- Last Week
On 9/13/2018 at 11:45 PM, machiavelli said:I have been here for many years (alts) and it was mostly you who pushed me to fractional ablative co2 (Deep and TotalFX rather than re:pair), Or it was being told to look at the science rather than the BDD naysayers this board was infested with 4 years ago. It's lightened up since but the risk is still being overstated.
That said, if you don't post before/afters that was anticlimactic af.
If I'm not mistaken, wasn't he like THE poster child for laser?
- Last Month
On 8/28/2018 at 3:45 PM, BallinLikeAnAthlete said:
Please let me know what types of scars I have and what treatments I can get done to make them less noticeable.
You have little bit of everything.The problem is that they are pretty deep. I suggest you forget everything and start with SUBCISION + FILLER. Your goal should be to fill those pits as much as possible, hopefully over 50%. Once you've achieved 50% improvement, then upgrade to INFINI + SCULPTRA.
15 hours ago, lotus21 said:
I need to know if fat grafting works for my acne scars and how much improvement should i expect?
Very expensive and very unpredictable, considering that not all harvested fat will survive. Yeah, sounds like a oxymoron considering that your own fat is considered "permanent". Anyway, start out with temporary fillers to see how it turns out. If you like it, you can then upgrade to permanent fillers, including your own fat.
- More Than a Month
Forums Scar treatments 6 repliesOn 8/1/2018 at 12:31 AM, sadwoman said:
My face has completely consumed my life. I feel like I can't be myself around my partner, friends, and family because I am always thinking about my skin. I don't exactly know where to go from here. I would greatly really appreciate any advice!!
First, it appears that what you need is not a skin booster, but a mood booster. If you're that obsessed about your skin, which looks hell of a lot better than most of us here, you should
0) Look on the bright side of life, knowing that scars are nothing compared to terminal illness like cancer
1) Uninstall Instagram and all other social media apps from your phone and computer
2) Quit looking at yourself in the mirror
3) Do not hang out with friends who can't lend moral support, eg. bitches and/or a-holes
4) Start telling yourself how special you are to your parents and others who genuinely care about you.
5) live your life as those who you have always wanted to imitate and emulate.
Forums Scar treatments 16 replies
If the scars bother you that much, whether mild or severe, then get them fixed. As my old lady used to say, don't just sit around fretting and bitching...DO SOMETHING ABOUT IT!
Forums Scar treatments 24 replies9 hours ago, Kratosandboy said:
Spoke to the derm and he said best course of action would be subsicion, prp and dermapen (he said heated so may be rf microneedling but not sure) all together in the first session, then 2/3 weeks later to do TCA cross and then can decide what to do for third session. I am thinking of asking him to do subsicion and TCA cross on the second session.
1) It's quite obvious that you have tethered scars. The best course of action is subcision. You could ask for NOKOR on the cheeks and CANNULA on the temples.
2) PRP, in my estimation, is way overblown and not very effective when it comes to collagen stimulation. If it were me, I go for the cheaper alternative: Saline.
3) RF microneedling will come in handy later, but I would not mix and match with subcision. Moreover, RF is only good for mild to medium scars. It's better that you elevate the scars as much as possible with subcision (possibly more than 1 session). When the scars are sufficiently raised, only then should you consider RF. Lastly, I suggest you pair RF with Sculptra (dermal filler) for better collagen production (1 injection per RF).
4) Temples: Hardest to treat. Don't expect much improvement in the short run. Sculptra and RF will help.
5) TCA (and Erbium laser) will be useful for correcting any surface irregularities like boxcar edges.
6) WAIT AT LEAST 3 MONTHS BEFORE REPEATING TREATMENTS. Rushing treatments will only halt the collagen production.
1 hour ago, SalientDouble said:
do you think Isotretinoin can help to produce collagen etc?
20 female patients, aged 45-50 years, with phototypes II-VI, none of whom had experienced menopause, were treated with 20mg oral isotretinoin, 3 days a week, for 12 weeks. They underwent clinical analysis and skin biopsies in the pre-auricular region, while histologic cuts enabled assessment of the solar elastosis level and morphologic analysis.Go to:
Clinically, patients, as well as the researching and the assessor physicians, noticed improvement in skin quality. One patient presented severe solar elastosis, 11 manifested the moderate form, while 8 presented the discreet type. According to histological analysis, 65% of the patients revealed alteration in the distribution and thickness of the elastic fibers, which can be interpreted as a histological improvement, while 60% showed an increase in collagen density. We observed an increase in collagen density, from 51.2% to 57.4%, (p=0.004). At the end of the 12-week follow-up period, this density decreased to 54.7% (p=0.050). There was an increase in the density of elastic fibers, from 26.5% to 31.3%, (p=0.02), which had dropped to 27.5% at the end of the 12-week follow-up period.Go to:
The study confirmed the role of oral isotretinoin in remodeling the extracellular matrix against photoaging, as well as its durability after 12 weeks, especially when we consider collagen fibers.
15 hours ago, Tcacrossfirsttimer said:
What can can I do apart from moisturise, sunblock, stay out of sun etc? Am going to go to the GP to get antibiotic prescription this afternoon.
Question: can easily veterans here advise if my healing process sounds normal or if something has gone wrong? I am Asian with light medium skin.
Why do you need an antibiotic for? Is the skin infected or are you sick? Never take antibiotics on a whim. Think of the consequence you might have to face in the future when you run out of ammunition because you've become resistant to all antibiotics.
With regards to the craters, you're jumping the gun. You should wait at least 4 weeks before thinking about treatments. In the meantime, apply Propolis, which has been shown to help build type I and III collagen.
Same ariticle from NCBI: https://www.ncbi.nlm.nih.gov/pubmed/23781260
1 hour ago, Katski84 said:
What would be the best treatment plan for me? I would continue with subsicion but what else? Thanks for any reply... The last picture is how my skin was before any treatments.
Your scars look pretty shallow in the pre-op picture. I'm not sure if subcision was even necessary since it's not very effective for shallow scars. Anyway, even after 8 days, you're not completely out of the woods just yet. Microswelling and bruising will still be present. So give it another 3 weeks. Be that as it may, it's far too early to decide what you will be doing in the coming months. You might not need to do anything should you heal nicely. But I would wait 6 months, not so much because full collagen production takes that long but waiting 6 months actually helps give better result for your next treatment IMO.
On 7/19/2018 at 5:36 PM, GallantNight said:
What is the difference between "regular" subcision and multi level subcision?
Basically, NOKOR is used to re-enter the same scar at different depth.
On 7/16/2018 at 6:38 PM, GallantNight said:
Do you know an acne scar specialist in Texas by any chance?
Not everyone can do subcision. You'll want to go with someone who has a long history under one's belt. If you can afford to travel, I suggest you visit Dr Rullan in San Diego. Give his office a call or an email explaining your situation and the reply you got on RealSelf. I'm sure he'll lead you in the right direction.
9 hours ago, getschwifty said:
I've had subcision + sculptra + cooltouch laser twice before (I just got my 2nd one a 6 days ago).
I intend to get another scar treatment four weeks and I'm not sure what procedure to undergo. Please note, I still have one big lump and two small lumps on the subcised area. I am also using tazorac for acne & collagen renewal.
Did you get the sculptra injected on the same day you got the subcision? Just for reference, sculptra should be injected at least 4 weeks before subcision. It takes about 4 weeks for the PLL acid to kick in and start stimulating collagen production. Moreover, it takes approximately 6 months to see its full effect. So, in essence, if you were to get another subcision in 4 weeks, you will likely just screaw up the collagen renewal. Hence, as @BA suggested above, go with the flow and don't rush it. So if your doctor, who shoud know better, is suggesting you get subcision or laser every 4 weeks, it's in your best interest to fire the SOB and find someone else.
8 hours ago, ProbableLorry said:
Do you think laser is that poor in my case that I should just cancel it, or should I continue it in addition to the treatment you recommended?
How scar revision should be approached is similar to road construction. You fill the potholes first and than repave the surface afterward, not the other way around. But with laser, you're essentially resurfacing the skin without first filling the pits. Not a good idea. I would definitely cancel the remaining treatments (for now). As already mentioned above, laser will come handy later. But concentrate on elevating the pits first.
8 hours ago, ProbableLorry said:
Im also very new to this forum so im a bit unsure about what all those things are, so where can I get those treatments? Are they commonly found in private clinics, or do I probably need to travel outside Norway to find a doctor who has the treatment? Also, will the results be permanent as I thought fillers like botox just gave temporary change?
As @beautifulambition mentioned, there are reputable doctors abroad who specialize in acne scar revision. However, there really is no need if you plan to get the procedures that I suggested. Botox and fillers (both Hyaluronic and Sculptra) are injected everywhere in the world, including Norway. Cannula is already widely used to inject those fillers. Radiofrequency devices, including Infini, will most likely be available in medspas. First, I would ask your dermatologist whether he or she would be willing to do subcision using a blunt-tip microcannula while injecting fillers. Also call medspas around you for RF devices. There are many RF devices besides Infini.
Will the results be permanent from Botox? No, Botox is used mainly to loosen up the years of sustained muscle contraction from the scars. This will, however, enhance the outcome from other treatment like subcision. How much collagen your body is able to produce will ultimately determine its sustainability.
2 hours ago, ProbableLorry said:
I was left with a lot of scars on my face, especially in the temple and forehead area.
The forehead and the temples are the hardest to treat. Your chance of improvement is very low. This is mainly due to low volume of collagen/fat. The more you have, like in the cheek, the better the outcome. So do keep that in mind and don't become too discouraged if you get less than expected.
2 hours ago, ProbableLorry said:
My dermatologist had me wait a year before laser treatment, and now I've completed 1 out of 3 treatments (6 months between each treatment) with co2 fractional laser.
With all due respect to your derm, but the use of laser is a poor choice for the forehead and the temple region. I would suggest getting these treatments in the following order:
2) Subcision using a cannula
3) Combination of Sculptra (for the temples) and Infini
(Note: 1 Sculptra injection suffices per Infini treatment. Sculptra needs to be injected 4 weeks prior to Infini. This is ony for the temples. HA filler should be used for the forehead.)
1 hour ago, FreddiHendersson said:To be honest, your skin isn't that bad at all like mine. Did you ever seen some really severe cases in this forum here? We should be lucky for how it is Maybe it would be better for you and go to a therapist like I do at the moment...
This is not aimed at anyone in particular, but those with low self-esteem usually will manifest other BDD symptoms regardless of acne scars. They will always see themselves as inferior creatures, always casting doubt about themselves, always comparing themselves to others, and most likely will blame others for their problems. It's a vicious cycle that never ends. Please get a grip on yourself and know that you may not be able to save the world but you can save yourself.
9 hours ago, beautifulambition said:
“We demonstrated that the inflammatory response is still present in 21-days lesions in acne patients prone to scarring compared to those who do not develop scars, suggesting a difference in the acne lesion life-cycle between the two populations,” Dr Johannes Josef Voegel said.
“Inflammatory lesions persist after three weeks only in patient with scars, with an exacerbation of number and modulation of genes involved in the immune response. This was in line with higher influx of T cells and macrophages observed by immunohistochemistry.”
I'm not at all surprised by this finding. Inflammation is part of our immune response and any prolonged inflammation is a good indication of poor immunity, namely your health is really messed up. As such, I'm a big proponent of balanced gut health. A healthy gut equals healthy body and mind.
2 hours ago, Katski84 said:
I don't like what I see and I know I'm still healing but my skin texture is awful. I hate the boxscar on my right side and I can see he tried to do subcision on it which I feel have made it worse. The chin area is purple
Listen, girl. I know we live in an age of instant gratification, but as @beautifulambition correctly stated, OUR BODY DOES NOT NOT NOT HEAL IN A WEEK!!! (I'm not screaming, just emphasizing.)
Give it at least 3 months of healing time and you will most likely see overall improvement.
15 hours ago, beautifulambition said:
IF you do sculptra a set of 3 injections is done. You can space them out if you wish.
You might not need 3 injections of Sculptra when you pair it with Infini. Only if you go solo with Sculptra. Also it's up to the doctor's discretion whether you need all 3 or less. Some do, some don't, depending on the severity of fat loss.
@GallantNight I suggest 1 session of Sculptra 4 weeks prior to getting the Infini. The combination of the two works really well.
3 hours ago, Katski84 said:
Hi! Thanks for your reply. I wasn't 100% sure what kind of laser he actually used but I said that I didnt want an aggressive one as it's my first scar treatment. Would have prefer if I just had said no but oh well it's done now. I am just very concerned about the healing. I am going to Croatia in 2 weeks so definitely have to avoid the sun.
It's usually the worst for virgin skin, namely the first exposure to energy devices, whether laser or RF. Subsequent treatments should be much easier to tolerate. You're going to Croatia in 2 weeks? Hmm, that sounds too rushed. Anyway, make sure to wear a big brim hat and apply sunblock frequently. Avoid swimming if possible.
2 hours ago, Katski84 said:
How do I go about the vinegar soak? Just water and vinegar? He recommended Avene cream cicalfate which I'm applying. Very painful and hot at the moment, have loads of whiteheads I just saw. Just trying to be patient and staying positive, I would be devastated if this procedure made my skin worse as I finally found the courage and money to do a treatment
Warm water (1 liter) + white vinegar (1 Tablespoon)
Dampen a cotton ball and apply to affected area. You don't want to soak the wound, just lightly dab it. Let it dry naturally and apply a coat of Castor Oil, which has both anti-inflammatory and antimicrobial properties. It will also keep the skin from drying.
5 hours ago, Nina22 said:
Also, I have no idea what to do next, shall I switch to Infini or some more sub?
I think most of us have been there at one time or another. Either way, it's a real bummer when you see only a meager improvements, if even that. Anyway, from what I can tell, here's what went wrong from the beginning. Your scars are too shallow for subcision. Subcision should be done only on deep scars, which are for the most part tethered. Subcision will cut the scar anchored to the bottom, thereby lifting up the depressed pit. On the other hand, mild to medium scars are better off with Infini or other RF devices.
12 hours ago, RedMandolin said:
All scars look red in sun. Doctor said the redness is due to neovascularrization. How long will it take to come back to normal skin colour?
As already mentioned above, if you apply Comfrey faithfully every night, the redness should be gone under 2 months. Just apply it before bed and leave it on overnight.
Please let's not pretend hyperpigmentation is a scar. Pits are the real scars, redness is not. Redness will go away if you wait around long enough, pits are here to stay...for ever.
10 hours ago, RedMandolin said:
I have done 4 MRF treatment and 1 CO2 laser treatment. But i cant see any noticeable results also in some lightning i think it look more worse than before.
Huh?? Your most recent photo looks way better than pre-op photo IMHO. It could be due to different lighting, but the scars look much improved and less visible.
You can clearly see the scars distinctly even "with no sunlight" (pre-op) vs less visibly even with sunlight (post-op).
1 hour ago, incepticon said:
Actually nokor subcision is not entirely risk free. Although 5 months have passed since my nokor subcision there are still two raised lines on my right cheek. So it's not just about hematoma, sometimes it can lead to further scarring. Therefore it might be a good practice to lessen side effects
I understand your worries, but which is far worse? Acne pit that can and often will last a lifetime or hyperpigmentation that will fade in a year or two? Scars are tough to treat, let alone correct. It requires invasive treatment, and all invasive treatments come with side effects. If you believe otherwise, you're being too naive.
9 hours ago, TheBean said:
If you could expound on why you are so against them suggesting lasers?? Any tidbits you have--it may be helpful to be armed when I go in...
I'm most interested in the RF microneedling, my understanding is that it stimulates new collagen and that scars in the early months respond very well.
Actually, I'm not against laser. It just should not be used as a first weapon of choice. Think of road construction as an analogy. Would you not fill the potholes before you repave the top with new asphalt? The same logic applies to acne scar remodeling. Why do doctors and others continue this stupid practice of resurfacing the skin without first fixing the pits? As such, get your pits treated first with subcision or RF microneedling in order to elevate them as much as possible. Then use laser or chemical peel to even out any surface irregularity.