A. Treating deep acne scars is typically a multi-session plan utilizing different devices and techniques, often in combination. Overall, chemical peels and microdermabrasion are good starts to improve the texture and tone of your skin and improve pore size, but are not aggressive enough for deep scars. We also make sure that the patient’s acne is under control before addressing scarring. For deep pits, we use a combination of spot 90% TCA application, followed by laser treatments and topical maintenance. The Fraxel Dual can be a great treatment option to treat older pitted and discolored scars. The deeper 1550 wavelength helps to restore and repair the collagen underneath the scar, making it less indented, while the more superficial 1927 wavelength helps to restore the surface texture, pigment and general appearance of your skin. It is safe for virtually every skin type. If you still need more improvement after peels and lasers have been completed, localized filler, such as Restylane or Juvederm, can be injected into the scars to make them less noticeable.
Q. I have terrible melasma on my cheeks, which has only gotten worse since I’ve had children. It gets worse in the summer, and no amount of makeup will cover it up. What laser would I schedule to improve this?
A. Melasma can be a complicated condition that is not curable, only improved and maintained. The best line of defense against melasma is adequate sun protection. An SPF of 50 or greater, a wide brim hat and sun protection should be used at all times when out in the sun. For active melasma, we typically have our patients pre-treat their skin with a combination hydroquinone/retinoid/steroid cream that helps to reduce the dark pigment and calm down the pigment cells that have been activated underneath the skin. This is typically followed by laser treatment to reduce the pigment. Fraxel Thullium is a great option. It will bring the pigment to the surface of the skin to be exfoliated off, while improving the general texture and overall health of your skin.
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