Blog with Dr. Irwin

Acne Scars

Which laser would be best for acne scars if I'm Asian and had cystic acne?

Posted in Lasers, Asian skin, Acne Scars, Acne, 2012 on May 12, 2012 | Permalink

Dear Dr. Irwin, Being a fair Asian lady who had suffered from high grade cystic acne and completed a course of accutance, all I'm left with now is a face that is still somewhat pink and highly uneven. Certain parts of my face have sunk after accutane as previously, the lesions were protruding so much. I'd like to know if fraxel or mosaic would serve me better in leveling my skin and what I can do to lighten the pink patches left by the acne. Thank you.

Between these two, I would vote for the Fraxel (not the Fraxel Dual). It has much more data and experience behind it including several studies in Asian patients. The depth of... more

Can you help? I'm a male, 25 with acne and lots of oil.

Posted in Oily skin, Acne Scars, Acne, 2012 on May 06, 2012 | Permalink

Hello doctor, Iam 25 years old male Suffering with oily skin and acne from 4 years. My parents never had oily skin. Do I suffer with oily skin life long? Is there any product to reduce my oily skin? Please tell me

This is a little tough because you don't tell me how bad your acne/oil is? There are basically 4 types of acne.

Grade 1- just blackheads and whiteheads (closed & open comedones -

... more

In treating acne scars, is the timing of Fraxel treatments important??

Posted in Fraxel laser, Acne Scars, 2012 on Apr 04, 2012 | Permalink

I am a fair-skinned Asian and I have a mix of deep ice pick acne scars and shallow rolling ones on my cheeks, along with large pores. I am considering having Fraxel done on my cheeks and nose. What is the suggested interval between the treatments? I went to a dermatologist consultation and he told me I will need 3 treatments, but the timing depended on me. I did some research and later on saw that the recommended timing is 4-8 weeks between treatments - is this what you would recommend as well? Is there any disadvantage to spacing the treatments out (for 5-6 months between each one)? Thank you in advance

Most of the research that was done on the Fraxel and acne scars used treatment intervals in that 4-8 weeks range. But partly that was because it is more convenient for the researchers... more

Cystic acne with hyperpigmentation - what can I do?

Posted in Acne Scars, Acne, 2012 on Mar 11, 2012 | Permalink

Hi! I have been dealing with really bad skin the past few months. I had severe cystic acne. Now I am left with the hyperpigmation and dark spots. I am using retin a micro. It has been one month on it and I am more super oily then before, but it has not anything just made my spots darker and my face red. Any suggestions or should i wait it out?

Please, please, please run, don't walk to the nearest dermatologist. If you truly have severe cystic acne, it can and will leave permanent scarring on your face. Neither of us want... more

Would the fractional CO2 or the 'Mosaic' laser be better for treating acne scarring?

Posted in Carbon Dioxide Lasers, Acne Scars, 2012 on Feb 27, 2012 | Permalink

Hi Dr Irwin, I'm glad to come across your website. I'm a Asian male living in Singapore & I've spoken with several clinics here that offer a new Mosaic laser treatment for deep acne scar problems. I'll like to know whether is it safe & effective, & what is the difference between the Mosaic & Fraxel or Fractional CO2 treatments. Thanks a lot!

In general, unless your acne scarring is almost invisible, you will get better results with a fractional CO2 system like the Lumenis Active Fx or the DEKA DOT.

The 'Mosaic' is an erbium... more

How long do I need to wait after Accutane treatment before I can have my scars treated.

Posted in Lasers, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on Dec 08, 2011 | Permalink

I got off of Accutane in June. I have some acne scars and would like to use the Fraxel laser. How long do I have to wait? I don't want there to be any complications.

The short answer is this that if you are thinking full face traditional ablative CO2 resurfacing, then you need to wait a full year. If you are considering the Fraxel or the ... more

What is the latest laser technology for acne scars?

Posted in Carbon Dioxide Lasers, Acne Scars, 2011 on Oct 17, 2011 | Permalink

Dear Dr. Irwin, Kindly advise on the latest technology in acne scars after the Fraxel laser. I heard there's a new kind of laser recently released but i really cant remember it's name. Thank you. -Areej

Here is a link to the article I wrote on fractionated CO2 lasers. Sometimes in our practice here, we will combine several modalities like subscision, CO2 or Fraxel, and certain fillers... more

When Acne Products Do Not Work

Posted in Acne Scars, Acne, 2011 on Aug 18, 2011 | Permalink

I’ve been battling acne for almost 8 years now. It’s been getting worse. I have acne prone, oily, sensitive skin. I’ve tried everything from drugstore to proactiv to murad to burtsbees. Nothing has worked for me. I’ve stuck out each regimen for the recommended time and each time, my skin is filled with pimples and later, acne scars. I’m traumatized at how my skin’s behaving. I have been to a dermatologist who just prescribed benzoyl peroxide and tazorac both of which my skin is sensitive too. I’m about to try birth control pills but Do you have any recommendations of what I should do? Thank you

I would recommend getting a second opinion from another dermatologist. If you have true cystic or pustular acne with scarring, you are a candidate for Accutane. A 6 month course of... more

Can you help with large oil glands on the chest?

Posted in Oily skin, Acne Scars, Acne, 2011 on Aug 10, 2011 | Permalink

-------------------------------------------------------------- I have very oily skin and even enlarged oil glands all over my chest that are embarrassing. I am 22 yrs old and considering the cosmetic surgery to melt them down. Do u thing it would be beneficial to go through with this procedure? I have tried everything and it doesnt seem to work so im desperate.

I really think you should see a good dermatologist as soon as possible. Often when the pores are enlarging on the chest like you are describing, it's really a type of acne. There are... more

Update on the roller needle question.

Posted in Skin Care Products, Skin Care, Home use devices, Acne Scars, 2011 on Jul 20, 2011 | Permalink

Is there any science showing the roller needle product being sold by SkinMedix and others is effective at allowing better penetration of skin care products into the skin?

Okay so this is getting a little complicated and is taking a little longer than I'd hoped. Here's why. I have and have had for some time medical grade roller needles of different depths... more

What are these bumps on my chin?

Posted in Growths, Chin Lines, Acne Scars, 2011 on Jun 05, 2011 | Permalink

Dear Doctor, I believe I have the condition that you refer to as "cobble chin", but when I look at pictures that show people who have this condition they sometimes say it looks like dimpling. My condition under my chin actually looks like small bumps under my skin. They do not hurt and they give me no problems. If I pull in my lips (tightening the skin on my chin) they actually disappear. What is the best way to treat this condition? Sincerely, Donna

A common complaint is a bumpy texture on the chin area. Here are the 3 most common causes.

1) The first is old acne scarring. Some people have their most severe acne on their chins... more

Is there anything that really benefits acne scars?

Posted in Acne Scars, Acne, 2011 on Jun 05, 2011 | Permalink

Is there anything that really benefits acne scars?

Yes, read my article on Acne Scars and Other Scars In Depth for information on what options are available to reduce the appearance of acne scars. Dr.... more

Picking and acne scars - what to do?

Posted in Acne Scars, 2011 on Jun 05, 2011 | Permalink

Hi. My acne is very mild but unfortunately over the past couple of years I have used picking and squeezing my skin as a form of stress relief, which at times has caused rather horrific wounds. I have mostly gotten my behavior under control but am now left with multiple scars along my shoulders, chest, and back of every variety (raised, flat, red and white, from 2mm diameter to 1.5 cm). I am fairly certain that the rosehip seed oil I am looking into will work with my skin very well, especially on my face, but from the majority of my findings I'm afraid those raised white scars are going to need something a bit more rigorous... is there any non surgical way to return the pigment to those areas and shave them down a bit?

My heart goes out to you on this. You're very honest too in your understanding that this is a form of stress relief for you. To some extent everyone "picks" something at least... more

I have multiple acne scars on my chest and back. What can I do?

Posted in Scars, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on May 25, 2011 | Permalink

Hi, I have body acne and over the years the number of breakouts has diminished but has left a lot of scars which of them are mostly skin discoloration. I am dark skinned. I have tried varies things like micro crystal dermabrasion, topical cremes and glycol peels. I was not sure about the peel first but then I have tried most of the stuff out there and risked it and it left a couple of very dark spots which hasn't faded even a little bit after 2 months. I am starting to feel that the only option would be expensive laser treatments. I would really appreciate if you could offer me some advice. Thanks.

I really agree with your conclusion on this. With most acne scarring, it is deep enough that superficial treatments like microdermabrasion, creams and glycolic peels won't help much. ... more

Is a fractionated CO2 laser safe on darker skin types to treat acne scarring?

Posted in Lasers, Carbon Dioxide Lasers, African american skin, Acne Scars, 2010 on Nov 28, 2010 | Permalink

Hi Dr Irwin I was just browsing your website doign research on Fractionated CO2 lasers. I see it mentiond that it can be adjusted on more darker skin types to be safe. Can you elaborate if this is a viable and safe option for treatment of acne scars (ice pick/rolling types) on darker skin types? I see various websites listing CO2 as not safe on darker skin types though so i am curious if you can shed some more light on how it works on darker skin types and what are potential complications and recovery times especially for acne scars

Thank you for asking this. The answer is yes with some restrictions. First, you must go to an expert who has a lot of experience because the right settings really matter. They need to... more

Do you perform needling/subcision on skin that has been scarred from acne?

Posted in Lasers, Acne Scars, Acne, 2010 on Sep 06, 2010 | Permalink

Do you perform needling/subcision on skin that has been scarred from acne?

Yes. Like all treatments for acne scarring no single type of treatment will take care of all the scarring. We often use subcision occasionally alone but more often in combination with... more

Would fractionated carbon dioxide laser be helpful for me with acne scars?

Posted in Scars, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, 2010 on Jun 03, 2010 | Permalink

Re: Fractionated Carbon Dioxide Laser I was most interested in your article on this laser. I have acne-related scars including depressions in my skin. Also, I had some hypertrophic scars excised, which resulted in deeper depressions. To date I have done 5 treatments of Fraxel at ever increasing strengths. I have just had 2 treatments 3 weeks apart at Fraxel's highest level (i.e. level 12). Yet I STILL have the aforementioned scars. They have faded a bit, but they're still there and quite noticeable. Do you think the Fractionated Carbon Dioxide Laser would be a good option for me. If the answer is yes, do you know of a dermatologist located in NYC who has the necessary expertise w/ this laser? Thanks for your help, Simone

It's a bit difficult without being able to see you or knowing your age. But, yes, usually the fractionated CO2 is more effective than the Fraxel Restore for acne scarring. If you are 30... more

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