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I've been reading a lot of threads on here and looked at the FAQ but I'm unsure what my best options are. Ive been dealing with acne for 3 years now and I hope to limit the amount of damage that it will do to my skin including the scarring, which I have to admit is maybe also due to a habit of picking at my scars. I'm aware that my scarring might not be as severe as other cases and my own perception (damn you unflattering bathroom lighting) is subjective and fluctuates quite a bit. There are days I feel pretty down about it and while I am working on the mental part of acceptance I'd also like to see what medical treatments might help. I think I have a few boxcar scars and rolling scars (especially on my right cheek) and maybe icepick scars even though I'm not sure if theyre just enlarged pores. My skin is still not 100% acne free with hormonal breakouts and right now I'm going through an glycolic acid purge. I have a good amount of PIH (I have tan/medium brown skin) that fades really slowly. I am wondering what you guys think might be advisable treatments. I've done a bit of dermarolling at home but I'm not sure if that is helping much, do I need/would benefit from peels? Subcision? Laser? The few derms I've been at haven't bothered to look at my skin for longer than 20 seconds and that from a distance *sigh*. I live in Germany and the derm that's somewhat close that has been advised on here (Dr. Henningsen) seems knowledgeable but I don't know if it would be worth it. Any help or advice is greatly appreciated, I'm thankful for a community like this. 







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@Tunnelvision Ok good you know that getting the acne under control is important. OTherwise we will spread bacteria and make more acne. See a derm. Mention hormonal acne and Spironolactone a drug women use for this. I understand about the purge, use something to kill the bacteria (spot treatment). 

That is the first thing I saw, hyperpigmentation yes. Do the below nightly protocol and look into a laser like picosure or vascular laser for this. 

I see a few rolling scars and areas of tissue fat loss, 3-8 sessions of subcision here and some ha filler or Chinese cupping on the area for a month instead (creates bruises).

** 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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Thanks a lot for that quick response! Phew that's a lot of options...  I have thought about Spiro, thanks for reminding me, I might look into that again. If I remember it right however, it is not prescribed for female acne in Germany. I think the rf needling would be one of the first things I'd like to try, I'm just wondering if it improves rolling scars too? I guess otherwise I'd really have to see Dr. Henningsen. Dermatologists I have talked to have been really conservative about peels on my skin and I'm afraid it's because theyre often inexperienced on darker skin types. I hope I'll find someone good here. I'll keep you updated.

Edited by Tunnelvision

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Hi send to dr Emil your picture , he will tell you if he can help you or not , the best is to see in real because he use light to see your scars  so try you lost nothing 

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@Tunnelvision RF needling can help boxcars and rolling, but rolling also need sub and filler, but it helps some. I would always do manual methods first (before energy devices). But yes they do offer that in Germany so no need to get that elsewhere. It's the subcision that is hardest to find. We have had many Germans tell us this and goto Emil. Sadly often they have to be ethnic themselves to understand the skin type, ... but Emil does treat the ethnic skin type well. 

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