I dealt with severely inflamed adult cystic acne that covered my entire face, including the area under my chin and behind my ears. That was 3 years ago. Now I am left with scars all over my face, mostly concentrated on both of my cheeks. I have a mix of scars, mostly boxcar, with some ice pick, and hypertrophic (although not very noticeable). I've tried non-ablative lasers in Los Angeles with very little results. I've also gotten Infini RF done 6 times by Dr. Evan Ransom in San Francisco. I did initially see an improvement in the softening of scars with the Infini RF, but the results were not worth it for the price I was paying for each of the additional sessions.
@beautifulambition I've followed your posts, and have a lot of respect for you. I would be grateful for your advice. What do you recommend for reducing my scarring? I currently live in San Francisco, CA, and the only doctors I could find besides Evan Ransom, were Usha Rajagopal MD and Charles K Lee (Infini RF).
These scars have really ruined my self-esteem, becoming a daily obsession and fear of mine. It's been a struggle having relationships both romantic and platonic because my self-worth is so deeply tied to my appearance (that's the way I was raised).
Thank you for your help.
@GroovyRamThank you for the kind words
That is a lot of treatments. Perhaps provided poorly as it does not make since you had no/ very littleresults. Non-ablative lasers would do noting for your case, you need ablative sciton resurfacing or a deep peel at the end for surface textural issues. I believe what happened with the rf needlin is it was to deep to work on your surface textural scars, so it did very little.
I would have you see Rullan in San Diego for Phenol Cross of your textural boxcars. The missing piece here was manual methods. I would have done either multi-coat pain on to the box cars,(3 layers of a lower % than tca cross). Some of your scars could use tca cross as they seem to be small enough as well.
** 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.
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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.
@beautifulambitionThank you so much for your thorough and thoughtful explanation! I truly appreciate your time and expertise.I took some time to digest all of this informationbefore asking you clear follow-up questions.
You suggested Dr Pienin Hollywood for lasers in ethnic skin, or Dr Lopez in Fresno forSciton Fully ablative erbium resurfacing for ethnic patients.
Are there any other that you would recommend for in Los Angeles or San Francisco area?
Thank you again. I am so grateful for the work you do. Thank you for giving acne and acne scar sufferers more hope and direction.
@GroovyRamWelcome!
1) Ok great your going to Dr Rullan.
laser Drs. If you need someone to treat locally checkout the FAQ pinned to the main scar treatments sub, bottom of that.
Thank You,
Ba
@superburrito That's great to hear that! I have a lot of boxcar scarring which is my main scarring concern. A few questions which I hope you can help with 
:
I'm also weighing just going straight for a Co2 laser, instead of using TCA cross. I mostly have wide boxcar scars with fewer icepick scars or shallow small boxcar scars. What do you think?
Thanks for your help! 
- Was he able to improve or erase any of your boxcar scars with TCA or phenol cross?
A definite improvement, but not complete erasure yes. This week was my third Phenol cross - With TCA cross or phenol cross, how much have your boxcar scars improved on a scale of 110?
I would say my boxcar and icepicks scars have improved 30-40% - How many sessions did it take?
I did my third session on Thursday
If you only do Cross with Dr Rullan, then you can fly down and fly up on the same day without having to stay overnight. Cross is his cheapest procedure, not sure how much it is on it's own, but I think it's ~200. Southwest Airlines is your best bet for cheap flights from SFO or OAK.
I have not gone to Dr Lopez in Oakland. The reason being is that Dr Rullan is the only doctor I know that uses Phenol acid for Cross instead of TCA. This has less risk of post-inflammatory hyperpigmentation for folks with non-caucasian skin stones. It also does not cause the scar to widen like TCA does.
Not sure if Co2 is the right way to go as a first-line of treatment. First, it's a lot more expensive, and a lot of downtime. With Cross, it's very localized, and a lot less expensive. Dr Rullan also uses a paintbrush instead of a toothpick to apply the acid. So he's able to cover wider boxcars as well.
On 5/23/2019 at 2:20 PM, GroovyRam said:@superburrito That's great to hear that! I have a lot of boxcar scarring which is my main scarring concern. A few questions which I hope you can help with
- Was he able to improve or erase any of your boxcar scars with TCA or phenol cross?
- With TCA cross or phenol cross, how much have your boxcar scars improved on a scale of 1“10?
- How many sessions did it take?
In regards to Rullan, I'm worried about the costs of flying to San Diego, paying for a place to stay for a week (or more), and having to do that multiple times.
I'm weighing seeing Dr. Lopez in Fresno/Oakland instead because she is much closer and I would avoid multiple plane tickets and hotels/airbnb. Have you seen Dr. Lopez?
I'm also weighing just going straight for a Co2 laser, instead of using TCA cross. I mostly have wide boxcar scars with fewer icepick scars or shallow small boxcar scars. What do you think?
Thanks for your help!
If you're worried about costs, at the very least find someone in the bay area that can do TCA CROSS. You'll probably get hyperpigmentation like I did (fair skin), but CROSS will help you more than just blasting your face with a laser. You want to raise those pits to the level of the rest of your face, and a laser won't do that.
@SimpleMuttonI gave a full plan above. Cross + laser will not fix her problems alone. Her scars may not raise from cross, she has widespread box cars which may not respond. Her scars will take a multiple of treatments, resurfacing techniques and collagen stimulating therapies. This is not a easy case to fix. This is why treatment is not standardized, it's customized, ... we cannot compare scarring.No scar case is the same, we are not clones, one person could do a million procedures and not be you, your all different ages, ethnic backgrounds, healing capabilities, plans for treatment, outcomes, different surgeons (they treat differently as well), etc, we could go on and on. The point being is never compare yourself to someone else. Sure you can learn from their experience but do we really know every single detail about what was done and why - no. If someone heals poorly or had a poor Dr they typically hang around here.