Top products from r/AcneScars

I agree with what /u/jayfromo says about Dr. David Lim. I'll add my personal experience with rolling scars. I no longer have acne (10+ years now acne free) but the evidence of my severe cystic breakouts still exist in the form of rolling and boxcar scarring on my face.

 

Vitamin C, Copper Peptides, Niacinamide, Differin/Adapele – For indented scarring? I always wonder... who out there actually brought up a grade 4 scar up to a grade 1 using these?

 

0.1% Tretinoin, 5x a week, for 13 months. – Honestly, nothing appreciable in terms of raising indented scars level to the rest of my skin. It accelerated skin turnover/growth.. which would be great for PIH but not for PIE or scars. I gave up on this, my face was always way lighter than the rest of my body, it was itchy, peeling, and my face always felt raw. Yes, I could probably have lived #SlugLife (dedicate my mornings and evenings to heavy moisturizing with occlusives like Vaseline) but it just wasn't something I wanted to commit to or present to the world. I would rate tretinoin an F for indented rolling/boxcar scar improvement. If you have indents in your skin, that means you have banded scarring tissue deep in the papillary dermis (past the the epidermis) that is anchoring/tethering the skin layers above it down (this is what an indentation is).

 

Infini RF Microneedling, 3 sessions in office – This also did very little, but I was able to notice improvement (barely). It was not worth the $3000 total that I spent here in Southern California. It wasn't painful (they numbed my face for an hour before each session), it was super bloody, and my face looked like I fought and lost to a blowtorch for 5-6 days, then an additional 1-3 days on top of that to fully restore back to "normal." I would rate in-office microneedling with RF a D+, considering the price to performance ratio. I understand the "benefits" of the Radio Frequency (basically heating up and melting the skin) but it was just as effective as the next thing I tried below...

 

Derminator 2, 2.5mm depth, 6 at-home sessions – Figuring that I could continue the results of microneedling without the cost, I ordered a Derminator 2 device and several packs of their needle cartridges. Again, numbed my face and went to down on my cheeks and forehead (though on my forehead I could only tolerate 1.5mm). There's definitely a psychological element to this, as you're causing pain and trauma to yourself... but I was desperate and wanted these scars to raise. I would rate at-home microneedling with a C-. Rated higher than Infini RF microneedling solely because of price ($200 for the device and $4 per needle cartridge).

 

TCA CROSS, 80%, one time – This would is a bit difficult to assess for several reasons, primarily because I stopped after one session and moved on to weekly 30% Salicylic Acid peels. TCA CROSS is primarily for ice pick scarring... and boxcar scarring.. because you're creating a very deep tunnel wound right down to the papillary dermis. Imagine a zen garden. The sand is your skin. Create lines in the sand with a rake. That's scarring caused by damage. Now drop a basketball onto the areas that have been raked. That's also damage, but you're kind of leveling out or canceling the damage done by the rake. Works great on super narrow and deep points, because you're replacing severe damage with not-so-severe damage. Wouldn't recommend it for the wider rolling scarring since you may in fact be making the appearance worse. The idea is that the skin will heal up to a point that ends with an improvement over your baseline start. You will scab, and it will leave post inflammatory pigmentation that (in my case) lasted 7-8 weeks. It was random though... my forehead didn't have PIH when the scabs healed but my cheeks did. I only had TCA on my boxcar scars. Not going to rate this, but I did have this done on July 27, 2019. Today, the PIH from it is now mostly faded from this. If you do get TCA CROSS done, do not pick the scars. Vaseline up. Work from home if that's an option, or do this during a week break if you're in school. The scabs were not cute...

 

30% Salicylic Acid Peel, at-home, 6 times so far – Ah, finally some good news. I ran across a reddit comment that inspired me to try this. This guy writes:

> I had severe cystic acne as a teenager that left my face covered in scars. Accutane completely cleared up the acne. It’s been five years since I stopped taking it and I’ve had maybe two or three tiny spots in my fact since then. Unfortunately, the scars persisted for much longer. I’ve found that salicylic acid is very effective at getting rid of scars and hyperpigmentation. Not the 1-2% stuff that you put on and leave on all day for acne treatment, but stronger peels that you apply for a few minutes then rinse off. I use a 20% salicylic acid peel once a week and my acne scars have faded to the point where you only really see them if you look up super close.

Then I ran across a research study here that concludes this:

> Conclusion: The present results suggest that the architecture of the epidermis and the papillary dermis can be regenerated by simply injuring the cornified layer by using topical agents such as salicylic acid that do not cause degeneration or inflammation ... The findings of this study suggest that impairing the cornified layer may have essential effect on the remodeling of the epidermis as well as of the papillary dermis.

Basically, you don't have to go to the extremes of damaging all the layers of your skin with lasers/needles/TCA down to where the banded scarring tissue is tethered. Salicylic Acid at 30%, applied for 20 minutes (I go for 30 minutes, it's fine...) will kick start a process in your skin that causes remodeling and improvement.

 

So I hopped onto Amazon, and got this. I put about 3ml of it into a shot glass, wash and dry my face, put a nitrile glove on, dip a small square piece of gauze in it, and "paint" my scarred areas with it. Within 2-3 minutes it really starts to sting and heat up. I just sit in front of my bathroom mirror with desk fan pointed at my face and watch YouTube or Netflix on my phone. I keep the glove on and re-dip the solution using the gauze pad and apply to my face every 5-7 minutes. The lightest layer possible. After 30 minutes or so, I get up, take the glove off, and my carefully rinse off the solution ensuring no water gets in my eyes. For some reason, once water comes in contact with the solution... my face starts to really sting.. but I keep rinsing for another minute and it goes away. Pat dry... your face will look blistered for maybe 10 minutes (the skin doesn't break, it's fine). Then you'll look slightly pink and sunburned for 3-4 hours. I'm able to go about my day after that, or go right to sleep since usually I'm doing this on Sunday nights.

 

I've done this 6 times now and I want to say I have an overall improvement of 50%. It's definitely noticeable. Way more improvement from an $18 bottle (I get 5 uses from it) than I did spending $$$$ on office procedures, or days hiding at home because of "tretinoin flaking."

 

Everyone's different, maybe some have had holy grail success with the expensive in-office options, but I went that route first... and I wish I didn't. Salicylic Acid is one of the least hardcore and least invasive options out of anything you could be doing to level your scarring... even at 30% strength.

 

Anyways, just wanted to share my experience because I know how it is struggling with intended rolling scars, and the literature/studies out there are few and far between. Just because something is expensive, doesn't mean it's the end all be all. Remember that these dermatology offices, laser treatment facilities, medspas/whatever, are out to make a profit. They're educated, they're licensed, and they're also a business. Fancy devices with marketing. Whichever options you pursue, I wish you the best of luck and hope you find something that brings your skin to a level that is satisfactory to you!