@ViceroyHi, .. I believe I was mentioned in that video by Lim. Checkout the FAQ, pinned in the main scar treatments sub, bottom of that and find NYC. Several good Dr's on there. It all depends what kind of treatment your seeking and specifically without seeing pictures of yourself(Scars make shadows) I cannot give a appropriate plan based on your scars. Other advise is see 3 or more Drs for consult only without treatment and pick the one you like best.

Look for Dr's who do Subcision and TCA Cross - call and ask if they do that and how often, ask for that specifically, laser is only done in the end of treatment and not best for scar treatment, manual methods first.

Sorry I don™t really have a better picture. But as you can see the marks are still red, and I was told they™re easier to treat at this stage. 

@ViceroyThank you so much for your patience, I get more than 100 PM's a day of the worst scar suffer's to help. Takes me 24 hrs to respond sometimes.

Your scars are only 3 months old so you may need less treatments. I would definitely do some subcisions with a cannula and some filler to prevent re-attachment. See the FAQ on the main scar treatmentssub, pinned there, goto the bottom, find NYC. Consult a few of those Dr's.

For early scars we mainly do subcision and filler, Some pulse dye laser for the redness or PIE of the wounds. A good treatment is subaltive RF or ematrix several treatments for early scars, ... rf needling can be done as a substitute as well.

I would have you use nightly a differin (OTC Walmart / Target), tretinorin, or retinoid, also the PCA hydroquinone free gel sold on amazon I would also use nighly as it helps with the redness.

So your plan of attack would be subcision, ematrix or rf needling, and finally pulse dye laser as needed for redness with 3 month old scars. The sooner you treat the better the outcome.

Some with early scars also have sucess with monthly alternating dermastamping at home or derminator (Google it), and some glycolic peels.

5 hours ago, beautifulambition said:

@ViceroyThank you so much for your patience, I get more than 100 PM's a day of the worst scar suffer's to help. Takes me 24 hrs to respond sometimes.

Your scars are only 3 months old so you may need less treatments. I would definitely do some subcisions with a cannula and some filler to prevent re-attachment. See the FAQ on the main scar treatmentssub, pinned there, goto the bottom, find NYC. Consult a few of those Dr's.

For early scars we mainly do subcision and filler, Some pulse dye laser for the redness or PIE of the wounds. A good treatment is subaltive RF or ematrix several treatments for early scars, ... rf needling can be done as a substitute as well.

I would have you use nightly a differin (OTC Walmart / Target), tretinorin, or retinoid, also the PCA hydroquinone free gel sold on amazon I would also use nighly as it helps with the redness.

So your plan of attack would be subcision, ematrix or rf needling, and finally pulse dye laser as needed for redness with 3 month old scars. The sooner you treat the better the outcome.

Some with early scars also have sucess with monthly alternating dermastamping at home or derminator (Google it), and some glycolic peels.

 

Thanks for taking your time to help me. The only thing Im suck on is my derm wants me to start accutane because I still have the occasional breakout that hasnt responded to any other treatments. Its my understanding that If I go on accutane I cant do anything to treat the scars during the course then like 4 months after. This would essentially make my scars a year old by the time I can have them revised. I really dont know what to do, can you give me any advise?

@ViceroyEasy solution for you. Go on your Accutane. Do CAnnula(only cannula -type of needle) subcision and some HA filler for your scars while on Accutane. This is safe. NO energy devices, until as you said you heal and have your period after Accutane to recover.

If you do Subcision that should be done every 3 to 6 months (some only can afford it once a year), this will allow you time to heal between procedures and then you can do other treatments above once that 6 months after accutane occurs. Low mm .5mm to 1mm dermastamping can also help if not done overly aggressive.

again, thanks for the advise. My only concern is Ive done a decent amount of research on the subject and thought that any treatment would be bad because accutane makes your skin weaker and less resilient. Has there been new evidence to support the idea that treatment on accutane is safe? Its not that I dont believe you because you are very knowledgeable but its just not something Ive read myself.

Viceroy

Before you take accutane I suggest make sure your acne is not now fungal acne. Fungal acne is caused by taking antibiotics and possibly by taking accutane. One can start with ordinary acne, which over time changes to fungal acne due to taking antibiotics and some other meds.

Redness and ongoing "acne" can be a sign of fungal acne. Do you have dandurff or seb derm /flaking skin. Are the affected areas itchy ?

If you read the posts on this site you will see that accutane is very dangerous (as are antibiotics.... )

13 hours ago, Aussie Scientist said:

Viceroy

Before you take accutane I suggest make sure your acne is not now fungal acne. Fungal acne is caused by taking antibiotics and possibly by taking accutane. One can start with ordinary acne, which over time changes to fungal acne due to taking antibiotics and some other meds.

Redness and ongoing "acne" can be a sign of fungal acne. Do you have dandurff or seb derm /flaking skin. Are the affected areas itchy ?

If you read the posts on this site you will see that accutane is very dangerous (as are antibiotics.... )

I only took antibiotics for my acne for like 2-3 weeks about 3 months ago. I didnt stick with it. I actually do have seb derm but it hasnt really flared up in a few years, it was way worse before when my skin was flawless. And in the beginning my skin was very red and itchy but not anymore and I still get pimples (but much less frequently) how can I tell if its fungal acne?

Seb derm and itchy red skin are both caused by fungus. The simplest (and safest) way to see if one has fungal acne is to apply a topical antifungal cream and see if that controls the "acne".

I suggest that you start by applying clotrimazole antifungal cream (often sold as Canesten) and see how things go with that. If the breakout stop then you had fungal acne. If the breakouts continue, you might need a different antifungal cream (we can discuss this, if necessary) or the problem might not be caused by fungus.

But seb derm IS caused by fungus, as is itchy skin (usually), so fungus is very likely the cause of the breakouts.

Topical antifungal creams are totally safe. They are cheap and they are worth trying before using dangerous (and expensive) treatments/drugs such accutane.

On 5/29/2019 at 11:41 AM, beautifulambition said:

@ViceroyThank you so much for your patience, I get more than 100 PM's a day of the worst scar suffer's to help. Takes me 24 hrs to respond sometimes.

Your scars are only 3 months old so you may need less treatments. I would definitely do some subcisions with a cannula and some filler to prevent re-attachment. See the FAQ on the main scar treatmentssub, pinned there, goto the bottom, find NYC. Consult a few of those Dr's.

For early scars we mainly do subcision and filler, Some pulse dye laser for the redness or PIE of the wounds. A good treatment is subaltive RF or ematrix several treatments for early scars, ... rf needling can be done as a substitute as well.

I would have you use nightly a differin (OTC Walmart / Target), tretinorin, or retinoid, also the PCA hydroquinone free gel sold on amazon I would also use nighly as it helps with the redness.

So your plan of attack would be subcision, ematrix or rf needling, and finally pulse dye laser as needed for redness with 3 month old scars. The sooner you treat the better the outcome.

Some with early scars also have sucess with monthly alternating dermastamping at home or derminator (Google it), and some glycolic peels.

 

Hi, I forgot the PWto this account so I tried to reach out to you on another thinking this advise was over PM and lost forever so I apologize for the inconvenience. But how many subscision treatments do you believe I should do before looking into ematrix or rf needling?

@ViceroyIt's completely fine 😉 I would not do subcision first. I would do ematrix or sublative rf now if you can find someone. Your case is either early scarring with PIE / Pustuals, or it's bacterial . fungal.

I would normally say rf needling is also a choice, but in your case I fear the infection would only spread, where ematrix or a non ablative procedure would work on the bacteria and swelling. It takes several treatments.

Also it is worth considering what the poster said above about fungal acne, just get some nizoral shampoo or a ketoconazole anti-fungal and see if things get a bit better.

6 hours ago, beautifulambition said:

@ViceroyIt's completely fine 😉 I would not do subcision first. I would do ematrix or sublative rf now if you can find someone. Your case is either early scarring with PIE / Pustuals, or it's bacterial . fungal.

I would normally say rf needling is also a choice, but in your case I fear the infection would only spread, where ematrix or a non ablative procedure would work on the bacteria and swelling. It takes several treatments.

Also it is worth considering what the poster said above about fungal acne, just get some nizoral shampoo or a ketoconazole anti-fungal and see if things get a bit better.

 

Ok thanks so much. I honestly hope its not fungal because I believe the acne has already scarred and if it was I had the stuff to treat it all along in my bathroom, but no derm ever mentioned that as a possibility and I saw 3. In the beginning it was just red bumps and very itchy and the strangest part is that it was only on the rightside of my face. But now that that ship has sailed regardless, I am going to try and make an app with Dr. Geronomous since I've heard he's the best with lasers and he's in my area. Thanks again for the advise and just to be sure you think that my scarring is early enough to see more positive results(4 months by the time of treatment? - hopefully)

Also I forgot to mention that I use sulfur face wash every night then I apply a clindamycin phosphate/tretinoin gel before bed. When I wake up I rub some vitamin E oil on the affected area (my brother swears by its healing capabilities) and take a vitamin D (2000 ui) and Omega 3 pill and drink water all day long. Is there anything else I can be doing to help my scars in the semi-early stages? The area I'm most worried about is the area in the front to the right of mynose, that's where the cysts kept coming and going for the most part. and now there are two areas with what I believe are rolling scars since they're gradual and shallow with normal skin in between and its making the normal skin look puffy. That's really my big issue with the marks, the rest I could live with. But I think the tretinoin gel has helped smoothing the skin out marginally. From your previous post you mentioned that some things I can do at home are glycolic acid peels and dermastamping, how would I manage to work those in to my current routine? Is anything I am doing/planning on doing (glycolic acid) wrong or going to affect the efficacy of laser treatment? - also thought I should mention that the problem area is practically free of active acne, although there is one spot that wont go down and may be filled with fluid (not pus, feels and looks different from any regulartype of pimple, but it has been decreasing in size gradually) Lastly, would facial hair interfere with ematrix or sublative rf?

Sorry if I am being annoying, I just have one shot to treat these while they're still relatively young and I want to get it right.

Itchy implies fungal. Clindamycin gel will make the acne worse if it is fungal. Glycolic peels will make the problem worse if it is fungal.

I can provide information about how to control fungal acne cheaply and safely if you get back to me.

Fungal acne is caused by taking antibiotics and some other meds.

@ViceroyThe clue here is the beard, ... this sounds like folliculitus. I often have it with some patients who break out in the beard. You can try the Nizoral Shampoo on the beard area, leave it on for 5 - 10 minutes and wash if off.

Some guys cannot get it under control and have their hair removed with a laser and that can help as well.

Fungal acne also causes scarring. If you have any doubts see a dermatologist. But a simple test is to try the Nizoral and see how you do.

Most Derm's won't mention it as they treat the symptom not the cause. But perhaps your right and just have cystic acne and a flair of folliculitus, won't hurt to try the ketaconazole shampoo.

Dr Geronomous sounds ok, ... he has the lasers to treat for acne, PIE - redness, and your early scarring without antibiotics.

Yes 4 months is still early scarring.

Sulfur is good, ... leave that on for 5-10 minutes before washing off.

The vitamin E oil also may be causing some of this, stop that and see how you do. Oil is not the friend of the sensitive.

You could do peels (MUAC Brand sells these things) mandelic acid works pretty good to try. Pumkin enzymatic peels as well and niacinamide cream. But Geronomous has the lasers and energy devices to treat this as well. Do both.

I would not do dermastamping till your get things more under control acne / cyst wise.

Ematrix needs close contact to the skin, shave down the hairs with a trimmer or razor. This also will allow your actives to penetrate better.

Thanks again. I just called Dr. Geronemous office and booked an app for July 1st. The receptionist just said it could be up to 2k per treatment, I'll hold onto the app for now but still look for other options. I've come across Dr. Michele Green who speaks specifically about eMatrix RF and there's no way her prices could be higher than Geronemous so I'll give her a call as well. Is skill of the practitioner something I need to be overly concerned with for laser treatment? I'm sure both of these Dr's are at least qualified but do you believe Geronemus could do something for me this other Dr couldn't? Or at this point am I just paying for the prestige of his name?

Also if you know of any Dr's that you have heard good things about or think would suit my needs please let me know.

I have some early acne scars I'm looking to treat with eMatrix or Sublative RF. These are thedoctors in my area who I think may be able to help me;

Michele Green - https://www.michelegreenmd.com/

Ron Shelton - http://www.thenyac.com/

Roy Geronemous - https://www.laserskinsurgery.com/Dermatologists/Roy-G-Geronemus-MD (This guy is very expensive but supposedly the best)

and another viable option, but not someone I was able to find much information on is Julia Tzu - http://www.wallstreetdermatology.com

So yea, if anyone has any personal experience with these doctors or can recommend someone they've seen themselves for the treatment I mentioned above I'd appreciate your input.

@Viceroy

I don't think it's necessary for 2k per treatment, this is why I don't overly endorse him, ... goto whoever is cheapest. Call around and search for NYC and Ematrix or etwo also called subaltive rf. You will need many I am talking about 6-10 of them. Even a med spa might be able to do this. Laser is when we need more skill, this is not laser but rf based treatments. Pay for extra experience when you need laser done, ... not for this. This is a more common procedure and I am not fearful of it's usage. They can also do pulse dye laser in conjunction as needed - optional.

@ViceroyLook up the reviews online yelp and realself(be prepared for many winning people and happy posters do not overly review) for these Dr's. I answered your post ^, ... it does not matter who you see. These Dr's are on the master faq list because they have good reviews for the treatments needed for acne scars, patients have moved on from here.

Hi, I just have one final question for you. I posted the same picture I sent you originally on RealSelf a few days ago and got a couple answers from Drs on there. They seemed to unanimously suggest subcision and fractional lasers. Do you still stand by your recommendation of eMatrix? I feel I am more inclined to listen to you over them considering we have been able to talk pretty extensively and you help people with acne scars on a daily basis.

Regardless, thanks again.

@ViceroyLets clear up the confusion here is my prior post to you about subcision(see below). Unlike Dr's I am trying to save you some money. The best way to treat is conservatively. You state"I have early scars." Thus I am trying to do some early scar work with ematrix, ... if several sessions of that are not to your liking move onto subcision as I mention below.

** 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.

P.S. I know you said that even a medspa would be sufficient for eMatrix but after calling them and asking about the certification of their device operators, I'd pay more for a real Dr just to be safe.

@ViceroyI understand, goto a Dr if you wish it will just be more

See, as I said many Dr's will not take on the liability of early scar treatment if your post Accutane for 6 months. You can always not tell them and request ematrix or low density laser. Or you can just wait the time to heal and treat normally after that. It's not a mistake it's a evaluation of what the Dr will and will not Do. There are only so many Dr's that are risk takers like Lim, Med Spa's don't care as much as well.

You can always do glycolic peels and alternate at home with microneedling once a month until then. Retin - A is for the redness. I would get the acne and papuals under control with a general derm before treatment as we don't want bacteria spread.

Sounds Good.

- BA

I'd suggest Dr Ronald Shelton in NYC.

On 6/13/2019 at 2:26 PM, beautifulambition said:

@ViceroyI understand, goto a Dr if you wish it will just be more

See, as I said many Dr's will not take on the liability of early scar treatment if your post Accutane for 6 months. You can always not tell them and request ematrix or low density laser. Or you can just wait the time to heal and treat normally after that. It's not a mistake it's a evaluation of what the Dr will and will not Do. There are only so many Dr's that are risk takers like Lim, Med Spa's don't care as much as well.

You can always do glycolic peels and alternate at home with microneedling once a month until then. Retin - A is for the redness. I would get the acne and papuals under control with a general derm before treatment as we don't want bacteria spread.

Sounds Good.

- BA

Hello again, so I finally set up an appointment with a Dr who I think will best suit my needs. Her website has an entire section dedicated to acne scars and has spoken about the gratification she feels when helping acne scar patients so I believe she is somewhat of a specialist. I plan on meeting her on 6/27. The website talks about the use subcision and filler as well as the following energy devices; fraxel, eMatrix and Vbeam. By the time I see her the oldest of my scars will be 4.5-5 months old and they youngest approx. 2 months. Does this sound like a sufficient arsenal of devices to treat my case (pretty much a mix of all scar types)? Some other places have many more devices but we spoke primarily about eMatrix before which she uses.