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25 y/o with acne scars on cheeks and temple. Need advice on treatment

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Hello guys, finally after a long period of lurking on these forums i decided to muster up some courage and present myself with my acne scars. 

I had bad cystic acne in my teens which was successfully treated with accutane when I turned 22. 

Years of acne + post acne scarring has left me with pretty low self esteem and self-loathing. I just want to feel confident in my skin

I’ve had microneedling done 2 years ago and juvederm filler last year.  The microneedling softened the scars but the results were not that great. Juvederm was a waste of money in my opinion

I consulted a dermatology centre here in Toronto and the esthetician recommended me the Profractional Laser treatment (3-4 sessions)

I’m going to consult with another place to see what they say before going making a decision. 

I was wondering if you guys had some tips/advice on what has worked for you or people you know. Would be greatly appreciated. 



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Hi there, you have lots of textural box cars. Some rolling scars, some discoloration, and perhaps a few icepicks.

Microneedling is meant to be done at home between Dr sessions not to be a treatment alone. There is no ""one"" treatment. Filler without subcision is pointless.

Ah Canada, I get this all the time. Laser Laser Laser. We have a list of practitioners in the FAQ, pinned at the top of the scar treatments sub, find CAN.  Some are laser Dr's

You really need Subcsion and for your case it will be extensive. I would do over dilute Sculptra a vial or two after the subcsion (you can goto another spa if they do not do it in the one who is doing sub - as soon as the swelling goes down from treatment) you might need 3-8 sessions of sub total. HA filler is used latter on w/ sub for individual pits. 

See Fd93d's post in the scar sucess in the FAQ - top of post.  

I would then for your case do 3-4 sessions of rf needling spaced between your subcisions. All treatments are 3 months apart, even if the Dr will do them weekly. Collagen is slow to build. Dr's love $$$$$$. 

Do you microneedling at home between your sessions monthly.

If you need more of a boost co2 laser 3-7% density CO2, highest power. I would not let a esthetician do laser, ... that is how we get screw ups. Unless she has done thousands of cases on the machine and there is no other option. Laser is for texture, not for the scarring you currently have unless you raise it first.

Finish with several tca peels, or fully ablative erbium resurfacing.

Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), The Ordinary Granactive Retinoid (if you can't get the above). Cureology(USA) & Yoderm(USA) provides online prescriptions with customized skin care creams for your concerns, 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 (one or two days a week) if it's irritating and you need to build up %. This provides skin turnover - new collagen. To prevent (reds & browns from all Dr-treatments to ethnic skin or to work on current skin discoloration), try PCA hydroquione free gel for Hyperpigmentaion (Amazon) or Cureology/Dermatica includes this in their products if ordered. Using this prevents hyperpigmentation from treatments. Hydroquinone has side effects for some people, natural options  are better with ingredients like: kojic acid/Konjac, Alpha Arbutin, Niacinamide by The Ordinary is great for large pores, discoloration, and inflamation. The Ordinary, Cerave, Eucerin, Dr Sam Bunting Flawless Cleanser, La Roche-Posay (sensitive), and Acne.org's products are all great options for moisturizers and cleaners without fragrance / dyes / allergens. The Three most important things one can use are: Vitamin A skin turnover (retinol, retinaldehyde, retinoid), Vitamin C Serum which makes collagen, and a sunscreen (zinc oxide physical for sensitive skin).

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