LAM FACIAL PLASTICS

Hi Dr. Lam-

It took me a long time to come to terms with the extent of my prior acne scarring. Unfortunately I got several new cysts last year that left HUGE pits (rolling-type scars for silicone injections). This has put me back into a major slump because I know I can't go back and undo those cystic breakouts and will probably go to my grave with the additional new scarring I have now, which kills me. Anyway, I was wondering what your success rate in avoiding pitting has been for those who are scar-prone and prone to developing huge cystic sacs that hang on for months and months with the cortisone shots. I have never had a cortisone shot and from the success stories I have read, I am starting to feel so sorry I never had them done before. I now think I could have drastically reduced the extent of my scarring. I'm kind of beating myself up about this because my scarring is so severe it affects my ability to function in life. I had numerous procedures done in the past, including silicone with a doctor in CO, and those did not help, but I was ok with the scarring I had because in some light it did not look too bad. Now my scarring keeps getting worse I'm realizing, despite the accutane I took for a year 10 years ago, the lasers, peel, everything that has failed. Am I supposed to just become inured to having pitting that will never get better and only get worse? My outlook is so gloomy now and I am uusually good with money, but acne scar treatments have devastated my finances. I have a major blow to my life savings inaddition to more scars after already spending thousands to contend with. How do I cope? Can cortisoe shots help prevent the pitting from getting even worse should I keep getting new cysts?

hi,
sorry to hear of the effect that scarring has had on your life. unfortunately, cortisone in my opinion is a MAJOR RISK with very little gain. you can be left with greater holes in your face. i would have to see what type of scars you have. i generally use silicone (but that is very technique dependent) for large rolling scars and i use CROSS acid treatments for small pockmarks and ice picks.
best,
sml

dr. lam wrote:hi,
sorry to hear of the effect that scarring has had on your life. unfortunately, cortisone in my opinion is a MAJOR RISK with very little gain. you can be left with greater holes in your face. i would have to see what type of scars you have. i generally use silicone (but that is very technique dependent) for large rolling scars and i use CROSS acid treatments for small pockmarks and ice picks.
best,
sml

I had another cyst crop up under my right ear and I decided to take some leftover prednizone I had prescribed for swelling after my Deep FX. I feel this has dramatically reduced the swelling and pain from the nodule just overnight! Is it possible prednizone is a better occasional treatment for the occasional severe cyst than cortisone? I know it is prescribed more for injury-type swelling, but I have read about similar very positive experiences of others taking prednizone for reducing acne nodules in another acne forum online. I just hope I have been able to get the swelling down in time to prevent the area from caving in once healed.

i do not have experience giving medicines for cysts. however, typically the atrophy risk of something caving in occurs only with injectable steroids not by mouth steroids.
best,
sml