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Can anyone identify my scars and provide info on best treatments?

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Hello, my name is Jules. I am hoping someone can help me pin point the type of scarring I have and what treatments and options would be best effective. I definitely do still have some active acne, especially around the jaw/chin area, but my skin has come a long way from how it used to be. I also feel that some of the lumps along my jaw may not be active but possibly scars? I currently derma roll every 2 weeks with a .5 mm roller. Any information you might be able to provide would be appreciated very much! Thank you! Ps. Sorry about the poor lighting and angles Snapchat-1175779401.thumb.jpg.4a6930742f76ee93bca9f0df1cd1c85f.jpg




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Hi there I would rate your scarring as severe .

You have rolling scars mainly all over, perhaps some box cars, ... can't tell about the icepicks in the pics. Your raised scars are hypertrophic scarring, the microneedling might be causing this so discuss with the Dr and stop if they agree on hypertrophic scarring which is the body causing inflammation and excess tissues. Scarring around this area can be caused by hormonal acne, speak with your Dr about treating this and if they feel it's the cause. 

Typically raised scars they inject with steriod prior to laser. 

For these type of scars a customized plan for your scars is the following:
# Subcision (typically 3-8 are needed), filler is best done with this and is done 1-2 weeks after when the swelling has subsided. In your case I would consider over dilute scuplptra used as a buffer under the scars.  You don't have to get it done w/ sub after every time.  
# TCA Cross (several sessions), this raises the floorbed of the icepick so that the skin can be resurfaced in the end of treatment. Punch floats can be done on icepicks if you have a few of them or if nothing else works, but surgery can go wrong be prepared to find the most skilled Dr possible.
# RF needling (3-4 sessions),

# CO2 laser.
# Several TCA peels to soften the texture of the skin, you raised everything as much as possible by this step or a fully ablative erbium resurfacing peel(s).
# Any redness or hyperpigmentation discoloration can be treated with vascular laser (several sessions), for ethnic skin types picosure is best as it stimulates collagen as well.

** Everything depends on your bodies ability to heal / your surgeons skill, it's variable % of outcome, if you heal poorly or are overly sensitive (skin) please don't micro needle, see a highly skilled acne scar specialist.

** Please note all treatments are 3 months apart (drs often tell you to do them more often but the skin does not heal like this, it's verrrrry slow to heal. Always best to observe what works and what does not to take next steps. Also It is advantageous for Drs to do quicker treatments as swelling hides scars and gives them quicker $$$$. Tell them you will call to schedule at a latter time.) Everything is optional.

** Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), Cureology(USA) provides online prescriptions with customized skin care creams for your concerns, Yoderm for online derm scripts for all conditions(USA), or those in UK Dermatica provides the same thing. Apply a moisturizer when your face is dripping wet. Wait 5 minutes for it to dry, and then apply the tretinoin. This cuts down on irritation, you can also skip days of application if it's irritating and you need to build up. This provides skin turnover - new collagen. If you have any sort of skin discoloration (reds or browns), try PCA gel for Hyperpigmentaion (Amazon) or Cureology/Dermatica includes this in their products if ordered. Using this prevents hyperpigmentation from treatments.  Sunscreen is a must (for the sensitive use zinc only ones).


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