Hello everyone again. The last time I posted here I only had a few scars. It has been 5 months and I have had many scars. I am very sad. I did everything to stop pimples, but I could not stop them from leaving scars. I have been using Rouccutane for 1 month.
Currently, my boxcar and pick scars are intense. I think they are pick scar, not ice pick. I also have light rolling scars.
I have dark skin (skin type IV). 26 years old. Do you think non-ablative lasers (Icon) + subcision + prp is a suitable treatment?
I have received 3 Scarlet Rf treatments in the last 5 months, but I have not seen any effect.
My doctor told me that fractional co2 lasers are not suitable for my skin. But Dr. Lim explained that he was practicing on his last insatram post. What are you thinking? So many questions, but I feel sad, psychologically exhausted. I don't want to go outside in daylight. Please share your experiences.
Can we see your scars? When taking pictures, consider the following instruction.
Angled lighting is an approach used to create a heavy shadow that will accentuate the scar for better evaluation as shown below. This is done by pointing a bright light perpendicular (90-degree) to the angle of the lens. See below.
Also don't shoot so close that it only shows the cheek. Try to include other parts of the face (eg. nose, mouth and/or ear). This will give better perspective of the scar size.
Since there is no proper lighting, I can shoot this much with the phone. There are denser marks on my right side, there are structural distortions. Less on my left cheek.
Since it has sunscreen, my skin color looks lighter.
Help me to improve what I can do.
I cannot find a doctor who does TCA cross in the country where I live. What other treatments can help?
11 hours ago, colorful said:Since there is no proper lighting, I can shoot this much with the phone. There are denser marks on my right side, there are structural distortions. Less on my left cheek.
You don't have another phone laying around?
Anyway, before you can start a treatment, you must get your acne (especially cystic acne)under control. Accutane (isotretinoin) or Retin-A (tretinoin) is probably the best.
There are many treatments other than TCA. Your scars look pretty shallow, so you have many choices to choose from. But get those acne cleared up first.
Hello, I have been using Accutane for 3 months (30mg). Another doctor I went to today recommended radiofrequency therapy and fractional ablative erbium laser to treat my cystic acne.
What do you think about using Radiofrequency + erbium laser + Accutane?
She also said that she can do fractional CO2 laser for scars after my acne is completely gone. But first she had to dry the acne and she said that the erbium laser would be good for my scars too.
The doctor said she could do TCA cross or Phenol for my icepick scars.
Your feedback is important to me, thanks.
On 1/14/2021 at 3:12 PM, Sirius Lee said:You don't have another phone laying around?
Anyway, before you can start a treatment, you must get your acne (especially cystic acne)under control. Accutane (isotretinoin) or Retin-A (tretinoin) is probably the best.
There are many treatments other than TCA. Your scars look pretty shallow, so you have many choices to choose from. But get those acne cleared up first.
Yes, control your acne first.
A lot of what you have is erythema or redness. This makes things look worse. Most of your scars really aren't that deep which is a great thing.
I usually don't recommend microneedling but since your scars look shallow, you can give it a shot. There are a few areas where TCA Cross would help. Lasers are the end would be something I'd consider - only if your doctor knows what he/she is doing.
23 hours ago, colorful said:Hello, I have been using Accutane for 3 months (30mg). Another doctor I went to today recommended radiofrequency therapy and fractional ablative erbium laser to treat my cystic acne.But first she had to dry the acne and she said that the erbium laser would be good for my scars too.
Is the Accutane not working? You should note some people experience purging that makes their acne worse in the beginning. It can also take up to 4-5 months to clear up acne.
However, I don't understand what you mean by "dry the acne". That's what Accutane is for. If you're experiencing flare-ups, I suggest you apply hydrocortisone cream to bring the inflammation down.
At any rate, you have to treat cystic acne BEFORE getting RF or laser.Otherwise, you'll end up with more scars.
11 hours ago, Amanda Hall said:A lot of what you have is erythema or redness. This makes things look worse. Most of your scars really aren't that deep which is a great thing.
I tried to shoot it clearly with a better angle. I hope it was clearer.
11 hours ago, Sirius Lee said:However, I don't understand what you mean by "dry the acne". That's what Accutane is for. If you're experiencing flare-ups, I suggest you apply hydrocortisone cream to bring the inflammation down.
Yes I know Accutane is for that, and I told the doctor that. Rf and erbium laser can work to control acne before any more scarring, she said. At first, she did Rf and fractional ablative Erbium with Accutane and suggested fractional CO2 when the acne outbreak stopped. In addition, she said he could make TCA cross or phenol to the remaining traces. How will it affect my skin type and scar types? I uploaded new updated photos.
42 minutes ago, colorful said:Yes I know Accutane is for that, and I told the doctor that. Rf and erbium laser can work to control acne before any more scarring, she said. At first, she did Rf and fractional ablative Erbium with Accutane and suggested fractional CO2 when the acne outbreak stopped. In addition, she said he could make TCA cross or phenol to the remaining traces. How will it affect my skin type and scar types? I uploaded new updated photos.
Oh my god, some people here would kill to have your skin. Just what are you complaining about? LOL
Alright, you do show some very shallow boxcars with distinct borders. You can try applying 50% TCA cross to those scars or high powered low density laser angled to the scar borders. This will smooth the edges and, consequently, make your scars less visible.
32 minutes ago, Sirius Lee said:Oh my god, some people here would kill to have your skin. Just what are you complaining about? LOL
Alright, you do show some very shallow boxcars with distinct borders. You can try applying 50% TCA cross to those scars or high powered low density laser angled to the scar borders. This will smooth the edges and, consequently, make your scars less visible.
Thank you very much, but this situation affects my psychology badly and I get psychological support. I want to achieve max improvement. I know it will never completely pass, but maybe I can get 60-70%.
I will talk to the doctor for a 50% TCA cross. She said she was experienced in this matter. How many sessions of TCA cross do you think I might need? Also, what are you talking about when you say angled laser? Can this be achieved with fractional erbium?
10 hours ago, colorful said:How many sessions of TCA cross do you think I might need?
After 3 to 4 treatments, you should see a good outcome. Each treatment should be doneevery 3 months.
10 hours ago, colorful said:Also, what are you talking about when you say angled laser? Can this be achieved with fractional erbium?
You point the laser at an angle on the scar border. No, erbium is too weak, especially if it's fractional.
19 minutes ago, colorful said:What about Fractional CO2 laser?The doctor offered to make Fractional erbium first and then make Fractional CO2.
Yes, that's what I mean. Fractional CO2 with the setting at low density and high power.
But I believe TCA will be better than laser.
Fractional Erbium seems more like a "doctor wants to play it safe first" type of treatment. If you do this, you may be wasting time and money. Or I could be wrong and Erbium could help. I'm not a doctor. I've done Erbium twice for spot treatments and it didn't do anything for me.
Do you trust the doctor? Have you dug into his background regarding laser treatment? You want to make sure you go to someone who knows how to use a laser. The most results I got were from an aggressive treatment. My skin type is about a III. I think you should be fine getting fractional done as a IV. Just keep in mind that you're going to get PIH/PIE after the treatment if it's done deeply enough. Hydroquinone isn't going to help that much.
9 hours ago, Sirius Lee said:But I believe TCA will be better than laser.
Thanks I will talk to the doctor.She said to me you won't need CO2 laser after erbium laser but we can do it if you want.
3 hours ago, Amanda Hall said:Fractional Erbium seems more like a "doctor wants to play it safe first" type of treatment. If you do this, you may be wasting time and money. Or I could be wrong and Erbium could help. I'm not a doctor. I've done Erbium twice for spot treatments and it didn't do anything for me.
Do you trust the doctor? Have you dug into his background regarding laser treatment? You want to make sure you go to someone who knows how to use a laser. The most results I got were from an aggressive treatment. My skin type is about a III. I think you should be fine getting fractional done as a IV. Just keep in mind that you're going to get PIH/PIE after the treatment if it's done deeply enough. Hydroquinone isn't going to help that much.
I know the doctor has laser experience. But I don't know how aggressively it will work. I guess I should try and see this. Of course, I think it is a little difficult to see a difference after 1 session. Maybe if it works aggressively I can see a difference.
My skin type is IV. Is PIH / PIE temporary? How long did it last for you?
11 hours ago, colorful said:Thanks I will talk to the doctor. She said to me you won't need CO2 laser after erbium laser but we can do it if you want.
I know the doctor has laser experience. But I don't know how aggressively it will work. I guess I should try and see this. Of course, I think it is a little difficult to see a difference after 1 session. Maybe if it works aggressively I can see a difference.
My skin type is IV. Is PIH / PIE temporary? How long did it last for you?
She has years of experience and I'm just a patient and writing on this forum. 
Try the Erbium and let us know how it goes! It will definitely take multiple treatments. Erbium could work for you. I just have gotten enough laser treatments to experience the frustration of no results.
For aggressive treatments, PIH lasted at least 2 months and for another session, I had PIE for about 3+ months.
This is an update. Since the last time I wrote, I received 2 Erbium laser + 2 radiofrequency treatments (two of them were done in the same session). I continue to take my meds and the accutane is about to run out. I won't be trading for 3 months until the summer is over. I think that the improvement will continue in this process. What are you thinking?
I just wanted to let you know if anyone is following.
On 6/27/2021 at 7:15 PM, LivingWithFaith said:It looks great! How much improvement do you think you've got from the lasers?
Thank you! Honestly, I'd say 50%. Subcision was more helpful in my 2 deep scars. My doctor said she can wait 3 months and do it again. Until then, I would see max recovery. I will continue to have lasers done. It also helped with the red spot. From now on, I'm considering factional co2 instead of erbium. My doctor said it's not good for my skin tone, but herclinic doesn't have this device. That's why I can't trust.