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@Mercuryyy 

You have many box cars, Icepicks, rolling scars, some discoloraiton.

No niacinamide alone will not get rid of redness. IT can help with flushing but will not take it away. See below section under nightly and pulse dye laser

Never start with laser treat the deeeeepest problem and move to surface resurfacing.

* I would do 3-8 sessions of cannula subsision to your scars, this will help you most, ... they can do a bit of HA filler after OR you can do Chinese Cupping (Amazon) for a whole month (with cupping yes you bruise, so be prepared if you take this route, you can vary the suction strength, wear a concealer over the area like dermablend). A buffer keeps things from re-tethering.

* I would do rf needling to your scars, ... this helps rolling / boxcars (4 sessions or more)

* CO2 laser if you need a boost in low density and high power setting.

* If nothing else works for the box cars there is a surgical method called punch excision or punch float. Surgery always has side effects so I never recommend that first. Find a plastic surgeon who treats your skin type if you go this route, ask how many he does a month. Have him do a test area on your temples if you want.

* For texture we lastly do Sciton fully ablative laser resurfacing, notice I said ablative, non-ablative with do nothing for your scars. Jplasma, or a Deep Chemical Peel is good.  OR several TCA peels, or a deep peel on the scar areas only. You have sensitive skin discuss this aspect with the Dr you goto, talk about steriod shot to the hip, doing a test area, and aftercare. This works once you raise your pits, but there is down time.

* buy a dermastamp or derminator (google it) and stamp them monthly. You will be treating with the Dr every 3 months - the above things, regardless of what they tell you, the body is incredibly slow to heal and they want $$$$ quickly, observe your progress of what works). Once a month your dermastamping and you can alternate with do glycolic peels at home. Treatment for many takes 3 years, everything is optional. Treat as you have time and money (for some that's only 2 things a year), it's a slow process again with most of it related to how you heal and what works best for you, do more of that.  

For your case especially the single needle in the derminator could help you needle the borders of your boxcars.

* For redness we do pulse dye laser, or something like picosure, picoway. Laser resurfacing (Above) and Q switch is used if the pigmentation is not responding after several treatments. Alternatively you can try first peels for discoloration or hyperpigmetnation.

* Nightly before and after treatments until the issue is taken care of:

Use nightly: Retin-a or tretinorin(prescription), or Differin (Target/Walmart), The Ordinary Granactive Retinoid (if you can't get the above) or Avene or Osmosis (I am not a big fan of their other products) "Retinaldehyde" product (for sensitive skin). Cureology(USA) & Yoderm(USA) provide monthly - 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 (or do 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/Yoderm/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 inflammation. The Ordinary, Cerave, Eucerin (QV Skincare in AUS), Dr Sam Bunting Flawless Cleanser, Avene, 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 - DRMTLGY Active Sunscreen, Elta MD Physical, La Roche).

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. Please Note I do ongoing support by PM for complex cases / questions, daily - you can message me there. Please be patient as I can get over 100+ of the worst acne scar cases to help.



 

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@beautifulambition Thankyou so much for your response , Im planning to do it next month . But I can't find any doctor here in my country doing Nokor subcision, its not readily available here.  How about  subcision GAUGE? They use gauge 18 - gauge 25 as necessary. 

Subcision alone is okay ? Or I need combination treatment on 1 session?

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@Mercuryyy Try Instagram, Facebook, youtube, search for subcision and your big city nearby or country. Cannula is preferred but Nokor can also be done. If you have no other choices then they can try with a normal needle though I find the results are not as aggressive as the other needles. Deal with what you have available , where you are. 

Gauge does not matter, skill does. This is they have treated many patients that month doing the same procedure or have experience, you don't want just anyone doing this. You ask how many times have you done this, do you have any before and after pics, what did you do to them. 

Subcision alone is fine, ... you can do TCA Cross with it as well if you wish for your other scar types. Do energy device work latter once you see what you can do naturally. 

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