Q: Dr. Eppley, I have questions about the laser scar removal and which would be best for my kind of scars. I have acne scars on my face and I am determined to do something about it before to much time goes by. Because its ruining my life to be honest. I have a family with my 2nd child on the way and I want to be able to be myself for them and be able to do things with them. Right now this issue holds me back from literally everything. I pretty much won’t go anywhere unless its an absolute must. Im only 24 years old. I may not have the worst kind of acne scars because they aren’t too big in actual size and stuff, but I kinda just have a lot of them. At least too many for me to really handle. Its really affecting my whole life like I said. Im pretty much scared to death to even be around people anymore. Even my own family sometimes. i just want to be able to look in the mirror everyday and be happy with myself.. mainly so that I can make my family happy, because It can be hard to do when I’m depressed all the time.. I sometimes go weeks without actually looking in the mirror, and then when I do, I will only do it in a certain dim lighting. I avoid it because I tend to beat myself up to hard over it, and its just beyond stressful. I’d probably even be too scared to send pictures because I’m scared to have to see the picture. Im sorry to go into so much detail, i just want to make sure that I’m dealing with a Doctor that understands what I’m going through, and how important it is for me to get something done. So, I guess I hope to hear back from you soon. I really appreciate any of your time and the fact that you are giving me the option to have a free consultation. Thats really cool and is a big reason why I picked to contact you over anyone else.
A: Thank you for your inquiry. Acne scars are very troubling for many people so afflicted and your story is not an uncommon one. While there are numerous acne scar treatments available, the most effective and commonly used is that of the laser…specifically fractional laser resurfacing. What notion that I have to dispel for everyone from the beginning is that there is no such thing as ‘laser scar removal’. It is currently impossible to get completely get rid of your acne scars. It is more realistic to use the terms ‘laser scar reduction’ or ‘laser scar treatments’ as this is what will actually happen. The amount of acne scar reduction possible may be very significant or the results more subtle. That will depend on the size and depth of your acne scars, your natural skin pigmentation, and their facial locations. Most fractional laser resurfacing for acne scars takes more than just one treatment, but how many would depend on how one responds to the first treatment.
You will have to be seen in the office for further evaluation to provide much more than this basic information about fractional laser treatment of acne scars.
Dr. Barry Eppley
Q: Dr. Eppley, I’m hoping that the full facial laser ablation will help greatly with my acne scarring. My only concern is that I have a few scars on my cheeks that are noticeably larger than the rest (they look more like “boxcars” whereas the others just look like large pores) Would you recommend doing the full facial laser ablation first then tackling any punch excisions if needed? Or would it be better to do punch excisions on the few larger ones immediately prior to full ablation in order to maximize success? Of all of the aesthetic goals I’m trying to achieve, having a beautiful “poreless” face is of the most importance.
A: The most important concept about laser resurfacing of facial acne scars is that perfectly smooth and poreless skin is not possible. Improvements in skin texture and irregularities can be obtained, it is just about how much improvement can be obtained and whether one treatment alone is adequate. This can not be specifically gauged beforehand in any patient and more in that regard will be known after the results of the laser treatment is seen. Acne scars that are amenable to excision (ice pick scars, not boxcar scars) should be done beforehand. That way those scar revisions get the benefit of the laser resurfacing as well.
Dr. Barry Eppley