Will Fractional Laser Resurfacing Help My Acne Scars?

Q: Dr. Eppley, I am interested in fractional laser resurfacing. I had acne scars on my cheeks and decided to get revision surgery. A plastic surgeon suggested dermabrasion only on my cheeks. This left the area hypopigmented, uneven texture, and raised in the form of hypertrophic scars. I’m under the impression I can’t repigment the area. I’m using retinA to even out the texture and have received kenalog injections to reduce the hypertrophic scarring. However, since the injections are localized, and the scarring is over a broad area, I’m not getting the results I am seeking. I read a post by you where you suggested CO2 laser followed by topical corticosteroids which I believe could flatten the entire area. I’ve attached pictures for your review. I’m not sure if you can get an accurate understanding of my situation from the pictures. Note: the indented area on the left side of my cheek is due to a kenalog injection. I’m hoping this will fill in with time. 

A: Fractional laser resurfacing would be my treatment of choice for broad-based hypertrophic scarring from a prior dermabrasion. To prevent any recurrence, topical sterioids should be used as soon as the area is healed after about 5 to 7 days. Their penetration is aided by the channels cut into the skin by the fractional laser ttreatment. Whether the indented areas from the kenalog injection will fill in over time depends upon how long ago they were done and how many injections were done. If more than three months after the injections you should consider spot fat injections into the indented areas.

Dr. Barry Eppley

Indianapolis, Indiana