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dontstandsoclosepls

I've tried fraxel, rf microneedling, subcision, and tret. Scars look worse. Really need advice.

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Hey everyone,

I did fraxel in 2018 at age 26. I had moderate acne scars then (5/10 on severity). I did 3 sessions. It took a good 6 weeks for my skin to heal, but my skin actually looked incredible afterwards. My acne scars were maybe a 3/10 after. However, around 2 years after this, I began noticing my acne scars again, and they seemed to be getting deeper and there seemed to be more. It almost looked like every acne scar I'd ever had that kind of filled on its own over the last decade became visible again. I am not talking about pigmentation or PIH, I'm talking about texture and atrophic scars.

 

I went to 3 derms, who all told me this was just aging, and also could be from me having a baby. But in the pictures I have from just a few weeks after giving birth, the acne scars are clearly visible.

 

I know aging will effect my skin texture, but I am 30 and take really good care of my skin (always wear sunscreen, moisturize, don't smoke or tan or drink). Scars are now 5-6/10.

 

So far, I've been on tretinoin 0.06% for about 10 months. I've had subcision done once and 3 rf microneedling sessions over the last 8 months (the rf MN sessions were in Feb, March, and April, with morpheus rf). I don't see much improvement. 

 

These same derms all told me microneedling would help some, but if I truly wanted good improvement, fraxel would work for my scarring. I am nervous to do fraxel again, because I don't know if the worsening of my scars was from fraxel, from aging, or if I just convinced myself they looked better for 2 years and didn't hyperfixate on it til recently.

 

I don't want to continue with my face the way it is. I have to do something. I just don't know what. I've read lasers, microneedling, and tret might all cause fat loss. Literally the only things I can do for my skin, and they all might make things worse.

 

Does anyone have any advice? 

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Try to discontinue all treatments for now and just let your skin breathe for a bit. Your RF was still recent so it might take some time for your skin to normalize. I had microneedling done (not RF) and it sadly didn't give me good results/gave me more damage but my skin did improve after a year or so by keeping my face moisturized by using hyaluronic acid serum and cream religiously. Your barrier might have been compromised if you peeled several times in a short period of time. 

Childbirth puts a toll on women's bodies and causes hormones to go into overdrive. It's not uncommon for women to have transient hyperthyroid symptoms that affect the skin, hair and overall well-being. The good news is that this will pass, but focus on keeping yourself nourished and hydrated. If the doctor tells you to keep taking your multivitamins, take them. 

With regards to subcision - the first time I had it, my skin didn't show any improvement until over half a year. Some people have it lucky and see the improvements right away but I guess our body heals when it wants to. 

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Tret is really kind of not working for me but I take it sporadically and much lesser strength. If anything it just aggravates my skin at times. 

Derms always have the same line "aging" or "this will help... insert generic worthless thing here". Aging definitely does take a toll without a doubt but sometimes things beyond that take a toll as well and derms can't size it up.

I know you don't like the 5-6 indents but they are very shallow, even if they cast nasty shadows I get it, they are at least kind of even. If you want my opinion test another subcision or two spot with another doctor perhaps (research him/her) and maybe adding a filler might help.

Not really familiar too much with fractional as it's usually kind of flawed for most scars, and not sure why you responded so well from it. Possibly it tightened your skin or even generated some collagen? Question if fractional worked so well is there any reason you don't consider it again? Is it the risks if you "press your luck" with lasers?

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Yes, i am worried about the possible risk of facial fat loss or skin thinning. Being 30 now, I feel like if I make even one wrong choice my skin is gonna look even worse. And the fact that the fraxel results only lasted for under 2 years after 3 sessions with weeks of healing for each one. 

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Have you gone to your primary care doctor? My skin changes were so rapid when I had an undiagnosed health issue. Might be worth it to check your labs to make sure nothing is happening internally that is negatively affecting your skin.

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