Hi. This is my first time here. I have suffered from mild acne since I was 12, however, my mild acne has gotten worst when I was 19. (about 5 years ago). My first episode of severe acne lasted for 7 months and subsided after I had 3 chemical peels. About 2 years later, my acne came again but this time much more worst. I had never been on accutane. After some thorough readings and derm visits and countless youtube videos, I decided to start using tretinoin. My acne cleared up in 4 months time. Totally cleared up. And I am so glad, but before starting this tretinoin journey I have made extensive research. Now, I am left with scarrings.
In this past I have had (AFTER MY FIRST SEVERE ACNE EPISODE):
- 2 subcisions
- 1 deep chemical peel
I have seen slight improvement. I am not concerned with Post-inflammatory erythema as my PIE would normally last up until 3-4 months. My biggest concern is my rolling scars and few box scars. Can anyone suggest me which treatment/lasers that are suitable for my type of acne scarring? I am not expecting 100% result. A 60-70% result is enough to make me happy. Aside from my rolling scars I am suffering from large pores at the side of my nose area. Otherwise, my temple and forehead areas are pretty scars-free. And if I were to do lasers that tighten my skin would it help to reduce the severity of acne scars? ( as when I pulled and tighten my skin I do realize my scars were improving)
As for my skincare regime, I am currently using, a sunscreen with SPF 50 PA ++++, mild cleanser, cerave moisturizer cream, tretinoin 0.5%. Is there anything else that could help with pores/scarring tho I am much aware topical medication could not help with scarring.
p/s: My acne scarings look a little bit more worst in real life as I am capturing using iphone5s, hence the low resolution picture
Thank you
The only thing I see with your case is not scarring, but PIE or redness, it's concerning that it's wide spread over your face. Do you have Roscaea? You need several Pulse Dye Laser sessions.
I do see a bit of textural issues and you can do fully ablative laser resurfacing -erbium as that is the main issue or you can do your deep peel. Please be aware in your ethnic type you will have issues with a strong treatment. Goto someone very experienced, ask for pictures. You need to start nightly prep now niacinamide, tretinorin, and something like the pca hydroquinone free pigment gel. Susncreen. It also concerns me the inflamed nature of your face. Have you tried something like Nizoral shampoo or sulfur wash, it almost looks like fungal acne. You look like you have wide spread comedones and PIE or irritation.
I don't see the need for subcision, no pits?
Where are the box cars, ... perhaps you provided a picture that is not accurate, I don't see any. I need to see the shadow your scars make with a flashlight, then perhaps you would need subcision, I don't see it.
The resolution of the pictures does not matter, ... I need to see shadows using a flashlight or directional light, not a flash" type" picture.
I can further address a plan when I see new pictures, otherwise you have very slight textural scarring.
On 8/15/2019 at 6:43 AM, beautifulambition said:The only thing I see with your case is not scarring, but PIE or redness, it's concerning that it's wide spread over your face. Do you have Roscaea? You need several Pulse Dye Laser sessions.
I do see a bit of textural issues and you can do fully ablative laser resurfacing -erbium as that is the main issue or you can do your deep peel. Please be aware in your ethnic type you will have issues with a strong treatment. Goto someone very experienced, ask for pictures. You need to start nightly prep now niacinamide, tretinorin, and something like the pca hydroquinone free pigment gel. Susncreen. It also concerns me the inflamed nature of your face. Have you tried something like Nizoral shampoo or sulfur wash, it almost looks like fungal acne. You look like you have wide spread comedones and PIE or irritation.
I don't see the need for subcision, no pits?
Where are the box cars, ... perhaps you provided a picture that is not accurate, I don't see any. I need to see the shadow your scars make with a flashlight, then perhaps you would need subcision, I don't see it.
The resolution of the pictures does not matter, ... I need to see shadows using a flashlight or directional light, not a flash" type" picture.
I can further address a plan when I see new pictures, otherwise you have very slight textural scarring.
Thank you for your reply. I do not have rosacae but I do suffer from sensitivity. These are some new photos that I have taken. I hope you can further address a plan for me 
regarding any skin issues that you think I might be having. A for the fungal acne, I do think I have slight fungal acne but I do not know how to treat it. I just bought a 10% sulphur soap hoping it would works,
