Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
KRJP

Acne scarring help

Posted (edited)

Thank you.

Yes, smaller ones filled up and I don't see a dent when I look at them at the worst lighting. I'd say maybe 70% of my ice pick scars improved to the point of being even or close to even with the surrounding skin. My skin looks kind of rough now, no deep pits but not smooth either, and the scars are white in colour so that I have to wear a foundation regularly. And I still have atrophic rolling scars and some box cars..

Yes, I wouldn't trust my skin to just anybody. And I'd never try acid on my skin myself no matter what anybody says. I'd rather save for months/years than let a non-specialist near my skin.

Good luck with the treatment you should you decide to go for one. 

Edited by MihaelaP

Share this post


Link to post
Share on other sites

The scars are white? Did they become hypopigmented after the treatment?

And you said your skin looks rough now — was it smoother before?

Did you do any resurfacing treatment after TCA CROSS? 

Share this post


Link to post
Share on other sites
Posted (edited)

Yes, hypopigmentation of the treated scars. 

The skin was not smooth but scarred pitted scarring. Now the scarring isn't much visible but I'm left with 'rough skin'.

I don't trust the laser specialists in Europe - been to a paid consultation but the doctor dodged my more detailed questions and otherwise there is no account of a patient who is satisfied with him on this forum. And as a whole I haven't seen proof of lasers working for scars. Just horror stories. Disappointed with the result people.

Right now I'm saving up so that I can do the phenol peel with Dr. Rullan soon. 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
17 minutes ago, MihaelaP said:

Yes, hypopigmentation of the treated scars. 

The skin was not smooth but scarred pitted scarring. Now the scarring isn't much visible but I'm left with 'rough skin'.

I don't trust the laser specialists in Europe - been to a paid consultation but the doctor dodged my more detailed questions and otherwise there is no account of a patient who is satisfied with him on this forum. And as a whole I haven't seen proof of lasers working for scars. Just horror stories. Disappointed with the result people.

Right now I'm saving up so that I can do the phenol peel with Dr. Rullan soon. 

Lasers do work but for many people (I'd say majority) but it's not worth it in terms of money, recovery, and results.

A laser treatment can provide results but usually people always benefit from more treatments. People with lighter skin can have deeper treatments so they most likely will see better results. Lasers will probably do nothing for deep scars. Those need to be filled in first. It takes weeks to recover from lasers and lots of people don't have the downtime. If you get something like Erbium or non-ablative (worthless for scars), recovery is easier but results will probably be disappointing. 

A huge risk of going deep is that you'll end up with new scars. Sorry, that's just how it is. Some people are fine with that because the trade-off is worth it. Hyperpigmentation is definitely something to worry about if you're type III or darker. It may take several months for it to start fading so beware. 

For most atrophic scars, people should always look at other methods first: TCA/Phenol Cross, TCA peels, RF microneedlng, manual microneedling, fillers, etc.

Share this post


Link to post
Share on other sites
Posted (edited)
13 minutes ago, Amanda Hall said:

Lasers do work but for many people (I'd say majority) but it's not worth it in terms of money, recovery, and results.

A laser treatment can provide results but usually people always benefit from more treatments. People with lighter skin can have deeper treatments so they most likely will see better results. Lasers will probably do nothing for deep scars. Those need to be filled in first. It takes weeks to recover from lasers and lots of people don't have the downtime. If you get something like Erbium or non-ablative (worthless for scars), recovery is easier but results will probably be disappointing. 

A huge risk of going deep is that you'll end up with new scars. Sorry, that's just how it is. Some people are fine with that because the trade-off is worth it. Hyperpigmentation is definitely something to worry about if you're type III or darker. It may take several months for it to start fading so beware. 

For most atrophic scars, people should always look at other methods first: TCA/Phenol Cross, TCA peels, RF microneedlng, manual microneedling, fillers, etc.

Are you speaking from experience or in general, if I may ask?

It's not that I don't want lasers to work. I keep researching all kinds of lasers, keep reading personal accounts, but I find no convincing ones. (Sorry claiming you have results and not providing either photos or the name of your doctor is NOT convincing for me). 

 

But maybe I have missed the positive accounts. If you can point me to such, I'd be grateful. 

I am not well-off but with a better finantial planning and saving I could afford a laser treatment. Downtime in also no problem. I am Type I, caucasian and I've had 4 non ablative Erbium lasers when I was stupid enough to believe lasers help. It did nothing for my scars of course. Instead I ended up with more scarring due to laser-induced inflammation and the doctor denying it comes from the laser treatment!

Edited by MihaelaP

Share this post


Link to post
Share on other sites
2 minutes ago, MihaelaP said:

Are you speaking from experience or in general, if I max ask?

It's not that I don't want lasers to work. I keep researching all kinds of lasers, keep reading personal accounts, but I find no convincing ones. (Sorry claiming you have results and not providing either photos or the name of your doctor is NOT convincing for me). 

 

But maybe I have missed the positive accounts. If you can point me to such, I'd be grateful. 

I am Type I, caucasian and I've had 4 non ablative Erbium lasers when I was stupid enough to believe lasers help. Instead I ended up with more scarring due to laser-induced inflammation and the doctor denying it comes from the laser treatment!

Yes, I've done some laser treatments. I've also seen them done on YouTube with before and afters. However, these are usually not the average case - doctors always use their best results to put online.

Non-ablative lasers are almost a waste of money for atrophic scars. They are probably for really, really, really minor textural issues. Ablative lasers vaporize the tissue and causes the skin contract..... this is much more powerful than non-ablation. 

Anybody seeking to do this needs to go to someone with experience. Good treatments are device and operator dependent.

Share this post


Link to post
Share on other sites
11 minutes ago, Amanda Hall said:

Yes, I've done some laser treatments. I've also seen them done on YouTube with before and afters. However, these are usually not the average case - doctors always use their best results to put online.

Non-ablative lasers are almost a waste of money for atrophic scars. They are probably for really, really, really minor textural issues. Ablative lasers vaporize the tissue and causes the skin contract..... this is much more powerful than non-ablation. 

Anybody seeking to do this needs to go to someone with experience. Good treatments are device and operator dependent.

Can you please be more specific? "I've seen on YouTube" isn't a convincing proof. 

I've also seen some YT stories but the girls had hardly any scars to begin with. 

Share this post


Link to post
Share on other sites
Just now, MihaelaP said:

Can you please be more specific? "I've seen on YouTube" isn't a convincing proof. 

I've also seen some YT stories but the girls had hardly any scars to begin with. 

You can go to RealSelf, YouTube, or government sites to research this. Lasers are probably not for you because of your experience, and you don't have the mindset as well. I'm not saying lasers are all that wonderful and without risks. I said it's not worth it to lots of people. Ask Dudley on this forum. He will tell you that Fraxel helped him.

Share this post


Link to post
Share on other sites
Posted (edited)
1 hour ago, Amanda Hall said:

You can go to RealSelf, YouTube, or government sites to research this. Lasers are probably not for you because of your experience, and you don't have the mindset as well. I'm not saying lasers are all that wonderful and without risks. I said it's not worth it to lots of people. Ask Dudley on this forum. He will tell you that Fraxel helped him.

Well what should I say but thank you for proving my point. All you talk about is in general, no specific thread, no photos, not one satisfied scar sufferer. I've been to all those sites, spent countless hours reading everything there is to read about lasers - it's how I formed my opinion.

And please, don't direct me to DudlyDoItRight. I've asked him most politely to provide photos or just the name of his doctor, he still hasn't done this up to this day, but instead chose to play the "oh, i've suffered so much from my scars, and now you don't believe me" card. Well, guess what, we all suffer! We all don't want to shell out our hard-earned money on useless or potentially harmful treatments. The best he could do in terms of providing a thread with positive results from ANY laser was pointing to an article with burned victims, not acne scars at all. So how could I not be skeptical? I really wish lasers would work!

 

"Good treatments are device and operator dependent."

Really? Is it so? Or is this just some BS to explain why lasers don't work?? 

If good results are device dependent where are the accounts of MANY derms on Realself or here with good results from one and the same device? And why haven't we heard about it? Do you think they would fail to promote themselves there had they achieved even 50% improvement with a device? 

If good results were operator dependent where are the accounts of consistant good results from lasers by ONE doctor? But please with photo material, with publication of their good results in medical journals, with testimonials from real patients with their names. Dubious photos with obviously different lighting or taken while still microswelling is in play just don't count as reliable!

 

 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
1 hour ago, MihaelaP said:

Well what should I say but thank you for proving my point. All you talk about is in general, no specific thread, no photos, not one satisfied scar sufferer. I've been to all those sites, spent countless hours reading everything there is to read about lasers - it's how I formed my opinion.

And please, don't direct me to DudlyDoItRight. I've asked him most politely to provide photos or just the name of his doctor, he still hasn't done this up to this day, but instead chose to play the "oh, i've suffered so much from my scars, and now you don't believe me" card. Well, guess what, we all suffer! We all don't want to shell out our hard-earned money on useless or potentially harmful treatments. The best he could do in terms of providing a thread with positive results from ANY laser was pointing to an article with burned victims, not acne scars at all. So how could I not be skeptical? I really wish lasers would work!

 

"Good treatments are device and operator dependent."

Really? Is it so? Or is this just some BS to explain why lasers don't work?? 

If good results are device dependent where are the accounts of MANY derms on Realself or here with good results from one and the same device? And why haven't we heard about it? Do you think they would fail to promote themselves there had they achieved even 50% improvement with a device? 

If good results were operator dependent where are the accounts of consistant good results from lasers by ONE doctor? But please with photo material, with publication of their good results in medical journals, with testimonials from real patients with their names. Dubious photos with obviously different lighting or taken while still microswelling is in play just don't count as reliable!

 

 

It's understandable to be frustrated but you're taking it to a level to which no reasonable person wants to debate with you.  

I already told you I got laser treatment. You want my medical files to prove it? I can tell you from first-hand experience that I saw some improvement yet new scars. 

Digging up information online can be time-consuming and challenging. I did it. Maybe you're not that good with searching? Lots of tools... not just Google. Sometimes all you have to go by is biased incomplete, or scarce information. If I could go back and undo some treatments, it would be more than just laser procedures.

What's my incentive to defend lasers? I already told you multiple times that it has risks (new scars and hyperpigmentation), is expensive, and has stupid recovery times. I'm not a doctor. I'm not selling you laser treatment. All I'm doing is helping other members here and you're not helping. 

Maybe Dudley is busy or thinks you're annoying so he won't send photos. 

I fully agree that doctors will tell you good results but that's hard to prove. That goes with every treatment. That's why there's this forum, YouTube, and Google. I thought microneedling would help a lot but it didn't. Am I going to tell every YouTube person that they're wrong? No, I'll just write about my experience here and share with members what my results are.

 

Share this post


Link to post
Share on other sites
Posted (edited)
23 minutes ago, Amanda Hall said:

It's understandable to be frustrated but you're taking it to a level to which no reasonable person wants to debate with you.  

I already told you I got laser treatment. You want my medical files to prove it? I can tell you from first-hand experience that I saw some improvement yet new scars. 

Digging up information online can be time-consuming and challenging. I did it. Maybe you're not that good with searching? Lots of tools... not just Google. Sometimes all you have to go by is biased incomplete, or scarce information. If I could go back and undo some treatments, it would be more than just laser procedures.

What's my incentive to defend lasers? I already told you multiple times that it has risks (new scars and hyperpigmentation), is expensive, and has stupid recovery times. I'm not a doctor. I'm not selling you laser treatment. All I'm doing is helping other members here and you're not helping. 

Maybe Dudley is busy or thinks you're annoying so he won't send photos. 

I fully agree that doctors will tell you good results but that's hard to prove. That goes with every treatment. That's why there's this forum, YouTube, and Google. I thought microneedling would help a lot but it didn't. Am I going to tell every YouTube person that they're wrong? No, I'll just write about my experience here and share with members what my results are.

 

All I did was ask for an example of good results of lasers specifically, not in general. I didn't receive anything specific. Again. 

No need for you to be condescending,  I'm perfectly capable of doing a thorough scientific research, thank you very much. :-))

But interestingly, the researches you've done cannot seem to find a single convincing example of good results from lasers! Otherwise why not just point it out? 

I'm not disputing you've seen some results from lasers, but the question is what kind of scars you have, if it's very minor, more like textural issues/ anti-aging then yes, of course, but those are not real scars.

And Dudly didn't provide any proof of results, because he can't not because I'm annoying. I kindly asked twice. :-))

i have no intention of debating lasers with you. Sometimes I just get angry with how unscrupulous doctors take advantage of the hopes and the lack of information of scar sufferers, that's all. I wish somebody had told be think twice before I had the laser. 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
8 minutes ago, MihaelaP said:

All I did was ask for an example of good results of lasers specifically, not in general. I didn't receive anything specific. Again. 

No need for you to be condescending,  I'm perfectly capable of doing a thorough scientific research, thank you very much. :-))

But interestingly, the researches you've done cannot seem to find a single convincing example of good results from lasers! Otherwise why not just point it out? 

I'm not disputing you've seen some results from lasers, but the question is what kind of scars you have, if it's very minor, more like textural issues/ anti-aging then yes, of course, but those are not real scars.

And Dudly didn't provide any proof of results, because he can't not because I'm annoying. I kindly asked twice. :-))

i have no intention of debating lasers with you. Sometimes I just get angry with how unscrupulous doctors take advantage of the hopes and the lack of information of scar sufferers, that's all. I wish somebody had told be think twice before I had the laser. 

If you can't find examples of results, then don't get laser treatment. It's as simple as that. Some people like me have to go by reviews on RealSelf, YouTube videos, and forums. Sometimes that's all we have. We also have to have some hope too. At the same time, we should all be informed of the risks. Lots of before and after photos are touched up or Photoshopped. They are also the best results. Maybe the doctors are deceiving and using angled lighting. Who knows? That's all we have. You have the choice to get laser treatment or not. Most people here already know about laser risks and say that lasering should be the last thing to do because it's not safe.

Dudley could be lying for all we know. He might not even have done any treatments. You just have to go with your gut instinct sometimes. That's just the reality. 

We all agree doctors are corrupt and are money hungry. Does that mean I'm not going to get any treatments done? No. I don't like some of my scars and want them fixed so I will keep doing research and taking chances. If something doesn't work, write a review, pout, and move on. 

Share this post


Link to post
Share on other sites
Posted (edited)
44 minutes ago, Amanda Hall said:

If you can't find examples of results, then don't get laser treatment. It's as simple as that. Some people like me have to go by reviews on RealSelf, YouTube videos, and forums. Sometimes that's all we have. We also have to have some hope too. At the same time, we should all be informed of the risks. Lots of before and after photos are touched up or Photoshopped. They are also the best results. Maybe the doctors are deceiving and using angled lighting. Who knows? That's all we have. You have the choice to get laser treatment or not. Most people here already know about laser risks and say that lasering should be the last thing to do because it's not safe.

Dudley could be lying for all we know. He might not even have done any treatments. You just have to go with your gut instinct sometimes. That's just the reality. 

We all agree doctors are corrupt and are money hungry. Does that mean I'm not going to get any treatments done? No. I don't like some of my scars and want them fixed so I will keep doing research and taking chances. If something doesn't work, write a review, pout, and move on. 

What do you think I am doing by writing to you or to Dudley? My goal is not tp pout. I'm trying to see if there isn't some positive hopeful results from lasers after all as you so passionately speak in favour of them. Actually I'd be happy if lasers worked for real acne scarring. But sadly, neither Dudley, or you can point to a single example, just write in general. 

Yeah, hope is the most important. However, you also have to face reality, because the majority of those who've tried lasers regret it and there are many other treatments to be done for a fraction of the laser price. So I'd like to be informed and realistic, not just obliviously hopeful. 

 

Edited by MihaelaP

Share this post


Link to post
Share on other sites

Thank you for your response, MihaelaP.

Amanda, could you tell me more about your experience with Phenol CROSS? Was it painful? What was the downtime like? I know you said the 2nd treatment led to your scars getting worse. After the 1st treatment, how long was it before you saw real improvement, and how much better would you say it looked?

I know that all of these results are highly case dependent.

I'm still waiting to hear back from Dr. Rullan.

Also, does anyone else have examples of ethical doctors they would recommend in the U.S? I'm also interested in recommendations for Singapore and Australia (aside from Dr. Lim) -- both of those locations are geographically more convenient right now as well.

Share this post


Link to post
Share on other sites

This laser "thing" is really weird, many people claim they have good results, there are probably 100 000 lasers done per year, of course then theres chance there will be always some % unhappy with results, 

Drs like Davin Lim claim they use lasers all the time in scar revision and still its hard to find good results, its weird.

Share this post


Link to post
Share on other sites
3 hours ago, MihaelaP said:

What do you think I am doing by writing to you or to Dudley? My goal is not tp pout. I'm trying to see if there isn't some positive hopeful results from lasers after all as you so passionately speak in favour of them. Actually I'd be happy if lasers worked for real acne scarring. But sadly, neither Dudley, or you can point to a single example, just write in general. 

Yeah, hope is the most important. However, you also have to face reality, because the majority of those who've tried lasers regret it and there are many other treatments to be done for a fraction of the laser price. So I'd like to be informed and realistic, not just obliviously hopeful. 

 

We're all here to help each other. We have the right to complain to some extent but let's not lose sight of the fact that our goal is to share information to the community.

You've said a few times that there's no proof. Dudley wrote many times on this forum about his experience. I just told you about mine. We don't have proof but does that mean we didn't get treatment? I got treatment. No, I don't have photos because I didn't take any of individual scars. I used my own eyes. 

I saw improvement with some scars. One of my small crater ones was smoothed out because the shoulders of the scar was flattened. A linear scar was treated as well and it had less of a divot. The laser didn't work for a lot of other scars and I got side effects. 

You don't have to believe any of us. There are studies out there that document effectiveness (and lack of) for lasers. It's up to you to decide. You've already been informed and you don't think lasers work. So why harp on it? Tell your story to our members, don't get a laser treatment in the future, and move on to the next topic. 

For people who want to know more details about lasers, they are welcome to post about their concerns and people who have knowledge or experience can contribute.

33 minutes ago, KRJP said:

Thank you for your response, MihaelaP.

Amanda, could you tell me more about your experience with Phenol CROSS? Was it painful? What was the downtime like? I know you said the 2nd treatment led to your scars getting worse. After the 1st treatment, how long was it before you saw real improvement, and how much better would you say it looked?

I know that all of these results are highly case dependent.

I'm still waiting to hear back from Dr. Rullan.

Also, does anyone else have examples of ethical doctors they would recommend in the U.S? I'm also interested in recommendations for Singapore and Australia (aside from Dr. Lim) -- both of those locations are geographically more convenient right now as well.

Phenol Cross was not painful for me. There was no numbing whatsoever. Sometimes the application stung but it was a minor sensation. Pain should not even be considered unless you have alien skin that's paper thin or something.

The downtime is a concern especially if you work with people. Scabs came off my face in 4-5 days. Please don't pick at them or peel them too early! The scabs are dark so they will be noticeable. After my scabs came off, my face was left with red/pink marks that took another week to really lighten up. Tinted moisturizer helps. I believe you can put on makeup if your wounds are healed but I'm not a dermatologist.

I didn't see noticeable improvement after my first time but I knew in advance that it would take multiple treatments. I went to see Dr. Rullan again and he treated some of the same spots and some different ones. One ice pick like scar looked much worse initially but took 6-8 weeks to look normal or a little better. Another crater-like scar seemed to be shallower even if it was only very slightly or due to my hopeful demeanor. The ones that got worse were flatter boxcar scars with no sharp boundaries.

Singapore seems to be churning out a lot of scar treatment media online. I see doctorxdentist.com come up a lot through searches - it's like RealSelf. Lots of doctors seem to be doing more focused scar treatment so that's good news. Not sure if it's all hype they're talking about so please do your research.

Share this post


Link to post
Share on other sites
1 hour ago, Amanda Hall said:

Phenol Cross was not painful for me. There was no numbing whatsoever. Sometimes the application stung but it was a minor sensation. Pain should not even be considered unless you have alien skin that's paper thin or something.

The downtime is a concern especially if you work with people. Scabs came off my face in 4-5 days. Please don't pick at them or peel them too early! The scabs are dark so they will be noticeable. After my scabs came off, my face was left with red/pink marks that took another week to really lighten up. Tinted moisturizer helps. I believe you can put on makeup if your wounds are healed but I'm not a dermatologist.

I didn't see noticeable improvement after my first time but I knew in advance that it would take multiple treatments. I went to see Dr. Rullan again and he treated some of the same spots and some different ones. One ice pick like scar looked much worse initially but took 6-8 weeks to look normal or a little better. Another crater-like scar seemed to be shallower even if it was only very slightly or due to my hopeful demeanor. The ones that got worse were flatter boxcar scars with no sharp boundaries.

Singapore seems to be churning out a lot of scar treatment media online. I see doctorxdentist.com come up a lot through searches - it's like RealSelf. Lots of doctors seem to be doing more focused scar treatment so that's good news. Not sure if it's all hype they're talking about so please do your research.

In your personal opinion, is it possible for my scarring to be reduced to the point where it's almost completely invisible, provided I heal well? Or is that a pipe dream?

Is Phenol CROSS normally performed for 4-6 sessions like TCA CROSS? I also saw online that phenol can have side effects like cardiotoxicity (!), and I want to know more about the context for that. I've also read that TCA leads to scars looking much deeper at first before they improve -- at least in the cases where it works well. Is Phenol exactly the same in that respect? (You mentioned that one icepick scar looked worse, but I'm curious about the other icepick scars, if you had any.)

I've heard that Phenol tends to cause less hypopigmentation, which is good.

Share this post


Link to post
Share on other sites
Posted (edited)

@KRJP you're welcome

@Amanda Hall 

Yes, as I wrote above my goal is not to pick on you or somebody else but to ask for information, share my experience, discuss and compare. We are all in the same boat..

It's not that I don't believe you or Dudley, I've said that before, but acne scarring and improvement are subjective so I ask for objective reports / proof. Do you mind sharing what laser you had, the number of treatments and the name of your doctor? In dm if you prefer. Even though it seems you've got minimal improvement only on linear scars and one small one. It would be nice to be specific about those studies with the effectiveness or with a thread. It's all I ask. 

I've been a lurker on this forum for 10 years now and most laser threads are about orange skin, or other side effects, or abandoned threads. 

If lasers were so effective why aren't there reports by doctor on Realself showing those good results? Doctors go on Realself to promote their work, right? Why not do it if they have achieved good results? 

When it was clear that TCA cross started working for me at the last appointment it was the clinic not me that suggested let's take pictures. My brother also told me that he doesn't know what the dr did, but he transformed my face and I know my brother wouldn't lie to me. That's why I'm saying that TCA CROSS works. 

I believe we are on the same page with lasers, I'm just not so easily convinced and want to see proof of effectiveness, not just do invasive procedures on good faith.  

Edited by MihaelaP

Share this post


Link to post
Share on other sites

This guy had quite good results from laser treatments, combined with subcision 

 

Share this post


Link to post
Share on other sites
Posted (edited)
1 hour ago, Miro said:

This guy had quite good results from laser treatments, combined with subcision 

 

I know Ernesto's story, who doesn't? 

He posted an after photo some time after the procedure and then disappeared in thin air leaving us all asking for an update almost every year since then. So he never cared to give an update whatsoever, we don't know if he had good results 3-6 months post procedure. He promised us more photos but never delivered.

The doctor who treated him, Dr. Khan in Harley Street in London, wasn't able to replicate this supposed success story, on his website he didn't post any other scar improvement results but Ernesto's. Bear in mind we don't know when the post photo was taken, or how it was taken, if it wasn't too soon. For Fraxel Re:Pair it takes many weeks, months for the microswelling and the redness to subside because the laser is so invasive. That's the reason why you assess progress at the 3rd month or 6th month post procedure, everything earlier is not an objective result.

As far as I remember, nobody else on this forum who went to see Dr Khan after Ernesto reported any success, on the contrary all were disappointed. 

Dr Khan himself isn't even a dermatologist, he doesn't have the qualification doctor of dermatology or plastic surgeon. When I checked his credentials, he previously owned a general practitioner office, i'm not sure if he even has that medical qualification! His linkedin account doesn't state this explicitely. That's why I never booked a consultation with him.

Recently someone posted Ernesto's Instagram account and he seems to be doing really well which makes me only happy. But I took a closer look at his photos and at worse lighting you can still very much see extensive disfiguring scarring on both his cheeks and temples. Bear in mind that this is Insta so you can add filters or post just more flattering photos, or he could have had other treatments in the meantime like fillers, etc and he still had the disfiguring scarring. 

All this makes me skeptical about Ernesto's success story, but everybody is free to make up their own mind. 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
2 hours ago, MihaelaP said:

I know Ernesto's story, who doesn't? 

He posted an after photo some time after the procedure and then disappeared in thin air leaving us all asking for an update almost every year since then. So he never cared to give an update whatsoever, we don't know if he had good results 3-6 months post procedure. He promised us more photos but never delivered.

The doctor who treated him, Dr. Khan in Harley Street in London, wasn't able to replicate this supposed success story, on his website he didn't post any other scar improvement results but Ernesto's. Bear in mind we don't know when the post photo was taken, or how it was taken, if it wasn't too soon. For Fraxel Re:Pair it takes many weeks, months for the microswelling and the redness to subside because the laser is so invasive. That's the reason why you assess progress at the 3rd month or 6th month post procedure, everything earlier is not an objective result.

As far as I remember, nobody else on this forum who went to see Dr Khan after Ernesto reported any success, on the contrary all were disappointed. 

Dr Khan himself isn't even a dermatologist, he doesn't have the qualification doctor of dermatology or plastic surgeon. When I checked his credentials, he previously owned a general practitioner office, i'm not sure if he even has that medical qualification! His linkedin account doesn't state this explicitely. That's why I never booked a consultation with him.

Recently someone posted Ernesto's Instagram account and he seems to be doing really well which makes me only happy. But I took a closer look at his photos and at worse lighting you can still very much see extensive disfiguring scarring on both his cheeks and temples. Bear in mind that this is Insta so you can add filters or post just more flattering photos, or he could have had other treatments in the meantime like fillers, etc and he still had the disfiguring scarring. 

All this makes me skeptical about Ernesto's success story, but everybody is free to make up their own mind. 

Truth is he never did take after photos under same lightning as before photos, so this is weird, I saw his instagram improvement is there , but as u said u can clearly see scars are quite noticable 

Share this post


Link to post
Share on other sites
Posted (edited)
1 hour ago, Miro said:

Truth is he never did take after photos under same lightning as before photos, so this is weird, I saw his instagram improvement is there , but as u said u can clearly see scars are quite noticable 

He didn't? I don't remember. Anyways, I'm not impressed with these lasers at all.

I'm looking into the phenol peel with Dr. Rullan for the 'resurfacing'. Hopefully next year if everything goes well. 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
Posted (edited)

@MihaelaP @Amanda Hall

https://www.semanticscholar.org/paper/Ablative-non-fractional-lasers-for-atrophic-facial-Lee-Kang/8d3ac44e981030281e9da993bad07b720493c494

This is an article where they treated Asians (Fitzpatrick 3-5) with fully ablative Erbium laser. Same Angle and Lighting and it doesn't seem to be photoshopped. The after pictures were taken 6 months post-op - seems to be accurate since the skin does look fully healed. Is the skin scar-free? No, but those are very good results. Obviously they probably did take the most amazing transformations but this is proof. I would like to know how you guys feel about this article, maybe I'm buggin.

I would like to bring light/ mention a couple of things:

Way more people are being treated with lasers than people think. A lot of people don't visit these sites nor do they know of their existence. Are these people with real scarring? Probably yes and no.

I don't really like realself anymore but there are A LOT of pictures on there. You can look up certain doctors and go to "Pictures" on their profile and filter by treatment. Or look up "Acne scars" and go to Pictures. There are a lot of pictures and I believe some are manipulated by angle/lighting mosty, less photoshop.BUT doctors online lie about all the treatments they have used on a patient. They say "Results from laser" but patient has also received fillers etc.. On top of that they don't specify which laser nor how many sessions. This goes for realself specifically.

Also on realself a lot of negative laser reviews are from people who are a bit delusional, not going to lie. There are a lot of women in their 40-60s and have gotten treatment for wrinkles. They go on there crying about how they have gotten worse skin but the problem is: The before picture they use is always in amazing lighting far away from the camera and the after is a picture in which they make weird faces, super close to the camera to accentuate wrinkles and such + bad lighting. Of course it will look worse. People will be convinced that the treatment has gone bad and actively look for the worsening of skin to prove their point. Now this is not specifically about acne scars but people and their treatments in general wether it's a skin treatment or not.                                                                       I hope you guys understand what I'm trying to say.

In addition, people who've had bad experiences are always the louder ones and, more likely, are the ones who will make posts about their experiences. I've had heard stories about friends of friends who got xyz treatments and are happy (not acne scar specific).... without the internet ever knowing about it.

I'm not saying that there are not actual bad laser results. 100% they exist... I'm just trying to bring some context.

The only way to truly know if laser is for you is to do it. In my humble opinion, I would suggest to anyone to get a PATCH TEST with the desired settings to see how your skin reacts. Smaller treated areas also heal faster. I will probably do this as well.

Lastly, I am kind of annoyed that we never get information about treatment settings... depth in microns, the energy in joules and the density.... That would be objective information that could help to understand why or why not treatment was successful...

Edited by SaraTheGerman

Share this post


Link to post
Share on other sites
Posted (edited)

@SaraTheGerman

Thank you very much for this study on the fully ablative Erbium YAG for acne scarring. That's what I am looking for. I do not spend 24/7 on this board nor on researching doctors/ treatments so there are things that maybe I've missed. I only log on from time to time to try and catch up. I know the technology develops and is not what it was 10 years ago so I don't want to rule any treatment option out, I'm just looking for reliable evidence that a certain treatment works.

At first glance of the abstract, the study seems interesting, especially if they got statistically significant results. The sample of 22 patients is small, though. And side effects of 20% inflammation with potential new scarring is high. I couldn't read the whole study though. It's not available to the broad public. Do you get full access? Can you maybe post some of the pics here in comparision so that we all can see. And the technical details as well. What settings brought those good results about? 

You bring some very good points. Of course not everybody who has posts about lasers here or on realself, and those with bad results seem to be more vocal.

 

But 1.) Where should we look for information and advice if not on these boards?

2.) You know what I'm wondering? Ok. Let's assume derms treat lots of people, get good results from lasers and those happy and lucky patients just go on with their lives. How come there are so little before/after photos showing the improvement then? I've seen my fair share of derms/ plastic surgeons and most say no, we don't have b/a pics, if they show you some it's a case of different angles/ lighting most of the time. I'm asking when there are so many happy patients where are the photos? Is it so difficult to shoot some? Even those specialists who treat scars exclusively/predominantly don't boast decent before/afters. Why?? 

You said it yourself that often times doctors use multiple treatments to get a decent b/a photo and present them as post laser. What does that tell you? 

Your point about the technical details and the settings of laser is very spot on. I've spent countless hours to read every thread here on lasers and to study the different laser types, settings: intensity(energy), density, depth of the needle penetration so that I can UNDERSTAND which laser is going to give me the best improvement. Dr Lim's videos helped me a lot with that too to be honest.

But what happens when I ask a question about the technical details at a consultation. I am told not to worry, that they know their sh^t and practically every laser will give me results in the right hands. Sorry! Not good enough. Of course I wouldn't follow through with the treatment.

The cherry at the top was at one derm's office they refer to their laser as the fractional laser. What kind of laser it is - ablative, non-ablative, which firm produced it, they do not like to disclose and get annoyed when I ask further questions about it.

Tell me please how should I not be skeptical? 

So the suggestion Just Do It isn't an option for me. The idea of a patch test is a good one though. Should I find a laser specialist that seems reliable I will ask them definitely for a patch test. 

 

 

Edited by MihaelaP

Share this post


Link to post
Share on other sites
3 hours ago, SaraTheGerman said:

@MihaelaP @Amanda Hall

https://www.semanticscholar.org/paper/Ablative-non-fractional-lasers-for-atrophic-facial-Lee-Kang/8d3ac44e981030281e9da993bad07b720493c494

This is an article where they treated Asians (Fitzpatrick 3-5) with fully ablative Erbium laser. Same Angle and Lighting and it doesn't seem to be photoshopped. The after pictures were taken 6 months post-op - seems to be accurate since the skin does look fully healed. Is the skin scar-free? No, but those are very good results. Obviously they probably did take the most amazing transformations but this is proof. I would like to know how you guys feel about this article, maybe I'm buggin.

I would like to bring light/ mention a couple of things:

Way more people are being treated with lasers than people think. A lot of people don't visit these sites nor do they know of their existence. Are these people with real scarring? Probably yes and no.

I don't really like realself anymore but there are A LOT of pictures on there. You can look up certain doctors and go to "Pictures" on their profile and filter by treatment. Or look up "Acne scars" and go to Pictures. There are a lot of pictures and I believe some are manipulated by angle/lighting mosty, less photoshop.BUT doctors online lie about all the treatments they have used on a patient. They say "Results from laser" but patient has also received fillers etc.. On top of that they don't specify which laser nor how many sessions. This goes for realself specifically.

Also on realself a lot of negative laser reviews are from people who are a bit delusional, not going to lie. There are a lot of women in their 40-60s and have gotten treatment for wrinkles. They go on there crying about how they have gotten worse skin but the problem is: The before picture they use is always in amazing lighting far away from the camera and the after is a picture in which they make weird faces, super close to the camera to accentuate wrinkles and such + bad lighting. Of course it will look worse. People will be convinced that the treatment has gone bad and actively look for the worsening of skin to prove their point. Now this is not specifically about acne scars but people and their treatments in general wether it's a skin treatment or not.                                                                       I hope you guys understand what I'm trying to say.

In addition, people who've had bad experiences are always the louder ones and, more likely, are the ones who will make posts about their experiences. I've had heard stories about friends of friends who got xyz treatments and are happy (not acne scar specific).... without the internet ever knowing about it.

I'm not saying that there are not actual bad laser results. 100% they exist... I'm just trying to bring some context.

The only way to truly know if laser is for you is to do it. In my humble opinion, I would suggest to anyone to get a PATCH TEST with the desired settings to see how your skin reacts. Smaller treated areas also heal faster. I will probably do this as well.

Lastly, I am kind of annoyed that we never get information about treatment settings... depth in microns, the energy in joules and the density.... That would be objective information that could help to understand why or why not treatment was successful...

I agree with everything Sara said. 

RealSelf is getting worse. Honestly, I think you can Google better information. However, it's a good starting point and does provide ideas on what treatments are out there.

Yes, doctors manipulate photos! They want money. They exaggerate results. But we're in a bind and we just have to hope we can get a percentage of these results. Also beware of pictures taken weeks after laser treatment - there is still microswelling so people's skin looks a little better (scars look less atrophic).

As I've said, I don't believe the majority people will be satisfied with laser treatment. But that doesn't mean it doesn't work for some people. Based on my online research, I think lasers have a low success rate. However, if you want to get rid of your scars, you're probably going to take that chance. Am I right?

Treatment settings would be great except I don't know if all doctors will provide that. 

12 hours ago, KRJP said:

In your personal opinion, is it possible for my scarring to be reduced to the point where it's almost completely invisible, provided I heal well? Or is that a pipe dream?

Is Phenol CROSS normally performed for 4-6 sessions like TCA CROSS? I also saw online that phenol can have side effects like cardiotoxicity (!), and I want to know more about the context for that. I've also read that TCA leads to scars looking much deeper at first before they improve -- at least in the cases where it works well. Is Phenol exactly the same in that respect? (You mentioned that one icepick scar looked worse, but I'm curious about the other icepick scars, if you had any.)

I've heard that Phenol tends to cause less hypopigmentation, which is good.

Realistically, I don't think they will be nearly invisible. For me, I'm trying to get them to a point where I'm comfortable with them. If your scars are really shallow, then maybe in the right lighting you will barely see the scars.  

Yes, Phenol Cross is like TCA Cross in that multiple procedures will get you further improvement theoretically. I haven't heard anything about cardiotoxicity and I don't think any patient really pays attention to that. I'll happily trade cardiotoxicity for improved scars. Both TCA and Phenol will make your scars look worse for the first several weeks. The redness optically makes your scars look more noticeable and deeper. The scars could very well be deeper but the collagen takes time to build up. 

I only had a few ice pick scars. One improved slightly and the other (not sure if it's an ice pick or boxcar) seemed to get better. People here say ice pick scars are the best ones to get treated with TCA/Phenol.

I can't comment on hypopigmentation because I didn't get any but that's good news if it's true.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes


×