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vanBOOM

Help! Need scar treatment advice (aka, I f*cked up my face)

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Posted (edited)

Hi everyone, 

I know the expert users around here are extremely busy, so I'll cut right to the chase.

I'm 33, and am now grappling with my first REAL acne scars. They began taking shape ~7 months ago. As you can see in my photos, there's some PIE thrown into the mix but it's the skin texture/depression aftereffects that's really getting me down. 

Here's my questions:

1) What scar treatments would be best (and in what order), and what degree of improvement can I realistically expect?

2) Apart from examining a doctor's training, reviews, and before/after photos, is there something else in particular I should look for RE: each of the recommended treatments?

3) Is there anything I can do on my end to support my body's ability to heal from these procedures (i.e., nutrition, topical treatments other than sunscreen and any healing lotions I may be given, etc.)?

Thank you in advance for your time!

VB

(P.S. My acne has been completely under control for a few months now, so I'm past that issue.)

acne scar 1.JPG

acne scar 2.JPG

Edited by vanBOOM

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@vanBOOM Hi there,

You say 7 months ago, so these are recent (early scarring)? Have you tried something like Ematrix - also called sublative rf on them? Early scars are mainly known for their PIE or redness as the body is regenerating.

The one that looks more severe is the linear scar mid cheek. This needs subcision and some filler multiple times. 

RF needling would also help a few times between subcision sessions (everything except the ematrix are 3 months apart). 

V-beam or vascular laser could help with the redness or PIE (wounding post acne). 

I would not bother with co2 unless needed at the end. The above is the more conservative route. 

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).

1) Sadly I am not a mind reader, if you heal well, you should get at least 50% improvement, and the redness should be gone. I am moderate with my %, ... as you could get more.

2) Find the Ematrix device first, ... then go for the subcision on the linear scar and or any pits. We have a list of Dr's in the FAQ, pinned to the main scar treatments sub (goto the bottom of the post).

3) That is in the FAQ, ... Vit C, Green T, Lots of sources of Collagen, etc.

 

 

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Posted (edited)
7 hours ago, beautifulambition said:

@vanBOOM Hi there,

You say 7 months ago, so these are recent (early scarring)? Have you tried something like Ematrix - also called sublative rf on them? Early scars are mainly known for their PIE or redness as the body is regenerating.

The one that looks more severe is the linear scar mid cheek. This needs subcision and some filler multiple times. 

RF needling would also help a few times between subcision sessions (everything except the ematrix are 3 months apart). 

V-beam or vascular laser could help with the redness or PIE (wounding post acne). 

I would not bother with co2 unless needed at the end. The above is the more conservative route. 

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).

1) Sadly I am not a mind reader, if you heal well, you should get at least 50% improvement, and the redness should be gone. I am moderate with my %, ... as you could get more.

2) Find the Ematrix device first, ... then go for the subcision on the linear scar and or any pits. We have a list of Dr's in the FAQ, pinned to the main scar treatments sub (goto the bottom of the post).

3) That is in the FAQ, ... Vit C, Green T, Lots of sources of Collagen, etc.

 

 

Hi @beautifulambition!

Thank you so much for your thorough and speedy response. I must apologize: I got so excited when I found this forum last night that I didn't notice the FAQ section until I was reading on my phone, in bed, while trying to sleep last night. I thought I'd have time to rush back and perhaps edit my questions to be more substantive before someone like you saw them. But alas, you beat me to the punch by a mere 12 minutes, and then it was time to go to work. :) 

Anyway: I have now fully digested your recommendations (and the information from the FAQs). 

I do have some lingering clarification questions, if anyone would like to indulge me.

  1. To be absolutely sure about the order of the above recommendations: Fillers would be the absolute last step if I were to implement everything else suggested, right?
  2. My current skincare routine includes a combined clindamycin-tretinoin topical gel (basically, generic Ziana). Is this sufficient vitamin A for my healing purposes, or should I push for a full-blown tretinoin solution (Retin-A) instead? I think my gel has 0.025% tretinoin, whereas the images of Retin-A boxes that I've found seem to range from 0.025%-0.1%.
    1. NOTE: I'm cautious on active ingredient strength because it was actually adapalene--aka, Differin gel--that got me into this mess. My skin "purged" too hard during the first 2-3 months of use, resulting in my scars pictured above. My skin has always loved tretinoin, though, so maybe more of that, if need be, will be fine.
  3. Is there any reason to think that microneedling + PRP could be beneficial to how my scar depressions heal in between subcisions (as opposed to microneedling without PRP)?
  4. Is there a way to contact forum users who may have recommended a doctor for inclusion into the recommended doctors list? (No worries if some of these are meant to be anonymous. I'd love to talk to other former patients here and just noticed I wasn't having luck when entering some of the doctors' names or practice names into the search bar for the forums.)

I'm excited to get started on this journey, and may document my progress as I go along (because: why the hell not?). 

Edited by vanBOOM

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@vanBOOM 

1) No you can do filler after the first subcision if you wish, ... the swelling must go down for a week or so after first before it's done. For some it's a money issue, so they can do Chinese Cupping - Amazon and then on their final subcisions get filler as needed. I do see filler helping that indented scar. We want filler to be replaced by collagen if you heal well, ... some take more sessions than once.

2) Sure you can continue your clinda - retinoid. In the future you can separate it out if you wish to a higher amount, even once a week is fine or mixing it with a moisturizer. Skip days then or dilute as needed. Sounds like your skin is sensitive, so do whatever works best for you, ... don't power through angry skin, cut back.

3) PRP only causes one to heal quicker. I do not find it magical, like is marketed online. Now with your red marks - PIE, it may help with some healing, so why not give it a try. But it won't fix scars.

4)  Typically these people are gone. They have posted their experience. How it works is generally people get a plan, get some consultations (I suggest a few cosmetic derms and plastics). Then they move on. The one's who are still here, ...either treatment did not work for them (poor healers) or they had a bad practitioner - process. I think this plays very little part in a decision, and it's best if you consult with a few practitioners to treat with the one you feel best about. Your case is very easy compared to some severe acne scar cases. You might even be able to walk into any expert injector with filler have them subcise it a bit and place filler underneath, and treat your PIE. Scar work is not universal. I can say I dislike this Dr, and someone else loves them. Why because we are all unique and have different issues going on. Secondly it's your healing capability that makes this all possible. Some do other treatments and it stops that process. But sure PM them if you wish. IF the posting was older than 2018 they are gone and it's pointless. I know about all the Dr's here, so if your searching for general Dr's they will not be on this site unless they offer some acne scar services. As such realself.com is a better place to search for general energy device Drs, which might work in your case actually. Did you try the FAQ - pinned in the main scar treatments sub, goto the bottom, Dr's. 

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