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Question
Posted by: Tessie | 2011-12-19

pigmentation and scarring treatment options?

Hi Dr

I am a black woman aged 38 for whom Roaccutane is working brilliantly, I have been put on a very high dosage (80mg, and I only weigh 56kg) but yes it is working tho I had to build up over 3 mths to this massive dosage. BTW it is my 7th time trying this drug, my new derm says I was never on a high enough dosage that''s why I always relapsed.

Seeing as the clearing is going great, what are my best options in terms of getting rid of the scars and pigmentation once I am completely free of active acne? I so want to have decent skin. I a so excited, I got acne at age 10 and am my clearest ever. Now I want to address the pitting and scars, which Roaccutane cannot help. What do you suggest for black skin - I am happy to come to CT for your treatments. I will finish my Roaccutane course end of July.

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Our expert says:
Expert ImageAnti-ageing expert

Hi Tessie, thank you for the question.

This is a difficult question to answer over the net as one would ideally like to examine the skin, and the scarring and pigmentation, before deciding on the best treatment options.

Generally speaking the best treatment for the pigmentation and scarring (following acne) is fractional skin resurfacing (FSR) however one would need to choose a technology that is safe for darker skin types. The commonest reaction following laser FSR is post inflammatory hyperpigmentation (PIP) and typically the approach is to prepare the skin (using various topicals) and choosing the correct settings when using a laser for the FSR; as important is to find a doctor that has specific experience in using their FSR laser with your specific skin type.

A relatively new device called Matrix RF or Sublative Rejuvenation (www.syneron.com) uses radio frequency to produce the FSR; this technology is completely ‘colour blind’ so it can be used safely on any skin type.

One can expect some downtime with both of the technology groups I have mentioned above and you may need between 3 to 6 sessions in total which are performed every 4 to 6 weeks.

One would need to wait for at least 6 to 9 months after stopping the Roaccutane before considering these treatments so my advice would be to consider using a topical regime during this period; this includes depigmenting creams, moisturizers that contain alphahydroxy and polyhydroxy acids, vitamin C and vitamin A, and superficial glycolic acid peels.

You are more than welcome to see us for these treatments but I am not sure if logistically the above program will be viable for you so please let me know in which city you live and I can try and refer you to a doctor with specific experience in the concerns you have (send it as another question on health24.com and not as a comment).

The only other advice I have is to ask your current dermatologist if he or she agrees with the above answer and who they would recommend for further treatments once the Roaccutane course has been completed; I would also highly recommend that you use a good SPF (50 or higher) that is oil free and during our summer months to apply it several times daily.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

1
Our users say:
Posted by: anti-ageing expert | 2011-12-24

Hi Tessie, thank you for the question.

This is a difficult question to answer over the net as one would ideally like to examine the skin, and the scarring and pigmentation, before deciding on the best treatment options.

Generally speaking the best treatment for the pigmentation and scarring (following acne) is fractional skin resurfacing (FSR) however one would need to choose a technology that is safe for darker skin types. The commonest reaction following laser FSR is post inflammatory hyperpigmentation (PIP) and typically the approach is to prepare the skin (using various topicals) and choosing the correct settings when using a laser for the FSR; as important is to find a doctor that has specific experience in using their FSR laser with your specific skin type.

A relatively new device called Matrix RF or Sublative Rejuvenation (www.syneron.com) uses radio frequency to produce the FSR; this technology is completely ‘colour blind’ so it can be used safely on any skin type.

One can expect some downtime with both of the technology groups I have mentioned above and you may need between 3 to 6 sessions in total which are performed every 4 to 6 weeks.

One would need to wait for at least 6 to 9 months after stopping the Roaccutane before considering these treatments so my advice would be to consider using a topical regime during this period; this includes depigmenting creams, moisturizers that contain alphahydroxy and polyhydroxy acids, vitamin C and vitamin A, and superficial glycolic acid peels.

You are more than welcome to see us for these treatments but I am not sure if logistically the above program will be viable for you so please let me know in which city you live and I can try and refer you to a doctor with specific experience in the concerns you have (send it as another question on health24.com and not as a comment).

The only other advice I have is to ask your current dermatologist if he or she agrees with the above answer and who they would recommend for further treatments once the Roaccutane course has been completed; I would also highly recommend that you use a good SPF (50 or higher) that is oil free and during our summer months to apply it several times daily.

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