treatment for acne scarring
I have extensive (but moderate) scarring due to acne on my face,
primarily on my cheeks. I am south asian and have a medium skin
colour (light brown). I have now been to 4 different doctors
regarding scar treatment. Here's what they each said:
1). Use laser only - Patch test required due to skin colour, but no
major risk anticipated. Said dermabrasion is a bad idea.
2). Use laser only - but recommended that I do not have procedure as
skin changes are hard to predict in people with darker than white
skin. Eventually agreed that test patch would be indicative of final
results.
3). Use dermabrasion - did not think skin patch test is required. He
said that as I already had scars, and no major pigment problems,
dermabrasion would not be risky.
4). Use dermabrasion and then laser - recommends patch test as well.
In addition, he will not perform any type of resurfacing activity
during the summer due to the potential for sun damage. He won't even
do the patch test in the summer.
Anyway, to make a long story short, I've gotten somewhat differing
answers from every plastic surgeon I've visited. Therefore, I have a
two part question:
1). Would do you guys recommend I do regarding the laser and/or
dermabrasion? Which of the four doctors seems the most realistic?
2). If I have to wait a while before getting serious treatment, what
type of procedure can I have in the meanwhile that will improve the
look of my facial skin. Is there any procedure that can also help
contribute to/imrprove the final outcome when I get derm and/or laser
done?
BTW - I've been on retin-a (.1%) and hydroquinone (7%) in preparation
for a procedure for about 3 weeks thus far. I guess I have thick
skin, as these products have done nothing positive for me.
The above is the answer I'd consider if I were you. There is some risk
with hypopigmentation, but to be sure, try to find a doctor who's done
numerous laser resurfacings on asians - experience is everything! I
would definitely rule out dermabrasion - technician/technique dependent
- and no way of knowing how deep they're going - inconsistent results
possible, at best.
If you haven't been getting any AHA peels or other prep work, you may
not see significant results from the hydroquinone for another 1-2 weeks;
then again, if you don't have any hyperpigmentation right now, you won't
see anything happening now - and they've got you on the HQ to "turn off"
the melanocytes in preparation for any laser - which can create
post-inflammatory hyperpigmentation. This is good that they are
starting you off with the HQ prior to treatment. The Retin-A is also
used prior to laser resurfacing to stimulate cell turnover and prepare
the skin. Again, you may not see any "difference" prior to the
procedure, but it does help reduce the post-laser healing time.
Aagin, I'd go with the most experienced, conservative physician. And do
not have LSR done during the summer - wait a couple of months (depending
upon where you are) until it cools down a bit (preferably below 80F)