have some limitations when it comes to treating acne scars. As I have explained above, treating acne scars with certain methods in Finland isn't that easy as it may be for you. I would have to travel (maybe far away) a lot, if I wanted to be treated with certain methods. For example subcision, tca cross and manual/surgical methods for acne scars are not offered or marketed a lot here. Possibly because our derms and plastic surgeons are busy? It's hard to contact different derms and ask what they can do for my acne scarring (would cost me many consultations and a lot of time). Lasers however are easily available with high satisfaction rate, reasonable pricing and backed up explanations. I personally believe in my derm and that his co2 fractional treatments will benefit my acne scarring greatly. 

A: I believe what I'm looking for is someone who has done research on co2 fractional lasers and understands them. As I have been reading this forum for a long time, I would like to discuss with someone similar like @DudleyDoRight. If you read my starting post you can see that it's mainly why I came here. I also asked for opinions (and probably support), but not with this kind of negativity that is going on here. If ba came here to just say his/her opinion with neutral mindset I would have accepted it. But seems like all he/she had to say was that lasers do not work/they just want your money/lasers have no place in acne scar treatments kind of bs that simply doesn't have any other proof behind it than anecdotes/opinions from people. I agree there are better ways to treat scarring, but what I am looking for here is treatment that is worthy for me. Fractional co2 seems worthy for me because I believe it works, it is easily available (unlike many other treatments), it is relatively cheap for me, and fits in to my life and schedule.

Saying this once again. I mainly came here to say what I am going to do for my scars, discuss about lasers if there is someone who understands them well (discussing for me means literature and facts about these treatments, not some anecdotes of gentleman who did 30 lasers *wasn't even mentioned what settings the lasers had?*) and for neutral opinions without unnecessary insults and rhetorics like comparison of skin resurfacing and paving of the road. I also came here so I can possibly show and update results and treatments for people who are interested.

As ba mentioned it could be that it won't work for me as much as I want, I know my risks and accept them. I tried to discuss this without negative attitude but it seems impossible to debate with these people without someone getting angry or insulted.

Edited by Simp

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