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What would help my acne scars? Help requested please

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Hello all. I suffered from severe acne during my teenage years which left me with a lot of scarring. I'm 26 years old now. First three pictures show one side and the remaining two shows the other.

My cheeks look very uneven due to large pores and scars. I also have big scars(looks like boxcar) on my temples

I went to a local dermatologist and they are suggesting me to do Ablative laser resurfacing Erbium Yag or multiple RF microneedling sessions. I'm honestly a bit scared of ablative lasers because of the downtime and my brown skin.  Just want a second opinion from someone.

Will any the following help me out? RF Microneedling, TCA Cross, Subcision, Fractional CO2 laser. Any other recommendations would be helpful as well

Thanks in advance!|::)

tagging @Sirius Lee @beautifulambition

 

 

 

 

 

Edited by scarryface
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14 minutes ago, scarryface said:

My cheeks look very uneven due to large pores and scars. I also have big scars(looks like boxcar) on my temples

These are not the best pictures, but from what I can tell, you have a combination of boxcar and rolling scars. Good news is they're minimal in severity and there aren't that many. However, you have dilated pores that makes the overall appearance blotchy and uneven.

 

43 minutes ago, scarryface said:

Will any the following help me out? RF Microneedling, TCA Cross, Subcision, Fractional CO2 laser. Any other recommendations would be helpful as well

I don't believe subcision or laser is needed.

I suggest treatments in the following order: TCA, then filler and RF microneedling. Higher concentration TCA (50% and up) will be good for smoothing the boxcar edges while lower concentration (usually 35%) will be good for enlarged pores. Once the boxcars start to look more like rolling scars, you can get dermal fillers (temporary filler initially then permanent filler) to elevate the pits. RF microneedling can also be utilized towards the end of the treatment cycle to firm up the skin even more.

Hope that helps.

 

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On 11/12/2020 at 7:56 PM, Sirius Lee said:

These are not the best pictures, but from what I can tell, you have a combination of boxcar and rolling scars. Good news is they're minimal in severity and there aren't that many. However, you have dilated pores that makes the overall appearance blotchy and uneven.

 

I don't believe subcision or laser is needed.

I suggest treatments in the following order: TCA, then filler and RF microneedling. Higher concentration TCA (50% and up) will be good for smoothing the boxcar edges while lower concentration (usually 35%) will be good for enlarged pores. Once the boxcars start to look more like rolling scars, you can get dermal fillers (temporary filler initially then permanent filler) to elevate the pits. RF microneedling can also be utilized towards the end of the treatment cycle to firm up the skin even more.

Hope that helps.

 

Using permanent fillers in conjunction with microneedling is risky. Microneedling provokes a healing response that can detect fillings as foreign bodies and form granulomas (unsightly protective scars). It's common for people to recommend microneedling without informing others of the risks present if you've had filler done. With temporary fillers, you should wait at least two weeks before needling. If you've had semi or permanent filling done, granuloma risk is present for many years. And so it stands to reason that you should do microneedling before you get permanent work done, not after.

Edited by Nick Corona
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50 minutes ago, Nick Corona said:

Using permanent fillers in conjunction with microneedling is risky. Microneedling provokes a healing response that can detect fillings as foreign bodies and form granulomas (unsightly protective scars). It's common for people to recommend microneedling without informing others of the risks present if you've had filler done. With temporary fillers, you should wait at least two weeks before needling. If you've had semi or permanent filling done, granuloma risk is present for many years. And so it stands to reason that you should do microneedling before you get permanent work done, not after.

Is that what I said? Please go back and read it again, more slowly this time.

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57 minutes ago, Nick Corona said:

"RF microneedling can also be utilized towards the end of the treatment cycle to firm up the skin even more."

Actually, yes. Maybe you should read what you wrote, not me.

Okay, so getting RF micro "towards the end of the treatment cycle" means getting the RF micro AND fillers at the same time? Nah, I don't think so. I've never said that. Plus, my main suggestion was TCA. Filler and RF micro were merely byproducts.   

Anyway, where did you come up with this granuloma idea? Stacking RF micro and Sculptra is actually a good thing. Many scientific journal have recently come out validating it.

 

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15 hours ago, Sirius Lee said:

Okay, so getting RF micro "towards the end of the treatment cycle" means getting the RF micro AND fillers at the same time? Nah, I don't think so. I've never said that. Plus, my main suggestion was TCA. Filler and RF micro were merely byproducts.   

Anyway, where did you come up with this granuloma idea? Stacking RF micro and Sculptra is actually a good thing. Many scientific journal have recently come out validating it.

 

I didn't say getting it at the same time. You didn't even read what I wrote. Getting microneedling after fillers poses a risk of the formation of granulomas. That is what I said.

Classic case of projection. You accuse me of not reading carefully, meanwhile it is you who's guilty of it.

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