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  1. The papers seem to be solid, I really don't know what to think of this? All the dermatologist seem to practice old school method, expect for the ones select ones in the US and UK. It now seems that acne scars can be prevented or treated early with safe outcomes on patients on Accutane. It make sense to prevent scars, rather than treat them in the first place? I wonder how many dermatologist and plastics actually read and follow the latest research ? I think its a controversial video as most dermatologist will cover their back, rather than look after the interest of their patients, but I guess time will tell as these papers are only a few week to months old. Some of the jargon is beyond my limited understanding, and BA will have a objective view point on these papers and the video. Its seems to really change the way we should be managing severe acne and prevent scars. I think this will be highly controversial. (MOD edit:) Source: http://www.lasersandlifts.com.au/wp-content/uploads/2017/09/Acne-scar-guidelines-2017-Part-2.pdf
  2. Hi, I just got off 10 months of accutane and my skin has improved dramatically. But like a lot of people on here, I was left with pretty bad scaring. I plan on getting fraxel next summer with a reputable doctor and I have a few questions about this. 1) What type of scars are these (box, rolling, etc)? 2) How would you classify them in terms of severity? 3) About how many fraxel treatments would it take a good doctor to get my skin to an acceptable point? (I know "acceptable point" is a bit subjective, but in your opinion). Thanks for the help.
  3. I'm 24 and have dealt with acne scarring ever since I had really bad acne in high school and went through accutane (late 2007). I got fraxel laser treatments twice - I think the first treatment was around 2011 and they did about 3 treatments, and then I just finished the second round (went 4 times) in 2016. I am still having scars which I can easily see in indirect light. I think the second round in 2016 helped out a little bit to make my face smoother and round out the edges on my scars, but these scars are still very visible in my mind. I'm not going through any psychological issues where I dont want to be in public, its just I kind of want these all to go away and move on with my life. I'm still doing fine socially as well as with girls, but I feel like they can still definitely notice them. As you can see I can make the indirect light to show these scars, but in other lighting it doesnt look like I have any scars at all! I really just want to know what types of scars I have and what you guys think I should do about it. I'm open to anything, and id be willing to spend up to 5K if need be for any procedures. Do people think I shouldn't use lasers again? As to the scars - I think left cheek is worse because of the two scars at the top of my check which are the deepest scars that I have. I feel like the right cheek doesnt have as deep of scars. Also, on the bottom left side of my chin I have this very deep crater which is unlike any other scar on my face. It sorta just gapes deep into my skin. I think you can see it best in my very last picture. **let me know if you need me to post any more pics with better lighting to make a better read on what I have/should do, this was my first time taking pictures like this Pictures (I took two of each cheek): Right cheek: Left cheek:
  4. Never Give Up

    Well well well, here I am. Back again. Back in the early 00s this community gave me so much support. I thought I would come back and give an update. Back then I was known as "Guardedly Optimistic" now i'm "Guardedly Optimistic 2017" This is the thing, it's a journey. My skin is still very damaged; mostly visible under harsh over head lighting. But...and get this...I ended up pursuing my dream of being an actor and filmmaker! Yes, acne and scars and insecurities and all that crap was not going to hold me back. I don't want it to hold you back either. Here are some recent pics under overhead lighting. This is the harshest of pics I could take. It's painful for me even to look at now but you know what? That's ok. I will keep trying to improve it but not let it hold me back. After the accutane helped to take away the cysts, the scars started showing in time. I think i've spent the following, estimated: Doctor 1: Deep Fx Laser (4K) Doctor 2: Consult $100 Doctor 3: Consult $100 Doctor 4: Fraxel ($800) Subscision with Restylene Filler ($600) Fraxel ($800) Excision ($400) Subscision with Restylene Filler ($600) Doctor 5: Consult $350 Total: $7750 Never giving up = priceless You can see the scars are still there but they are definitely more shallow than when I started revision. Strangely, I think the micro needling (which was the least painful or expensive) was the most effective. I think i'm going to start doing that again at home because I was happy with the results I was getting. Now, and I don't know if i'm right, but micro needling soon after injury prevents the building up of scar tissue I think. Now back in the early 00s before YouTube or anything of the sort, we wouldn't have known that but now we do.
  5. Hey guys, I wanted to share what I consider to be really positive results after just a single session of Fraxel (I've purchased a total of three). I hope it helps anyone who might be considering this treatment. I have a mix of scar types, as you'll see in the before photo; I'm really pleased with the improvement so far and hope for more in subsequent sessions. I had the first treatment two days ago. I'd appreciate any feedback or advice you guys may have. P (before and after)
  6. Hey guys - I am new to this community and hopefully will find some help here. After battling with acne for a few years, I finally got it cleared and went it for fraxel to clear a few scars. Worst mistake ever. Infact the day I was going for my fraxel my niece even commented my skin was glowing. Anyways, the fraxel has now left white spots on several places on my skin and I have to idea how to treat it. Its devastating because now I have no acne but a horrible new problem. I would take back that acne anytime because I knew what to do , right now I am so depressed and desperate. If abybody has any suggestions, please please help. Thanks, Mia
  7. I need some help. I know the scarring is not terrible, but a few months ago I had no scarring and smooth skin. I went through, and still have some adult acne. However they never scarred until i used benzoyl peroxide. Big mistake. Anyways, I did one treatment of dermapen three months ago, but i think the esthetician did not do it correctly as her pen would stop mid treatment and get stuck!!! This probably made the scars worse. I feel like the texture of my chin is terrible. Please see the pictures below. Scarri
  8. Holes from fraxel

    Hi, I'm after 3 treatments fraxel and rf. 3 months after. I have big holes and my skin broken on its very forehead. Please help !!! who help me :(:(:( Please
  9. I had a few Fraxel and PRP treatments to repair my acne scarring and ended up with really bad skin quality that looks worse than an orange peel. (To be precise 3 Fraxel treatments and two PRP treatments -- all of them one month apart) I have wrinkles and inflammation all over my face and it has made even looking into the mirror really difficult. I have no clue how to fix this and now all I do is keep looking for solutions online or dermatologists or at beauty clinics. Dermatologists and beauty clinics keep dumping more treatment packages. The spa where I got the treatments refuses to even acknowledge my condition (How can someone be so cruel) Based on what I have read about skin that looks like mine, I might have burned the skin barrier and destroyed the facial fat (But this is just my assumption because my skin matches the appearance of lost barrier and fat lost texture) I have read a lot of articles mentioning what these harsh treatments can do to your skin. Wish I had read those before doing something so drastic. I read an article on how emu oil and honey helped a lady who had similar skin texture but she got that orange peel like texture from using too much Vitamin A on her face. I keep reading on forums that thermal damage is irreversible and skin can never recover from it. It pains me emotionally so much every time I read something like that. Now I seem to be stuck in a dark zone with little hope for light, a way to fix my skin. I wouldn't wish this on my worst enemy but does anyone have any experience with this kind of situation or know any treatments that can help my situation. I would really appreciate some help on this.
  10. Hello all! I'm new to the forums but I've been a bit of a lurker for a few months now. I am a 27 year old Aussie girl who, like many here, suffered terrible acne as a teenager and well into my twenties. In the beginning I was left with moderate to severe rolling scars and an uneven texture to my entire face. I was depressed, angry and constantly dodging any reflecting surface. In 2008 I decided I could live like that no more, so I got off my butt and did something about it. Fraxel I have had 5 sessions of the Fraxel Re:Store laser. I had my first session in 2008, I then had a further three (spaced three months apart) in 2010 and my last session in January this year. I have many things to say about Fraxel, but the first is that I rushed into it a little in that I did not do my research properly. I should have gone with Fraxel Re:Pair or a fully ablative laser instead of the Re:Store. Too late for that now, and I haven't ruled out the Re:Pair for the future yet. Pain: I have a really high threshold for pain so the first few sessions were okay. A little tender after them making multiple passes but in all it wasn't too bad. For some reason though, the last treatment I had was horrific. I don't know if they didn't use the same numbing cream or if they dialled the settings up dramatically or what it was, but I was practically convulsing on the table. Was not nice at all. Downtime: 2 full weeks each time. Even after the 2 weeks was up I was left with micro swelling here and there and an acne flare up to die for. Add in house-bound and sun sensitive and you've got a miserable 2 weeks. Results: Slow, like all good things. I'm ashamed to say that I didn't take before/after pictures whilst going through Fraxel. I felt too hideous. However, I think in all I would have seen around a 30% improvement in my scarring and a bigger improvement in my pore size and general skin texture. So it wasn't a complete waste of money, but i would like to go back and do it all again knowing what I know now. Cost: $1700 each time... so that's a whopping $8500. Eek! Other: The doctor. Curses to the doctor that I saw! He has no bedside manner, no care factor and is clearly out for the money. I am not a sceptic when it comes to the wonders of lasers. I know they work and I know in the right hands they can result in outstanding improvements. I'm not saying my doctor was useless, but I am saying that I will not pay him a cent more. 5 days to return an urgent phone call is unacceptable in my books, especially when I have paid so much. Not only that, but the clinic is poorly designed. In order to get to the treatment rooms you have to walk past the people waiting to be seen! That means walking past gawking patients while your face is smothered in crap and then walking back past them once your face has been attacked by a laser. Talk about awkward. End rant. Dermaroller So, after my last Fraxel session in January 2012 I decided to look for alternatives. I scoured the Internet looking for information on the Dermaroller. I think I found every medical paper, every website, every before/after picture. Months of research. When I finally decided that I was going to give it a shot I then went through the same process to find someone skilled enough to do the procedure. Firstly I really want to make it clear that I would never treat myself with a skin needling device. I've read things about people purchasing cheap rollers on eBay and on other sites and I am horrified! If you want to go out and chance further scarring your skin or causing infection by doing this procedure yourself then that's your risk. I pay someone to do the procedure using the genuine Dermaoller, the one made in Germany. 192 needles, medical grade material, 1.5mm needle length. I have had three sessions so far. The first was in July, then again in September and the third last Friday. Between each session I have waited 7 weeks to allow for proper collagen formation. Pain: Almost none. A little tender on the bony parts of my face and on my nose but nothing compared to laser treatments. Downtime: Around 4-5 days of redness and swelling all up, but I can go back to work on day 3 with a little bit of makeup and nobody's been scared to look at me! I do have a small acne flare up after each session but it's mild and might be more from the products I'm using (which are new and my skin is not used to them yet). Results: Colour me impressed! In my deepest rolling scars (on my left cheek) I can honestly say I've had around 40% improvement. This is over two sessions with my gauging results six weeks after the second session so no chance of me seeing micro swelling. My scars are slowing filling in. I didn't see much change after the first session and was a bit downhearted by that but I am sticking to my treatment plan of 5-6 sessions! Cost: $800 a session. Compared to Fraxel that's nothing, but till expensive I know. I pay for it because I know I'm getting the best treatment money can buy. Plus the person who is treating me with the Dermaroller is fantastic. She cares deeply about what she's doing for me. It's her passion and that makes me excited! Other: Just wanted to add a further blab on Dermarolling. I chose to go with the original Dermaroller as it is the only one listed on the TGA (Therapeutic Goods Administration) here in Australia. Every single copy of the original dermaroller is not listed and never will be unless they apply for it and are thoroughly tested. I didn't take the brochure's word for it, looked it up myself. It's there, all other rollers are not. Copies that claim that they are "TGA approved" etc mean absolutely nothing! There is no such thing as TGA approved. You're either listed, or you're not. Simple. Needles shorter than 1.5mm do nothing for scarring. They don't reach deep enough into the problem layers of your skin. Shorter needles are for product penetration only and are safe to use at home (although I'd still only ever touch the original Dermaroller brand). Needles longer than 1.5mm are a very unwise choice as they are too long and may cause damage to the deeper layers of skin. 2mm needles and longer are reserved for burn scar victims as their scarring goes deeper and into the layer of fat; unless this is your problem don't use them! When your skin is treated using the 1.5mm needles you want to see blood, and lots of it. Your blood contains fibroblasts and collagen fibres. More blood in each session means that your circulation is getting better, which is a really good thing. In my first session I hardly bled at all, but last Friday my face was an awesome mess! More is not better! Rollers with more than 192 needles are extremely dangerous. With more needles more pressure is required to puncture your skin and there is a huge risk of tearing your skin to shreds (think of is as a bed of nails, the more nails, the easier it is for you to lie on it without being impaled). I also have a blab I could get into regarding skin care lotions and vitamins but I'll save that for a rainy day, hehe. Sorry for the damn story... I just wanted to share my experiences and hopefully give a little, learn a little from others here! I have taken a few half-arsed before/after pictures on my phone but I'm still deciding on whether to put them up. All of this stuff I have posted is from my personal research and experiences. I tend to ask a million questions these days and am glad I do; I am not taking any chances on my skin. I may come across as a Dermaroller infiltrator who is out to brainwash you to go do the procedure. I'm not. I am just so freaking excited about find a treatment that has worked for me that I wanted to share. Not seeking perfection, just happiness.
  11. Skin condition

    Hello everyone, that's my first thread on this forum. Found it somewhere in the Internet cause I was looking for help and here's my story. As I started puberty, I got acne. It wasn't as bad as in some cases but it left me with scars - especially on the temples. Anyway - when I was 18 I've started taking isotretinoin for about a year and I got rid of acne. About a year after my isotretinoin therapy had ended I underwent a sieries of fraxel laser treatment (for the scars) - the last one was 2 weekes ago so the skin doesn't look healthy yet (redness and the peeling). I'm describing this so that you knew my situtation. I'd like you to assess condition of my skin. Especially the center of the forehead - don't you think there's something weird going on - I've got a problem with those dark little dots, what are they, are they scars? How can I get rid of them? Sorry if I made any mistakes writing this - English is not my first language .
  12. I had cystic acne on my chin in high school, I went to an asthetician who extracted the big pimples with a needle, yes BIG mistake, but I didn't know any better. Finally my acne had cleared up but I have been left with ice pick scars that I have tried to get rid of over the years (I am 28 years old now) and I have tried Maderma scar cream but that doesn't do anything for old scars. I have tried a session on microneedling two months ago (found a Groupon that had great reviews for this asthetician who does the treaments in New York where i live). She told me that it will take 8 sessions to see improvement but told me they will never completely go away, which I know, but I just need improvement. She also told me I had to get a facial to clean my skin prior to th first treatment, so I did, I paid $120 for that plus the microneedling session, well after one microneedling session of course you cannot see any improvement but I did notice my skin otherwise being smoother and less tired. I went to my derma doctor for another issue and he told me that microneeding is a waste of time for my scars and that I should do non-ablative fraxel in his office(I paid $65 for the consult on this that will go towards the first session of the fraxel plus I have to get a facial to clean my skin prior to the session ($100, not much money but still I am tired of paying for this service when I don't need it as I do not have active acne and my skin is fine otherwise). I did consider Fraxel before doing microneedling but am so scared of any bad side effects. He told me that the nonabalative fraxel will only help 40% which is fine, I want to improve my skin, I know it will never be perfect. He also told me to consider excision of each scar and then fraxel after, which I am certainly not considering. Can someone tell me what is best for my skin? I have posted my scars on my blog, link here. Any help will be appreciated asI really am lost and would like to stop paying money for something that will not give me results. Thank you! http://thedrasticallyblog.blogspot.com/2016/12/acne-scars.html
  13. I had fraxel restore on multiple scars on my face just several hours ago (pics were just taken with phone). The pics I have posted shows fraxel restore being done to a part of my face that didn't even have scars (totally unnecessary) and you can see two rolling scars that was not treated with the fraxel restore (technician missed it). My problem is the vertical fraxel restore treated area (3 inches vertical) is now indented, towards the bottom you can see a quarter size indentation and with broken skin and still oozing....it was perfectly fine before, smooth and scar free....help??? What should I do?...the office I had this done are closed. I'm afraid of ending up with more scars then I came in with. damn... Settings were 60 mj, level 7, and 8 passes.
  14. Hi Everyone, Long time lurker, and I finally bit the bullet to create an account and post. I need some advice for my pitted scars on my left cheek with active acne. For some reason my cystic acne loves my left cheek and crops up every 4 months or so for the past 2 years. I've had cystic acne all my life, and after different treatments it slowed down for the most part. Just my left cheek is active. My wedding is next July and I'm trying to lessen the severity of the pit appearances. My dermatologist recommended me RF - Radial Frequency? Microneedling or Faxel treatement. They recommend Microneedling for me. It costs $3,600 USD for 3 treatments. This seems very high priced based on what I've seen, however I really trust and like my dermatologist and she's never been one to push me to do things I didn't like. Based on the comments I've seen , RF microneedling hasn't really worked for a lot of people, in fact ive seen it damage people ? What about Fraxel? Should I just go ahead with Inifini or fraxel - even if it helps a little? I feel stuck with little options. Are there any other recommendations that are not aggressive like skin punching/surgery (both NOT recommended by dermatologist due to skin type) or subsicion or even dermarolling? I don't want to do any DIY stuff since I scar very easily - I'm prone to have keloids and raised scars. (If it's basic name brand creams - I'm all for it. Just nothing like aggressive such as 80% TCA peels at home) I'm also tempted to consult with other dermatologist, but it is time consuming and costly for several consultations. I just want advice on what has worked for people who have had not-too-aggressive treatments. Anything that has helped slightly improved appearance(10-20% improvement) would be good with me, I'm feeling desperate. Provided below is my skin background alongisde the duration or year completed: Skin background: -Cystic Acne (all my life, I am 25 yo) -3 Keloids scars from cystic acne on shoulders and shoulder blade (10 years old) -raised white back acne scars ( 10 years old) Treatments: -regular monthly "light" chemical TCA peels on face and back , 10 - 30% depending on face or back ( 2015 - 2016 current dr) -Steroid injections for keloids and cystic acne (2015-2016 current dr) -Laser treatment, Genesis - Did not work ( 2014, at skin spa) -Obagi Kit - Effective for forehead cystic acne , got rid of 80% of acne (2010, done at different skin spa) -Birth Control, got rid of 5-10% of acne - stopped working after 6 months (2010 PC physician) -Tetracycline, worked for 6 months (2008/2009 PC physician) Provided below is a pic of my lower half of my face, apologies as i have makeup on, but you can still see my pitted scars.
  15. What is the difference between fraxel repair laser, restore, pixel and pearl? I want to repair some individual atrophic scars. What kind of down time is there?
  16. i am a 41 yr old male and over the last few years have gotten a number sebaceous hyperplasia on the face. I have tried the following with results: -topical retin-a micro (tretinoin gel) 40% decrease in size of papule -topical tazorac 50% decrease " -topical epionce lite lytic lotion 50% decrease " -topical cp serum 10% decrease " -topical cellex-c 5% decreases " -benzoyl peroxide 20% decrease " -light electrocaughtery-not recommeded since approximately 1 out of 4 result in a noticable hole in skin due to unpredictable results. -levulan-decreases papules 75%-100% but result is temporary.lasts couple months.not worth the money and time you spend red and peeling to get final result. -fraxel-reduces papules by 60% but result is temporary not worth money spent -oral isotretinoin aka Accutane at 10mg per day 99%-100% decrease in papule within 14 days**this is the best solution i have found** switch to 10mg once every 2- 3 days. the only frustration is getting a dermatolgists to prescribe isotretinoin. none will suggest isotretinoin unless you ask and beg for it. this is due to the big scare with accutane and risk of suicide. the new mandate in the u.s. by the fda and ipledge does not allow a dermatologist to write a isotretinoin prescription for sebaceous hyperplasia. it is not a covered prescription on health insurance for sebaceous hyperplasia either. my dermatologist told me isotretinoin works great and nothing works better, and that no topical lotion will resolve sebaceous hyperplasia. but he was bound by the rules of ipledge. i had to persuade my derm docter to agree to give me a prescription, then go over the internet and order it myself from a canadian pharmacy. thus paying for it out of my own pocket. isotretinoin miraculously relieved me of sebaceous hyperplasia completely within 14 days. you are supposed to limit your alcohol intake to little or nothing per day due to the taxing affect alcohol has on your liver and the potential toxic vitamin a affect in isotretinoin. i have not been able to find any studies that indicate any negative affects of low dosage 10mg per day of isotretinoin. although with equal success, i changed to 10mg once every 3 days, after the first 2 weeks of daily dosage. i know with higher dosages for severe acne such as 80mg to 150 mg per day can pose some additional risks. in any case no matter what dose, it is suggested to get liver function tests periodically to check if your triglycerides are at the proper level.
  17. July 2016 Davin Lim on Energy Devices and Scar Treatment Interesting Infini (goes 3.5mm, laser only 1.5mm) is his favorite when he is the Fraxel Spokesman, he gets the machines for free and is paid to talk at conferences. Fraxel he said "is the most overrated treatments out there", good for minor scars but not many things. CO2RE is more powerful than the Fraxel device, even Re:pair. His number one recommendation seems to be Subcision & Filler depressed scars, & TCA Cross Icepics. As I have been saying in the FAQ for out Sub Forum... lasers are for surface texture and filler, subcision, microneedling, tca cross / spot tca peels, are great for scars before you go the laser route. Start with non energy treatments first and move to energy devices if you are ready ;-P He said to only do a derminator not a dermaroller they are not effective microneedles and often tear. https://www.youtube.com/watch?v=38Wty2Rpj7U Dr. Davin Lim covers Lasers and Radio Frequency Micorneedling in the Video with Pluses of Each New Technology for Acne Scaring, wrinkles, and large pores. Syneron Candela Core / Co2re laser (good for acne scars "laser of choice acne scars" as it is customizable up to 80mj setting and can do hybrid mode like Total FX or shallow settings like Re:Store ETC All-in-one) Fraxel re:pair (tightens, refreshes skin, acne scars) Cynosure Picosure focus laser (great for large pores, no down time, ethnic skin, hyperpigmentation) Lutronic Infini Radio Frequency Microneedling (tightens & plumps, fractionated skin refreshing, goes deeper than laser, low down time) Ematrix (active acne pustules ablates top surface of skin) Scition erbium laser (great for ethnic skin or stacking with CO2 laser) Video Overview / Fractional laser resurfacing- dermatologist Review of All New Laser Technologies and Radio Frequency and Pluses of Each: Syneron Candela Core / Co2re laser with deep acne scars: Results of Laser Acne Scar Procedures: Subscision is Still the Best Cheap Non Laser Treatment for Rolling Acne Scars: Tethered / Anchored / Puckered: TCA Cross for icepicks Procedure:
  18. ACNE SCAR Q&A / FAQ; LIBRARY of POPULAR THREADS <If You Have Updates / Hints/ Tips for This Thread, or Questions, Please PM Me> Special Thanks for Contributors : Robertitoo, DeLovely, PCT14, QuanHenry, Hope01, Dan Owner of Acne.org Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor, Dermatologist, or Plastic Surgeon provides you. Please keep in mind that this is for general information only and results will vary for each individual. TABLE OF CONTENTS: 1. SUCCESSFUL TREATMENT THREADS 2. WHAT IS ACNE & PREVENTING SCARS 3. DIFFERENT TYPES OF SCARRING 4. TREATING SCARS AT HOME 5. SKIN: TEXTURE, DRYNESS, RED, BROWN, WHITE MARKS, & COVERING UP SCARS 6. PUNCH GRAFTING & EXCISION 7. HYPERTROPIC / KELOID (RAISED SCARS) 8. SUBCISION 9. FILLER FOR SCARS 10. LASER 11. MICRONEEDLING 12. TCA CROSS FOR ICEPICK SCARS & ACID PEELS 13. LIST OF ACNE SCAR TREATMENT DOCTORS 14. ANATOMY PICTURES ___________________________________________________________ 1. SUCCESSFUL TREATMENT THREADS Scar Treatment Success > PCT14 Suction and Subcision Success with Suction http://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/ > MR. Matt Subcision Success http://www.acne.org/messageboard/topic/232731-man-in-the-mirror-pre-and-post-subcision-photos/ > Boxcar scars improved significantly through subcison http://www.acne.org/messageboard/topic/323172-my-total-fx-diary-procedure-scheduled-for-120412-updates-to-follow/ > DC Girl TCA improvement http://www.acne.org/messageboard/topic/337794-scar-success/ > Success Recell UVB Lamp + Melgain (Decapeptide - Basic Fibroblast Growth Factor) Fixing Vitiligo, Lightened Scar Hypopigmentation, Loss of Pigment Skin Discoloration http://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/ > Infini RF and Laser Didn't Fix It Filler and Subcision Did http://www.acne.org/messageboard/topic/322562-my-infini-treatment-for-my-acne-scarring/#entry3301228 > Scared pores/ice picks improvement of as well as a few boxcar scars http://www.acne.org/messageboard/topic/316133-just-had-ablative-fraxelrepair-and-ultrapulse-co2-with-photos/ ___________________________________________________________ EMOTIONAL / PSYCHOLOGICAL EFFECTS OF ACNE / SCARS (YOU'RE NOT ALONE) Many acne scar sufferers live a life of pain from their outward appearance. This often manifests itself with low self esteem or hiding away in the house from anyone seeing them. It can affect one's life in many ways that are not healthy, both physically, mentally, and spiritually. When the acne scar sufferer finds treatment, they often are overly critical of themselves and think everyone else sees them the same way; this is a sub form of BDD - Body Dysmorphic Disorder called Acne Dysmorphic Disorder. This can lead to a obsession for perfect skin and finding small faults in them and others. A roller coaster of unrealistic expectations of treatment outcomes and something to save them becomes not realistic. Part of healing from Acne Scars is realizing you will get a small percentage of improvement at a time with each treatment that can take many years in some cases. Glass perfect smooth skin is a goal but often not a reality of severe scarring. Therapy can help get that remaining percentage to live happy and healthy lives. Colleges offer low cost therapy to everyone and now there is a smart phone app even if you cannot leave the house where you can get therapy called Talkspace which has helped many. Acne.org also has a psychological challenges sub forum linked below. > Emotional/Psychological Effects of Acne Scarring (Individual stories) http://www.acne.org/messageboard/topic/360711-emotionalpsychological-effects-of-scarring/ > Emotional/Psychological Effects of General Acne - Sub Fourm for Acne.org http://www.acne.org/messageboard/forum/10-emotional-and-psychological-effects-of-acne/ ___________________________________________________________ 2. WHAT IS ACNE & PREVENTING SCARS Q: How Does Acne Occur? A: Sebum overproduction, hyperkeratotic obstruction of sebaceous follicles, and microbial colonization that promote perifollicular inflammation. When the content of a comedone, the mixture of keratin, cell debris, sebum and bacteria, is exposed to tissue due to the breakdown of the follicular wall, inflammatory cells aggregate and counteract these foreign bodies. That is why painful papules, pustules, nodules and cystic acne form. Inflammation in acne is typically a destructive process, reaching deep into the subcutaneous tissue where the follicular structures are situated. It is more destructive for the deeper structures than the superficial. The more manipulation through squeezing, pushing, and pricking, and picking the greater the chance follicles will rupture, and the more severely the acne will inflame. The longer the inflammation persists, the more tissue that will be destroyed and scar. Scarring tends to be genetically linked to an individual's unique inflammation response. Those people with a "secondary inflammatory response" to trauma tend to scar, while those with a "single inflammatory response" to trauma tend not to scar. This explains why some people will scar easily and others maintain a smooth complexion even through moderately severe battles with acne. Prevention is always better than cure Q: How can I prevent my acne from scarring? A: The best way to prevent scarring is to prevent the acne that causes it. See http://www.acne.org/regimen.html Sulfur cream, or Benzoyl peroxide on pimples, and Retin A cream nightly have helped many. ** The newest treatment is called Photodynamic therapy (PDT) which uses a medication which is absorbed by the bacteria and oil glands in the skin, and a light source (blue led) to activate the medication closing the pore after several treatments. Intense pulsed light that is used for photofacials can also be used to do a PDL type treatment by activating these medications. For extremely severe, widespread acne, you may choose to see a dermatologist to inquire about Accutane medication which does have side effects. Many dermatologists contend that scars are really more from picking than from the acne itself. Occasional popping can often be performed quickly and safely. It is the picking afterward that often leads to the worst scarring. Scarring tissue theoretically has no regenerative capacity, and will not grow unless it is hypertrophic or a keloid. Meaning you can improve the cosmetic "look" of the scarred skin but the underlying skin structure is scared tissue. If you have pimples specifically underneath the nose region or in the chin / goatee region, or they could be just near your ears and on the cheeks. These pimples or cysts maybe keep appearing in the same spot(s). This could be due to Staphylococcus Aureus bacteria, do not pop these, ask your dermatologist to swab and send to the lab to culture, antibiotics will be needed. Pimples tend to be all over the face, staph can be more cystic or in a contained region. Q: What happens to my scars as I age? A: In ageing skin, progressive tissue laxity worsens the problem of unevenness around scar tissue. Aged skin loses its elasticity and descends under gravity, the scarred tissue and the normal ageing skin behave differently. This difference makes the skin appear more uneven. More Fat loss naturally makes the scars appear much worse, this is why we use fat and hyaluronic acid fillers for ageing augmentation. Q: What is my Fitzpatrick Scale of Skin Darkness & Type (This Determines Treatment) Please note non-white skin can hyper pigment with energy devices source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 ___________________________________________________________ 3. DIFFERENT TYPES OF SCARRING Q: Can you describe the different types of scarring? scar types: source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 Icepick: Looks like an ice pick has been pressed into the skin. It is generally small in diameter, but can be shallow or deep. Boxcar: Looks somewhat like a chicken pox scar with more rounded edges. It can be small or large in diameter and is fairly deep, though not usually as deep as icepick scars. Rolling: Looks like a smooth indentation in the skin. These scars can be deep or shallow, but are generally shallower. Macules: Pigmented scars, These are most common on the back, chest and arms. They are small areas of hairless scar tissue that will initially be red but will usually fade to pale ivory within 1-2 years. They can be raised (hypertrophic) or indented (atrophic). There are two basic types of Raised scar types: Hypertrophic scars - are scars that are raised above the skin surface but remain within the boundaries of the original injury. Scarring and can be treated with silicone sheets , liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam / QuadroStar Pro Yellow Laser. The treatment options include laser ablation, electrodessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful. Keloid scars - which are raised scars that extend BEYOND the boundaries of the original sore, blemish or injury. It is scar tissue gone wild. It can continue to grow. Some people are genetically prone to keloid scarring. (Treatments are the same as Hypertrophic Scars above, with steroid injection & cryosurgery being the number one treatment for the raised texture). Q: How can lighting effect the appearance of acne scarring? A: Lighting can have a tremendous effect on the appearance of acne scarring. Some women use silicone primers to fill the scar / pore before makeup or blurring creams, serums, and primers you can get from a makeup store. Your scars will look worse with fluorescent lighting and when not moisturized and plump. Night light and harsh lighting can look worse for many, this is why they put HD makeup (which is thick) on at night. Guys can grow facial hair to cover it, put lots of sunscreen, or avoid sports where they get red and it shows the scars. Pure higher weight serum has bigger molecules,... hyaluronic acid makes your skin moist, low weight HA inflames and plumps the skin hiding the scarring. Use a gel moisturizer over a cream, less break out potential though often the thicker moisturizers plump the cells. Indirect lighting - shows the true scars (scars make shadows, turn out the lights and use a flashlight) . ___________________________________________________________ 4. TREATING SCARS AT HOME Q: Is it okay for me to treat my scars while I am on Accutane? A: No, it is suggested that you wait at least 6 months to a year to treat your scars after taking Accutane. Some individuals have reported that they seem to scar more easily while taking Accutane. If you have completed a course of Accutane and only use it occasionally or in low dose form your probably ok to do acne scar treatments (you can stop 2 weeks before major treatment). Q: What is the Lemon & Vinegar Method? A: This is a method that may improve the appearance of shallow, rolling scars. Drink either Robinson, Lemon Barley Water or plain water with half a teaspoon of lemon juice to a full glass of water throughout the day. It is best to use fresh lemons if possible. Use any diluted vinegar (organic apple cider if possible, malt or white are also acceptable) in warm water to splash onto the face day and night. You may have to experiment to find the right combination of water to vinegar. Try diluting it 1 part vinegar to 4 parts water to start with. First wash your face with your normal cleanser, and then apply the vinegar (dab the solution on with cotton balls and leave on) before other topicals / moisturizers (apply topicals 20 minutes later). You should see an improvement within a week or two. Q: What can I do NOW (at HOME) to improve my scars without going to the doctor? A: Retin A topical from ebay turns over skin quicker. Microneedle the scars we recommend you buy the Derminator (see link below) and use at 1.5mm once per month. When that heals alternate with a Acid Peel (like TCA - Can be bought at "Makeup Artist Choice"). TCA Cross is the best treatment for icepicks, see below for more info on these treatments. Makeup will help guys and girls spot treat their scars and even out color (all the stars and people on TV wear it) Dermablend at Macy's and Nordstrom was made for surgical scars and tattoos (Unisex). http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ A: As mentioned, most people with moderate scarring do not find that topical solutions have a significant effect on their scarring. However, they can help lessen scars if used in the healing stage. Topicals typically do nothing for scarring. They are a preventative, but Retin A Gel and Vitamin C Serum can help the skin heal and create new collagen. Many combine these with their other treatments like microneedling. Q: Will Microdermabrasion reduce the appearance of scarring? A: It is generally thought that Microdermabrasion cannot penetrate the skin deeply enough to affect the appearance of moderate to deep scarring. It is a great method of exfoliation at home using a microfiber cloth or spin brush. Be careful of bacteria. Q: What treatments offer the biggest change? A: Subcision can help smooth out the skin for those with tethered scars. Filler with subcision to avoid tethering down again if you have atrophy (missing fat under scars), be sure to see a specialist who has done acne scars before, you can always ask for pics. If they don't do subcision to create a pocket under the scar the tethering will not lift with filler. For ice picks, TCA Cross to make the ice pick raise and widen. Microneedling for all types of scars makes the skin heal and renew itself, it's a slow process (also breaks up scar tissue). TCA peels renew the skin and cause it to refresh what's under the controlled chemical peel (similar to laser without the cost). -- See below detailed subcision section. Q: Is there anything I can do to optimize my healing responses following invasive scar procedures? A: Yes. Through a healthy diet (no sugar, carbs, highly processed foods, lots of fruit, veggies, and greens, lean fat meats, low salt). Supplementation: collagen, vitamin c, vitamin K, Bromelain, pure HA serum. Topicals: Vaseline - keep it moist until scabs fall off, don't pick it, vinegar soaks with diluted vinegar water, Arnica Montana for the bruising and red, sunscreen all the time, hydroquinone for bleaching and hyperpigmentation issues. Do not take blood thinning products (i.e. Ibuprofen / Motrin...take Tylenol instead, vitamin E). Spices that thin the blood: cayenne pepper, onion, ginger, paprika, peppermint, thyme, cinnamon, dill, oregano, turmeric, garlic, chocolate, fish oil. ginkgo biloba, ginseng, magnesium, taurine energy drinks. You may take these once your body has healed from the initial surgery (a few days , to a week). Using makeup can cause infection if the skin is not healed fully. Drinking and smoking hinder healing. Make sure to get plenty of rest during recovery, & drink lots of water. Q: How do I get multiple doctors opinions for treatment "FREE"? A: Post a few pictures of your scars using indirect lighting (scars make shadows) like below on http://www.realself.com . Some doctors will give you their opinion. Be aware sometimes their treatment recommendation is a canned response (the "laser" they own or are sponsored by). Post treatment recommendations for a second opinion on the forum here. Start with Non- Energy treatments first. source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 ___________________________________________________________ 5. SKIN: PIH, PIE, Erythema (red), Hyperpigmentation (brown or other colors), Hypopigmentation (white), TEXTURE, DRYNESS, & COVERING UP SCARS DEALING WITH SPOTS OF ALL COLORS AT HOMEQ: Where do I start?A: Hyperpigmentation takes a long time to heal. You can try to simply wait it out...but it never hurts to try and heal your spots naturally:-Aloe vera gel + honey and vitamin K (gets rid of bruises and red) keeps the spots moist creating quicker healing.OR You can use Emu oil or triple antibiotic cream to keep your wounds moist (Note: this breaks out some people so please spot test). In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation.-Fresh lemon has helped some people fade their spots and also topical green tea. -Topical Vitamin C serum can help some fade their reds and browns and in others it has irritated their skin. Always wear sunscreen. In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. These spots can take months to heal being irritated wounds, the remnants of acne or other skin issues. If this doesn't work stronger treatments are below>> https://www.youtube.com/watch?v=Re_NdcVGI_A ___________________________________________________________ DIET NEEDED FOR HEALINGQ: What can I do diet-wise to deal with my spots (red, brown, white)?A: Eliminate: sugar, dairy, gluten, start eating fermented foods and bone broths, take your probiotics, and antioxidants such as green tea, vitamin C, and niacinamide. Smoking stops healing as does too little rest. You need animal foods in your diet, especially healthy fats, so don't be afraid to eat fatty meats! If you are a vegetarian eat nuts, hummus, coconut & olive oils, Many with these spot flare-ups mixed with red hyperpigmentation have candida (yeast) and gut health issues. This might need addressing. After antibiotics, this common yeast can cause issues in the body.___________________________________________________________ WHAT IS: POST INFLAMMATORY ERYTHEMA (PIE) - red spots that turn white after being pressed on Q: What Is Post Inflammatory Erythema (PIE)? A: Post Inflammatory Erythema (PIE) describes pink to red discoloration after an inflammatory acne lesion. Patients with lighter skin types (I-III) the post-inflammatory dyspigmentation is often not hyperpigmentation, but instead discrete erythematous macules (PIE). Acne may not be the only cause of post inflammatory erythema, as any resolving cutaneous inflammatory process may have residual erythema. Treatments (ranked most effective to least): V-beam, or IPL, or Excel V, or 1064nm, or QuadroStar Pro Yellow Laser (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), steroid creams from the derm, Retin-A Cream, Bactroban cream, Silicone Sheets and topicals (known as scar gels), 2.5% hydrocortisone twice per day (only for a weeks time - it thins the skin), triple antibiotic. Some find light (%) peels helpful like Salicylic Acid or Glycolic (Acne.org has an excellent one in the store)... Your skin must not be raw, overly thin, or any allergy to aspirin (Sali) . Please do not use Scrubs, Harsh Soaps or Exfoliants that prolong the wounding. Emu Oil, Honey, Aloe Vera, and Green Tea are soothing / healing. Visine aka red reducing eye drops temporarily reduces the red and concealer (makeup), while you heal. How to care for Erythema First, get your skin completely clear from active acne. This way you are preventing any future Erythema. Once you are clear, you can try a Erythema treatment above to reduce the marks you might have. Topical treatments are the first choice for treating Erythema. The treatments most commonly prescribed by dermatologists are Steroids.Erythema is common among people of Caucasian descent. Erythema can also occur in darker skin, albeit less frequently. UV light – the light from the rays of the sun – can make Erythema worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of Erythema and allow any Erythema you currently have to heal as fast as possible. How to prevent Erythema Picking at acne lesions is the worst culprit when it comes to creating Erythema. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping Erythema skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.1,5,9 The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any Erythema that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option. ___________________________________________________________ WHAT IS: POST INFLAMMATORY HYPERPIGMENTATION (PIH) - brown spots or red that stay after being pressed on Q: What Is Post Inflammatory Hyperpigmentation (PIH)? A: Post Inflammatory Hyperpigmentation (PIH) is related to brown spots, and permanent red spots. The discolorations are caused by an excess production of melanin. Vitamin C, Glycolic, Hydroquinone (skin bleaching cream) are all great tools for inhibiting melanin which will fade the discoloration. PIH is more common in darker skin types (Fitzpatrick IV-VI), although it is not limited to any skin type. Treatments ( ranked most effective to least): V-beam, or IPL/ photofacials, or Excel V, or 1064nm, or QuadroStar Pro Yellow Laser (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), Alpha Hydroxy Acid peels: glycolic * good also for smaller pores, TCA, Mandelic (Acne.org has an excellent one in the store), Skin bleaching creams (aka hydroquinone or Kojic cid w/ Arbutin), Retin-A Cream for cell turnover, Vita-K cream for Blotchy Skin . How to care for hyperpigmentation First, get your skin completely clear from active acne. This way you are preventing any future hyperpigmentation. Once you are clear, you can try a hyperpigmentation treatment from above to reduce the marks you might have. Topical treatments are the first choice for treating hyperpigmentation. The treatments most commonly prescribed by dermatologists are hydroquinone (HQ) and retinoids.11Hyperpigmentation is common among people of African, Asian, and Latino descent, as well as other forms of non-Caucasian skin.1-5 Hyperpigmentation can also occur in Caucasian skin, albeit less frequently. UV light – the light from the rays of the sun – can make hyperpigmentation worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of hyperpigmentation and allow any hyperpigmentation you currently have to heal as fast as possible. How to prevent hyperpigmentation Picking at acne lesions is the worst culprit when it comes to creating hyperpigmentation. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping hyperpigmented skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.1,5,9 The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any hyperpigmentation that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option. Hydroquinone: (Bleach Eze®) Hydroquinone is the first choice of treatment for hyperpigmentation.12 It is normally used at a concentration of 4%. In higher concentrations it can cause "spotted halos," which appear as lighter colored ring around marks. Hydroquinone treatment results in a marked improvement or complete clearing of PIH in 63% of the patients.4 The efficacy of hydroquinone may be increased by the addition of a retinoid and a low potency corticosteroid, such as hydrocortisone.13 Side effects of hydroquinone include burning, redness, and itching in 30% of the patients.12 The addition of ascorbic acid (Vitamin C) to a topical hydroquinone treatment may help minimize side effects.2-3 Hyperpigmentation starts to subside after 4 weeks of hydroquinone treatment, but maximum results usually require 8 to 12 weeks of treatment. Be certain to work closely with your physician or dermatologist if you decide to use hydroquinone to ensure proper dosage and reduction of side effects. Read Reviews No Reviews Retinoids Tretinoin (Retin-A®), Adapalene (Differin®), or Tazarotene (Tazorac®). Retinoids are vitamin A analogues that are typically used together with hydroquinone. Retinoids are topical treatments that can help fade marks and treat acne at the same time. According to the Journal of the American Academy of Dermatology, “Of particular significance to skin of color patients is the ability of retinoids to treat both acne and PIH. By increasing epidermal turnover, these agents facilitate melanin dispersion and removal.”8 A study published in The New England Journal of Medicine on people with skin that was darkened by hyperpigmentation showed that daily retinoid treatment resulted in “much lighter” skin in 53% of participants and in “somewhat lighter” skin in an additional 33% of patients.14 If retinoids are used alone and not in combination with hydroquinone, dermatologists often prescribe a topical corticosteroid in order to reduce the irritation and potential worsening of PIH that retinoids can cause when they are used alone. An expert opinion in Skin Therapy Letters sums it up: “The use of retinoids as monotherapy is not recommended as an irritant reaction may cause inflammation that induces paradoxical hyperpigmentation; a similar concern exists over the use of HQ as monotherapy at very high concentrations (i.e., 8-20%).”12 Retinoids typically take 8 to 12 weeks to produce maximum results. The frequency and concentration of retinoid therapy depends on the severity of hyperpigmentation and should be determined by a dermatologist. Tretinoin Read Reviews 3.54/5 - 1396 reviews Adapalene Read Reviews 3.3/5 - 1305 reviews Tazarotene Read Reviews 3.51/5 - 615 reviews Niacinamide, also known as Nicotinamide. Niacinamide is a B vitamin that can be administered topically, and is currently being investigated as a potential therapy for hyperpigmentation. A study published in the journal Cutis in 2015 showed that a topical cream containing 4% niacinamide in combination with the other pigment-lightening and anti-inflammatory compounds arbutin, bisabolol, and retinaldehyde reduced hyperpigmentation due to melasma by 34% over a period of two months. Melasma is a common skin problem where brown marks appear on the face due to pregnancy or sun exposure.15 To date, there exists no published research that has investigated whether niacinamide is also effective in treating PIH, but studies are currently in progress. Read Reviews 4.5/5 - 3 reviews Azelaic acid Azelaic acid is another topical acne prescription that is sometimes used for PIH that works by slowing down the production of melanin. It is a gel that doctors normally prescribe in 20% concentration for PIH, applied twice a day. Azelaic acid is safe and effective for the treatment of both acne and PIH conditions in darker skin types. Common side effects include mild redness, scaling, and burning.16 Due to the mechanism of action of azelaic acid, results are not seen for the first few months of azelaic acid treatment, but results are eventually seen after six months. Read Reviews 3.89/5 - 218 reviews Gentle Chemical Exfoliation Over-the-counter glycolic acid products are available in strengths up to 10% and can provide gentler chemical “peeling,” which is better described as gentle chemical exfoliation. At lower percentages in over-the-counter products, glycolic acid does not cause the skin to visibly peel off in sheets like professionally administered chemical peels do, and instead provides exfoliation of only the surface cells of the skin. This is a slower and safer way to achieve the skin turnover required to reduce hyperpigmentation and can be used on a more frequent basis when compared to chemical peels. Most people find that they can tolerate over-the-counter 10% glycolic acid products every two or three nights, or every night when mixed ½ and ½ with moisturizer. Acne.org AHA+ Read Reviews 4.41/5 - 332 reviews Alpha Hydrox Enhanced Lotion Read Reviews 4.11/5 - 58 reviews ___________________________________________________________ WHAT IS: HYPOPIGMENTATION - white spots (loss of pigment) Q: What Is Hypopigmentation? A: Hypopigmentation is: Vitiligo, pigment loss due to burns, scars, skin discoloration. Treatments: XTRAC Excimer Laser at 308nm or Light Box phototherapy treatments UV-B lamp, Melgain (Decapeptide - Basic Fibroblast Growth Factor), and microneedling at home. Clinics use costly Recell which only has a small percentage of working on scars. A new spot treatment is LATISSE (bimatoprost ophthalmic solution) to darken the hypopigmentation and and cause "some" pigment to slowly return. Checkout the link below for how a member fixed his hypopigmentation. If nothing works there is medical tattooing http://basmahameed.com/paramedical/surgical-scars.php Read More here: http://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/?page=5 https://www.youtube.com/watch?v=lW7VAUMclIk ___________________________________________________________ TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, Large / Scarred Pores Q: How do I improve my large pores, and orange peel texture? -- Please See the Filler and Subcision Section below for a detailed description for scars. A: At Home Retin-A - Increases Skin turnover production. BHA (Glycolic acid peels) like you find from Acne.org store above. Paula's Choice 10% niamincide booster. Niamincide has been proven to thicken skin and shrink pores. There is a cream called Benefit Cosmetics "Pore"fessional that blurs these spots, used as a primer under makeup or by itself. TCA Cross using 50%, you need a very tiny way to either get into the pore and not hit the walls doing a little at a time until they heal. Some have used a broom bristle, shaved down toothpick, and tiny needle to fit inside pores or ice picks. For a larger area you can spot treat with TCA full peels (spot treatment on your scars 35% and under, start at 15% and move up, do a test spot to see how your skin reacts before going crazy). Always degrease with acetone or rubbing alcohol and a pre-peel jesner / glycolic peel before. You can do a few at a time, so you can cover with makeup. Doctors treatments: -PDT (Photo Dynamic Therapy) using led blue light and medication to shrink pores -Infini shrinks pores -Laser Genesis, Clear and Brilliant, Fraxel 1927 (only, not 1550), Shrinks pores and small acne scars -Sublative (ematrix) is good for surface texture takes many treatments, results are subtle like laser genesis -Microneedle .05mm followed by botox to the pores superficially shrinks them. Q: Can Guys Do Anything to Cover Their spots and Help with Self Esteem?A: Guys you can be as manly as you want and wear makeup (the ladies have had this tool for some time). Hear me out. Movie stars, news anchors, models, musicians, Youtubers, and even politicians wear makeup. Buy a concealer for just your acne scars and spots (spot treat them). You want it to match exactly your skin color and not be shiny ("matte"). My favorite is sold at Sephora (they color match you) Makeup Forever Camouflage Concealer, this looks extremely natural on the spots. Dermablend is sold at Macy's and Nordstrom. This is used for medical scars and to cover tattoos (they match your color) and it's very thickly pigmented. Ben Nye Cover All Wheel and Bill Nye Concealer Wheel sold on Amazon and Ebay (it has various shades), this is used in the theater. Q: What can I do for extreme dryness, bumpy or bad texture, small wrinkles, or marks? -- Please See the Filler and Subcision Section below for a detailed description for scars. A: Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation or ... Skin boosters (very popular in Europe and Asia) like Restylane Vital, Juvederm Hydrate or other HA products are not crosslinked like what is used in filler and much more superficial (just under the epidermis). Filler provides lift; but boosters are different making a bunch of small injections to provide intense hydration, minor skin correction, and small textural improvements.http://www.acne.org/messageboard/topic/357406-skin-boosters-restylane-vital-hyaluronic-acid/ ___________________________________________________________ 6. PUNCH GRAFTING & EXCISION Q: What is Punch Excision & Dermal Grafting? A: Punch Excision is a procedure whereby a doctor will use a tool to punch out the scar and then sew the remaining skin together. Dermal grafting is a procedure whereby a doctor removes skin from a different part of your body (usually from behind the ear) and places it into the scar. Ice picks are often treated this way. Dermal Grafting has lost favor with dermatologists because the fat does not last and we have fillers now. Acne Scar suffers heal poorly, so there is a high outcome of poor results using this method. ___________________________________________________________ 7. HYPERTROPIC / KELOID RAISED SCARS Q: My scars are raised (hypertropic), not indented (atrophic). How can it be treated? A: This is called hypertropic (aka keloid) scarring and can be treated with silicone sheets (OTC - Walmart, Walgreen's, CVS, Boots), liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam / QuadroStar Pro Yellow Laserlaser. The treatment options include laser ablation, electrodessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful. Keloid scars, different from hypertropic, are scars with tendencies to invade the peripheral tissue, expanding in size, and growing persistently. Keloid scars should not be treated by way of surface destruction. ___________________________________________________________ 8. SUBCISION Q: What is subcision? Will it improve my scars? Should I use filler? A: Subcision is a method whereby a doctor uses a "Nokor" needle to break up the scar tissue underneath the surface of the skin. It is said to be best for rolling scars that are bound down. If your bound-down scar tissue looks smoother when the skin on the sides of the scar is pulled tighter apart you're a good candidate. Some people's scarring has improved by this method, others have had minimal or no improvement, and others have had their scarring deepen (though this seems to be more rare). Please see your dermatologist for further information on this procedure. UPDATE: Filler and Subcision is now the GOLD standard for acne scar revision for rolling and box scar scars that are sunken (fat deficient). Fillers typically used are Perlane also known as LYFT, Ultra, Belotero, and permanent solutions you should only try if satisfied from filler are Aretefill / Bellafill, Fat. Note, if your doctor does not subcise the scar to make pockets for the filler and release the scarring, it will doughnut around the bound-down area and do nothing. Fat Grafting or Fat Transfer is used for those with large acne scars where it would take several syringes to fill one scar. Q: What is Vacuuming / Cupping / Suctioning After Subcision (Prevents Re-Tethering)? The role of suctioning is to prevent re-tethering, induce repeated hemorrhage, delay healing. You should begin suctioning 24 - to 48 hrs after your procedure. Depending on how you heal you will want the wounds to be closed enough that you don't break them open when Suctioning. You will continue this 8 times a day for 4 seconds for 2 to 4 weeks after your subcision, you can also do it 3 times a day (3 sets a time of 15 seconds, or however long you can stand it). This will enhance the results of your subcision. We recommend doing filler after subcision for consistent and instant outcomes... It's not as cost effective (filler is expensive) and vacuuming / cupping / suctioning with a acupuncture cupping set from Amazon or ebay. You will get possible bruising after subcision because of the hemorrhage creating filler under the scar and in the pocket wear make-up over this. > Success PCT14 Suction and Subcision Protocol http://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/ source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394 https://youtu.be/ansKjWAw_G0 https://youtu.be/SrtA44lPO_c ___________________________________________________________ 9. FILLER FOR SCARS In Depth Thread on Subject: http://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/ Q: What are injectable fillers and how can they reduce the appearance of scarring? A: There are many types of injectables used for augmentation. It has been shown that once they are injected into the skin, they can raise the surface of the scar. Unfortunately, most of the injectables widely available are not considered permanent. In addition, some are not available in all countries. Always try non-permanent fillers before you go the permanent route. Here is a list of some of them to get you started in your research: Juvederm Ultra or Perlane / LYFT HA Filler: <12 Month (If you're lucky) Filler / Cheaper / Lots of Lift: http://restylanelyft.com/ Volbella by Juevederm: Softer filler, can be used near the surface in the upper Dermis with subcision, great for under eye area. Beletero: HA filler, softer dermal filler, shorter lasting period great for thinned-skinned areas, no water hydration from surrounding tissue http://www.belotero.com/ Restalyne: Shorter lasting period: HA, cheapest Semi-Permanent / Permanent Fat (harvested from your own body - only some survives, may be lumpy and need a few surgeries, some is longer lasting). This is used for scars that are large (over 10mm) and would take several syringes of filler costing more than the fat grafting surgery itself which is a few thousand dollars - See your doctor for further info. Not Recommended but some users have success with these (our skin ages and changes, fat is lost, so long-term use outcomes are unknown - yet they are permanent). We heal poorly as acne scar sufferers or we would not have scars so it's a gamble... ArteFill / Bellafill, FDA approved - Microspere beads that are permanent, can migrate or cause grandulomas or fibrosis around the material. This is the number-one recommended permanent filler for acne scars right now. Silicone Microinjections, Not FDA approved - off label usage (Must be an experienced doctor who has done thousands of these), can migrate or cause grandulomas or fibrosis around the material. Here is a thread on various types of fillers: http://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/ ___________________________________________________________ 10. LASER In Depth Thread on Subject: http://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/ Q: My doctor says to get laser, will this fix my scarring quickly {NO IT WONT!}? A: Run, the doctor wants you to pay for his or her $110,000 new toy. They tell everyone it can slice and dice and do miracles light-based treatments of acne scars, patients are often encouraged to receive a greater number of treatments to get more satisfactory results but are seldom told that the clinical results are good for only 2 years (see the harmful side effects below an Dermabrasion which is permanent). Start with non-energy devices: your diet, hygiene, topicals such as Retin A, Accutane, Food allergy or allergy test from beauty products, acid peels, tca cross for those ice picks, microneedle, subcision to lift the tethered scars w/ filler to keep things plump. As acne scar sufferers we heal poorly, or we would not have the scars to begin with. Next step is move onto the big guys - energy devices that have high side effects (fat loss, healing worse) and only possible rewards. V-Beam / QuadroStar Pro Yellow Laser is safe for discoloration and most lasers are for surface texture only (acid peel also do this), it will not make fat appear or magical new skin. Laser smooths and softens texture and makes scars wider (the rough sharp edges). Q: What are the side effects of laser? A: I go into this in-depth in the below post... Burns, additional scars, hypopigmentation, hyperpigmentation, thinning of the skin, long-term redness, scar worsening, bacterial infections, breakouts, fat loss, blistering, scabbing, crusting, months of down time, demarcation lines, bruising, sun sensitivity, pain, swelling, itching, milia, lumps, bumps, large pores / orange peel, and acne. http://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/ Q: I did all the non - energy device recommendations first with no changes in my scars. What lasers should I take a look at now (remember it is a gamble of outcomes...as acne scarred individuals, we do not heal properly)? https://www.youtube.com/watch?v=sQUM3Xxzm3Q Q: What is the difference between ablative and non-ablative lasers? Definition of ablate from dictionary.com: "To remove by erosion, melting, evaporation, or vaporization." Ablative lasers are much more invasive than non-ablative lasers. Ablative lasers are not recommended for use on darker skin colors. Of course, with higher energy and removal of skin (in fractional cores) better outcomes are often had than non-ablative means. Also higher side effects, and in fact may make it worse. Seek an experienced professional of acne scarring. Always try non energy device solutions first. Laser is a gamble. Examples of ablative lasers: - CO2 - Erbium: Yag Non-ablative lasers do not remove layers of skin, but instead penetrate through the skin in an attempt to stimulate collagen growth from underneath the surface of the skin. They also are not very effective. Q: Will ablative lasers (CO2 or Erbium) reduce the appearance of my scarring? A: It is possible that it will reduce the appearance of your scarring but it can come with a hefty price tag, a significant amount of downtime and a risk of new scarring (see below). Q: What are the side effects of Ablative, Non-Ablative Laser Procedures / IPL / RF? A: Risks from ablative procedures include: Swelling, scabbing, and oozing Bleeding, flaking, and redness Significant irritation that requires a longer time to heal Long-term skin discoloration and more scarring Fat Loss, Filler Loss Poor Healing by Acne Scar Sufferers (who already heal poorly) Does nothing, a waste of money with long down time and healing For ablative resurfacing with a laser, the quality of the postoperative techniques is as important as the skill of the physician during the procedure. After ablative laser treatment, the skin oozes, crusts, and needs to be cleaned and dressed for about two weeks before you look even vaguely normal. Because the top layer of skin has been stripped away, the raw, exposed skin needs to be cleaned and treated very carefully. Patients need to make sure they follow post-op care instructions precisely, because inconsistency or incomplete care can cause infection, delay healing, and increase irritation. Non-ablative resurfacing has none of the side effects associated with ablative resurfacing. However, non-ablative resurfacing doesn't produce the same dramatic or impressive results. The advantage for non-ablative resurfacing is its minimal downtime and they work on ethnic skin without hyperpigmentation. Women can reapply makeup before leaving the doctor's office and return to work the same day. Non-ablative lasers can cause: Swelling and potential bruising (this fade within days) Enhanced redness or a sunburn-like reaction (this is temporary) Temporary darkening of treated spots (these lighten as they heal) No improvement, a waste of money Q: What should I get instead of laser if my scars are bad? A: Microneedling, subcision, and several medium TCA peels. This is done over 2 years. ___________________________________________________________ 11. MICRONEEDLING & Derminator In Depth Thread on Subject: http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ Q: What is Microneedling A: This is a technique whereby an aesthetician, doctor, or tattoo artist uses either a hand tool or a tattoo machine to needle the skin without using pigment. This is said to "break up" the scar tissue thereby smoothing the appearance of the skin. This is also known as a cheap man's laser, the skin heals the tiny cores that are made. NOTE: It is possible to needle yourself, but there are risks associated with this. Also, results are generally not as pleasing. It is best to see a specialist whenever possible. For more information, read this thread: http://www.acne.org/messageboard/topic/359068-the-derminator-thread/ To buy an automated machine to do this at home: http://shop.owndoc.com/product-list.php?Derminator-pg1-cid61.html Q: What is the "Dermaroller"? Can it improve scarring? A: The Dermaroller is an instrument that has tiny needles embedded in it that is rolled across the surface of the skin. It is mainly used for better absorption of topical treatments and does not appear to actually break up scar tissue. ___________________________________________________________ 12. TCA CROSS FOR ICEPICK SCARS, TCA FULL FACE AND SPOT PEELS, All Other ACID PEELS ** MUST READ -Everything About Acid Peels! How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ Q: What is the difference between TCA CROSS and a TCA peel? TCA CROSS is a method whereby a doctor or skilled practitioner uses a high percentage of TCA Acid (100%) and spot treats each scar. This procedure is especially beneficial for ice pick scarring. TCA CROSS is something that should be done by a skilled practitioner because the risk of damage to your skin can be great. TCA peels (Spot Peeling) are of a much lower percentage (15-35%) than TCA CROSS. TCA peels are done by dermatologists and aestheticians and affect hyperpigmentation and more shallow scarring. Buy TCA, Excellent Customer Service (Not Chinese Made Industrial Chemicals!): http://www.makeupartistschoice.com/ What is TCA Cross for Icepicks, Please Read The Below Link for All Things Acid Peels: ** MUST READ -Everything About Acid Peels! How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): http://www.acne.org/messageboard/topic/366754-discussion-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-phenol-glycolic-salicylic-methods-and-techniques/ https://www.youtube.com/watch?v=7qRj0pLXPIQ ___________________________________________________________ 13. LIST OF ACNE SCAR TREATMENT DOCTORS ** Please note we are not responsible for your treatment and care. Please be informed before you contact the physician for acne scar improvement. Further doctors can be found that are board certified on the Real Self website. Some Great Places for Reviews are http://www.yelp.com and http://www.realself.com Dr. Davin Lim ** Highly Recommended, Famous Specialty Acne Scars Dr, YouTube Channel : Lasers and Lifts Brisbane, Australia Specialty: **Lasers for Acne Scars, Subcision, TCA Cross, Filler, PRP, Vbeam / Picosure, multiple treatments at the same time. http://www.lasersandlifts.com.au Dr. Adrian Lim Sydney, Australia Dr. Davin Lim's Mentor While in Med School and Famous Derm Specialty: Fillers, Microneedle, Subcision, TCA Cross, Vbeam, Lasers http://urepublic.com.au/our-expertise/ Dr. Naomi Sydney, Australia Specialty: All Things Filler Core Interest (Expert Injector), Skin Boosters, Lasers http://drnaomi.com.au/ Professor and Department Head Tony Chu Chiswick, London Specialty: Dermatologist Expert, Subcision, TCA Cross, Microneedle http://www.westlondondermatology.co.uk Dr. Emil Henningsen Denmark / Nyborg, Sweden Specialty: Subcision, TCA Cross, Microneedle, Lasers http://www.emilhenningsen.dk/behandling_ar/ Prof C.L. Goh Singapore, Malaysia Specialty: Lasers for Asian Skin http://www.nsc.com.sg/Patient-Guide/Our-Doctors/Pages/Dermatologists.aspx Renewme Various Korea Specialty: Acne Scars, Nokor Subcision, Lasers, Plastic Surgery, Micro Fat Grafting http://rnmeskin.net/ Dr. Rullan ** Highly Recommended as a Top Scar Dr For the West Coast by Many Forum Members Chula Vista, California Specialty: Fillers, Microneedle, Subcision, TCA Cross, Vbeam, Lasers http://www.drrullan.com/ Dr. Emer YouTube Channel: Dr. Emer Hollywood, California Specialty: (Expensive) Liposuction, Fat Grafting, Microneedle RF, TCA Cross, PRP, Bellafill, Fillers, Lasers /QuadroStar Pro Yellow Laser, multiple treatments at the same time http://www.jasonemermd.com Professor and Department Head UC Irvine Chris Zachary Irvine, California Dr. Davin Lim's Mentor While in Med School Specialty: All Things Dermatology, TCA Cross, Subcision http://www.drzachary.net/ Dr. Sandra Lee AKA Dr. Pimple Popper YouTube Channel Upland, California Specialty: General Derm, Popping Pimples and Cysts, Acne Scars, TCA Cross, Microneedle, Subcision http://www.skinps.com/ Dr. Suzanne Kilmer Sacramento, California Specialty: Lecturer and Trainer on anything about Lasers http://www.skinlasers.com/ Dr. Greg Morganroth Mountain View, California Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.morganroth.com/ Dr. Evan Ransom San Francisco, California Specialty: Facial Plastic Surgeon, Infini RF, Lasers, Aesthetics, Dermabrasion http://www.sanfranciscofacialplasticsurgery.com Dr. Seven Swengel Los Gatos, California Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.RefinedMD.com Dr. E Victor Ross San Diego, California http://www.scripps.org Dr. Philip Young Bellevue, Washington Specialty: Acne Scar program with multiple treatment at once ... TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.drphilipyoung.com Dr. Joe Niamtu YouTube Channel: Joe Niamtu Midlothian, Virginia Specialty: plastic surgeon and trainer laser expert, fillers, subcision, chemical peels, excision, dermabrasion, and scar revision http://www.lovethatface.com/ Dr. Nelson Lee Novick ** Highly Recommended Acne Scar NYC Favorite Dr. NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.doctornovick.com Dr. Yang NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.GeorgeYangMD.com Dr. Ron Shelton NYC, New York Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm http://www.thenyac.com Dr. Roy Gerononus in NYC, NY Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.laserskinsurgery.com/Dermatologists/Roy-G-Geronemus-MD Dr. Berry Dibernardo Montclair, New Jersey Specialty: TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.newjerseyplasticsurgery.com Dr. Weiner Youtube Channel: Dr Weiner Panama City, Florida Specialty: Expert Injector/ Plastic Surgeon /Famous trainer, pioneer Infini RF spokesman, Fillers, Laser, Aesthetics http://www.theclinique.net Dr. Jill Waibel Laser Burn and Traumatic Scar Specialist Miami, Florida Specialty: Jill specializes in major burn scars with lasers and steroids laser drip, grafting, surgeries, General Derm http://www.miamidermlaser.com/jill-waibel/ Dr. Richard Sadove ** Highly Recommended Acne Scar Fat Grafting Facial Plastic Surgeon Gainesville, FL Specialty: Fat Grafting For Acne Scars, Subcision, Excision http://acnescarflorida.com/about-dr-sadove/ o2Clinic Antwerp Belgium Specialty: Micro Fat Grafting / Injections, Lasers, Plastic Surgery http://www.o2clinic.be/en/ Dr. Philip Bekhor Box Hill, Melbourne, Australia Specialty: Lasers, TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.drphilipbekhor.com.au/ Dr. Sam Lam Plano, Texas Specialty: Fat Grafting, Plastic Surgery, TCA Cross, Subcision, Microneedle, Fillers, General Derm http://www.lamfacialplastics.com/ Dr. Michael Gold Nashville, Tennessee Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.goldskincare.com Dr. Tina B. West Chevy Chase, Maryland Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://www.westskinlaser.com Dr. Noelle S. Sherber Washington, District of Columbia Specialty: TCA Cross, Subcision, Microneedle, Fillers, Lasers, General Derm http://sherberandrad.com/ Dr. Moon Choi Vancouver, Canada Specialty: Subcision, TCA Cross, infini Dr. Jeffrey Orringer Ann Arbor, Michigan Specialty: Subcision, TCA Cross Dr. Mark Taylor Salt Lake City, Utah Specialty: Extensive subcision Dr. Payman Kosari Charlotte, North Carolina Specialty: Subcision, infini Dr. Murad Alam Chicago, Illinois Specialty: Subcision Dr. Steven Mandrea Chicago, Illinois Specialty: Subcision with sculptra ___________________________________________________________ 14. ANATOMY PICTURES
  19. The 1.5 year war with acne, and my success

    This is going to be a long post. A little background info, I have had acne since I was 10 years old, and I am turning 20 this year, finally with clear skin. I call the past 10 years the "decade of hell". I think we all encounter some kind of moment where we go, damn, I've had enough of this crap. And thus began my last ditch efforts to salvage my skin, which I am happy to say has finally become beautiful. Having lurked on this forum for years, I feel like its time for me to give back. 1. Diagnosis First I narrowed down and diagnosed what conditions I had. Cystic acne on forehead, painful boils on my butt and pityrosporum folliculitis on my back (recurrent, would flare up from time to time). Now this was tricky, because I had both bacterial AND fungal infection. Am I supposed to care for my face and butt and aggravate the situation on my back, or the other way round? Damn this body of mine. 2. Prevention Having determined all the skin conditions to be treated, the most important thing now was to PREVENT FURTHER SCARRING AND PIGMENTATION. I cannot stress how important this is, because deep scarring is so much more difficult to cure, and being fair skinned, my hyperpigmentation takes a hell lot of time to clear. I'm talking about dark spots that remain even after a year. For my bacterial infections (acne on butt and face), I immediately went on doxycyline. Cheap, effective, doesn't cure the root problem but it did the job for now. The doctor would only prescribe me 3 months of doxycyline, 2x100mg pills per day. What I did was take a 100mg pill a day with breakfast, which lasted me for 6 months and worked fine. For my fungal infection on my back, I began orally taking oil of oregano by Swanson. The dosage is 150mg per softgel, and you are recommended to take 1-4 pills per day. Now this varies by manufacturing brand, so follow guidelines accordingly. I started off with taking 2 a day in the afternoon and evening (not clashing with my doxycyline). In addition, I would also apply topical oil of oregano to my back (either buy the liquid in bottle kind or cut open a softgel). Be sure to do it sparingly, and dilute it with an oil/cream of your preference if its not diluted beforehand because the strong stuff can burn your skin. Last of all, I used Head and shoulders shampoo to wash my back as it had 1% zinc pyrithione. All this is gonna make your back dry as hell, but do not moisturize because the fungus thrives in wet environments. Along with all these, I was applying 5% benzoyl peroxide on my forehead and 2.5% on the rest of my face as a precaution. I use the brand Benzac, but probably any kind of BP will do. All of these worked to curb the acne from ever rising to the surface for the time being. 3. Dealing with scars/pigmentation Now the acne was gone, but there were A LOT of scars and pigmentation, which looked especially terrible because I'm a fair skinned Asian. This is the part where it all gets expensive. For my face, I caved and did a full ablative Fraxel on it, which removes pigmentation, scars, and returns pores to original size. This is very costly in most countries, but I was in Seoul, South Korea for a month, and I managed to find a clinic that offered Fraxel for 280 usd. Fraxel was significantly painful and I had red peeling monster skin for about 7 days, but the end result was flawless. For my back, I did a 35% TCA peel for about 130 usd. Once again, skin blisters, angry red skin, the whole works. This was truly painful as hell after the numbing cream they used wore off. However, I had clear skin after it all peeled off and the one week mark. For my butt, I had been using arbutin and hydroquinone creams, but the results were too slow for my liking. I did a ng yag laser for brown spots at about 130 usd. I believe that alexandrite lasers could do the job as well. One session was all it took for the brown spots to dry up and flake off, but if I had not been using creams beforehand I might have required more sessions. 4. To cure the root cause Now this was the hardest thing of all, because I suspect my acne has hormonal causes (it got drastically better when I was on hormonal birth control for 6 months). However, I am not willing to be on hormonal bc full time (I use a copper iud), so that made things difficult. In addition, as a female who is open to having kids in the future, what the hell am I going to do when I get off bc? Suffer the same skin conditions once more? So I did it. I WENT ON ACCUTANE. Now there are smart ways to do this, and stupid ways. One stupid way is to go on low dosage accutane (about 10mg-40mg) and then complain that the results don't last. I am horrified at the number of derms and docs that actually allow this. Of course it doesn't work, accutane is not meant to be used this way. One good way to calculate dosage is by body weight: 1.0mg x ___ kg = your dosage I weigh about 45 kg, and this was my dosage for 6 months Month 1: 40 mg (To adjust to the dryness etc.) Month 2, 3, 4: 60 mg Month 5: 80 mg Month 6: 120 mg to knock the acne senseless forever Depending on whether your weigh more or less, your dosage will vary. Monitor yourself, don't push the limits of your body and take care of yourself. Note the side effects you suffer from accutane and DO NOT STOP taking it halfway just because your skin has cleared and you think you're set. You are not using accutane as an antibiotic to keep acne at bay, you want to knock out this pesky acne once and for all. Be smart about this, take a fatty meal with accutane so your body can absorb it better. For dry skin, any rich moisturizer will do, for painful cracked peeling lips, go to the pharmacy/get a prescription for certain brands of lip ointments that not only moisturize but promote healing of lips. (there are several, they cost about 10 bucks a tub, ask your doc/derm about it) Most people do not experience the feelings of depression that may come as a side effect, but if you do get a family member/friend to monitor you. Remind yourself that this lasts 6 months, but the results will be for a lifetime. Now I know some of you are firmly against accutane and prefer changing your diet/using whatever topical creams and solutions. I'm happy it works for you, but you have to understand that for a lot of people acne is not necessarily caused by diet, and topical treatments only keep the acne at bay, not cure the root cause. Do you really want a lifelong battle to keep the acne from erupting to the surface? 5. Aftercare All the problem skin areas on my body are finally clear after approximately one and a half years since I started this entire war against acne/pityrosporum folliculitis. For maintenance, I use very simple and gentle products on my face, just a face wash, toner and moisturizer. Sometimes I apply some 2.5 % bp on my nose, to keep it from getting too oily. For my back, I bought a znp bar to wash my body with, and I am starting with a new treatment-ELECTROLYSIS. Yes, without the hair follicles, there is no way for the fungus to survive. Ha! This is because although I no longer have even a single red spot on my back, 10 years of suffering have made me paranoid as hell and I will never go back to that ultimate emotional and physical low I was at before. Summary: Acne: Doxycycline, Accutane, 2.5% and 5% BP Pityrosporum folliculitis: Head and shoulders, oil of oregano (oral and topical), znp bar, electrolysis Scars and pigmentation: Fraxel, Ng YAG, 35% TCA chemical peel, arbutin cream, 4% hydroquinone cream Long story short, a battle with skin conditions can be long and tedious, but in the end when you look in the mirror and have clear beautiful skin after a decade of hideousness, it will all be worth it. Honestly, now I have friends who only knew me after I solved my skin problems, and they complain over a single small pimple and tell me "Omg you're so lucky, your skin is so good and you don't understand how stressed out I am over my pimple". This makes me think about just how much effort, money and time I put into researching and healing my skin, and just how far I have come. I hope this post can help some of you readers out there, if only in the slightest way. I love you guys and may we all achieve clear, beautiful skin. Work hard! Lots of love, Pursuitofperfection
  20. Executive Summary: After 7 years waiting and months of research I decided to undergo treatment for my severe acne scaring with Dr. Khan in Hayley Street, London. On December 24th I will undergo Subsicion, Fraxel Re:pair and Re-Cell all in one go over a period of 4 hours. I have created this post to share my story with you all. -------------------- Dear All, I joined this forum a while ago when I started a long research process to find out how to get rid of my severe acne scaring. It took me a lot of reading and browsing through the message boards to understand all different types of scar treatments, their benefits, risks, etc. The very first challenge was to understand all the different type treatments (leave the types of lasers alone!) and my own skin type and condition to finally determine what was the most advisable procedure I should go for. After a few months of research and the help of many of you fellow acne.org users I came to the conclusion that Fraxel Re:pair was probably my best option. The second challenge was to then find out what doctors in the UK do the procedure and also find references and talk to people who had met them and had previous experiences with them. I did all that research, used all the search options of these message boards and came up with a list of 12 doctors in the UK who could do the procedure. Of those 12 I chose five and made appointments to go and have different opinions. I visited some famous doctors in London, from Hayley Street to Knightbridge and other areas of London and I must say that I wasn't very impressed with some of them. Specially those who i had to even pay consultation for. I finally felt that Dr. Khan in Hayley Street was the most professional and experienced and I somehow felt a connection with him. He also show willingness to take me up as a case, whereas other doctors where reluctant to do even Fraxel Restore give my dark features. Dr Khan, not only recommended me to do Fraxel Re:pair but also said that subsicion would be very good and suitable for me, specially having it done just before the Fraxel. I had come across the subsicion techniques during my research but never considered as an option. He explained well and I became more interested in the possibility of a COMBINATION PROCEDURE which could bring better results. I slept on it, consulted other dermatologist and surgeons (friends of mine abroad) and also did my own research and my finding were that the combination was supposed to create great results, so I decided to go ahead. A few days later, the Khans also suggested to have Re-Cell during the same day (not sure if this is the right spelling!). Basically to take a sample of healthy skin from my neck, and produce a solution based on a mix of enzymes with my own collagen which the Dr then would spray onto my skin after the laser. This procedure, apparently very recent, is supposed to enhance the healing of the skin and accelerate the regeneration of collagen. I decided to have the three procedures done on the same day. So, this Thursday 24th December I will be going to have subsicion first, then Fraxel Re:pair and Re-Cell. An estimated 4 hours procedure all together. In order to prepare my skin Dr. Khan has injected Botox on my forehead and put me on Pigmanorm a week before the procedures. To give you a bit more info about my case: I had terrible acne outbreak between I was 13 and 26. Unfortunately I didn't manage to control it until I was 21 by the time I had already lot of damaged skin and scaring. I am from South America (Latin Skin), Skin Type IV with -apparently- dark features, brown eyes, black hair. I have taken photos for you to see. My risk include: bronzing, hyper-pigmentation and the typical possibility of another acne outbreak. I have requested Dr. Khan to put me on antibiotics just in case. My story begins this Thursday 24th December 2009. This is probably the best Xmas Present I have ever give to myself. PHOTOS TO FOLLOW
  21. Hi everyone, I am a 21 year old Asian-Indian origin female struggling from moderate-severe acne scars. I first battled moderate acne for years before going on a low dosage of accutane (10 mg) for four months after which my breakouts stopped. I haven't had a new pimple in months now (yeeeeaas, thankfully) but I have horrid horrid acne scars all over my cheeks. These are almost impossible to conceal with makeup so I had decided to visit a dermatologist who could help me get rid of these using different techniques. I went through 4 rounds of subcision+ co2 laser over the span of 2 years and I recently (last month) had a fraxel treatment done at a new dermatologist's place. Needless to say after spending all this money, time and effort I have had barely 10-15% improvement in the scars. This is incredibly upsetting and I was wondering if people here who have had scars and have successfully minimised them to a large extent could provide some insight here. I have attached two pictures here. This was the harshest light I could find and my scars do look pretty pretty bad here. appreciate the input!
  22. Scarring

    I'm 22 and have acne scarring. If you would please help me and suggest what treatments I would need. I also have a scar on both my mouth lines. Is there anyway I can make it normal again?
  23. VBeam didn't work

    I no longer have acne (accutane) but I have horrible redness on my cheeks which has existed for at least 10 years. I had VBeam done recently which caused purpula and heavy bruising, but it still hasn't got rid of the redness. I just want an even skin tone. Is fraxel worth a shot? Co2? I don't know what to do anymore.
  24. About 4 hours ago I had Fraxel:Repair (the ablative CO2 fractionated laser) done on my temples, forehead and cheeks. The doctor also used the Ultrapulse CO2 done around the eyes because it was better for skin tightening. The total cost 3000 USD here in California. I decided to have the treatment done for icepick scarring on my cheeks and poor texture. I should also note that I have had 6 treatments of the non-ablative laser treatment, Cynosure Affirm Multiplex, with ok results but I decided it was time to take a more aggressive approach. Scroll down to next post for after pictures.
  25. Holy cow.. that must have taken a long time to do, but I think this guy has covered a lot in that time slot. Great video - a must see as he tell it like it is.