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Luckyelephant

Old acne scarring in indian male

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Hi all,

I think it is fantastic how an online community exists solely to advise and help each other out with this terrible disease! I have read the stickies on general scar advice but I would be extremely grateful if any experienced member could advise me further.

 

I am a 26 indian male living in the UK. I have had terrible cystic acne from 13-17 and eventually started Accutane which worked miracles. I’ve been lucky and relatively acne-free since Accutane but the scars persist. The hyperpigmentation has mostly faded.

I am not looking for a quick fix, I am not looking for expensive treatments. I am very realistic and am looking to improve the general appearance of my skin, soften the scars and even the tone. My research suggests topical retinol and peels would be helpful but I do not want anything too drastic! 

 

Thank you for reading and I look forward to some advice!! DCEADCEF-D596-468B-A552-7BF4F821C39D.jpeg.2f4534e6871a1eba008c663e0345d4bd.jpeg53822A1B-ED46-4DB9-AC75-E0A2127B5A73.jpeg.f5d8056652aa8b4c41e7aba4368fb512.jpeg

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@Luckyelephant Hi there, thanks for including your pictures helpful

You have lots of boxcars, icepicks, and surface issues, and some hyperpigmentation.

You have a few options, one is to see Dr Anil who is in the UK, he is more generalized. The other is to see Dr H consults in the UK, ... he uses energy devices more and is more aggressive, and the ever popular Dr Emil in Denmark a cheap Ryanair flight away is who many see.

I gave you a full plan below, everything is optional. Some only do one or two Dr's treatments a year. As you stipulated cost you will be doing a majority of peels monthly and Derminator (Google it) at home, alternating monthly between your Dr's treatments. TCA Cross is cheap though and subcision. You will reach a point with box cars that if you do not do energy devices (We do this at the end of treatment), then results will be limited.

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 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.
* TCA Cross for icepicks can be done at the same time as subcision

* 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 your box cars were non responding, you could find a plastic suergon who does punch float or punch excision and do that if you so wish.

* For texture we lastly do a fully ablative laser resurfacing. Or OR several TCA peels. 

* 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 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.

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.

 

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