About four months ago I was getting into the backseat of a taxi when I looked into the rear-view mirror. I always do this when I get into the backseat of any car. Call it vanity or call it OCD, but I hate having even one hair out of place or looking shiny from sweating out of my forehead, which, by the way, is the only real part of my body that sweats — thanks, genetics!
But the only thing I could see that day in the mirror were two pitted acne scars staring back at me on my left cheek.
Right there, right then — that's the moment these scars started taunting me.
I walked around for the the next week trying to catch a glimpse of myself in any mirrored surface (including chrome surfaces and the reflection in the window surfaces of the E train). Sometimes I caught myself staring straight on at them, like giving them the stink eye was going to make them disappear. Sometimes I did a drive by, trying to avoid the inner monologue with myself all over again. I had noticed them in the mirror for years, sure, but something in me suddenly became obsessive about it. It was the one flaw I, for some reason, could not unsee.
The closer I looked, the more I got upset. I even started avoiding different types of light that I knew were more likely to reveal these pitted monsters.
Direct sunlight? Nope. Overhead lights and recessed lighting, especially of the white varietal that shine down in a unique way and can make a scar look even more pronounced than it actually is? Avoid. Candlelight became a risk, and even soft yellow lights could somehow find their way into the crevices of my scars on occasion.
I felt like I wasn't really safe anywhere I looked, and it was beginning to take a huge emotional toll on me. I found myself wanting to leave the house less and less.
For years, I had avoided uploading photos with friends where my acne scars were exposed. Sure, there's nothing FaceTune can't fix — except, when it starts to affect how you feel about yourself emotionally. Anytime I looked in the mirror, all I saw was a hideous person staring back at me, two gigantic pits for light to fill at every possible angle they could.
Look, I realize there are a lot of people out there who have struggled much worse than I have. I see people with acne scars similar or worse than mine and have instant empathy; I was pretty lucky not to have a ton of them to deal with, but the ones I do have are deep and what's considered "atrophic." And regardless of whether you have 1 or 100 of them, an acne scar is a constant reminder of your long-standing battle with acne and a visual reminder of the toll it took on your face.
These two pitted acne scars were the ones I was most concerned about, but I also had another less-visible scar on my right cheek, smaller "ice pick" scars on other parts of my cheeks, and — because the universe is ever so kind — even a chicken pox scar on my forehead.
They all had to go.
A few years ago, I had the Fraxel laser done with the promise of reducing the signs of my acne scars. While I did see a minor improvement, the procedure hurt like a motherfucker, and I swore I would not go back, even though you see the best results after multiple treatments. I never wanted to go through that excruciating pain in my life again, and the downtime (about 10 days of redness and heavy flaking) was nuts.
During my "obsessed period," as I now like to refer to it, I would go straight home and Google "acne scar revision." Was there a solution out there for me? Something that could finally fix the way I saw myself in the mirror?
I came across a lot of information on ways to reverse or at least reduce the visible signs of acne scars. There are actually lots of different types of ways you can revise or reduce them — lasers (like Halo or Fraxel), subcision, excision, fillers, peels. But microneedling was one that kept popping up over and over again on RealSelf, which is a complete rabbit hole for people like me who like to research procedures before trying them.
I finally landed on EndyMed Intensif, a microneedling treatment that also uses radio frequency to stimulate the skin's natural production of collagen and elastin. Collagen and elastin are important in keeping you looking young, but they're also an important part of the skin-remodeling that helps to reverse the damage of acne scars. Wanting to enjoy summer, I figured it was something I could safely do during that time (unlike most lasers, which are a no-no in summer) and it seemed to have the least downtime (and pain) of any treatment I researched.
The average price for a series of six EndyMed Intensif treatments is $1,800, or $300 per treatment, but it can range from $1,500-$2,500 ($250 to $550 per treatment without a series discount). The procedure is actually pretty simple from the patient's perspective. I had mine done at Sadick Dermatology under the care of Dr. Neil Sadick and his awesome RN, Mariesa Streett. The first thing the doc did to me was numb my face. They use this clear/whiteish numbing cream that looks like cupcake icing. It does not, in fact, taste like cupcake icing though, and I can only confirm this because I accidentally licked my lips the first time I had it on and swallowed a bit.
The doc will normally leave the numbing cream on for a minimum of 30-40 minutes. For people with a low tolerance to pain (read: me), it stays on closer to an hour. And if you're especially a big baby about pain, they may even give you a Percocet to set in just in time to have your face stabbed. That was, in my opinion, the most virtually pain-free way of doing it (I did not take the perc the first time, but I subsequently requested it on my second and third visit).
After removing the numbing cream from your face, your doc will lay you in a flat position and turn on the EndyMed 3DEEP machine with the Intensif handpiece. Usually at this point, they've already placed your "tip" onto the machine.
The tip is kind of a cool concept because you get a certain number of radio frequency pulses with it, so you can come back and have your EndyMed treatment performed again and again until the pulses in the tip run out. I asked Dr. Sadick's team as to how many treatments they thought it would take until I saw good results, and they said three — so that's exactly what I did. Since I was doing it in a series, I spaced them out four to six weeks, another recommendation from the doc.
Mariesa (who performed all of my treatments) would move the tip of the EndyMed Intesnif handpiece onto my forehead. A quick beep sound would come out of the machine, and the needles would puncture my skin and deliver the radio frequency heat.
Why would I purposely stab myself in the face like this? Because the "wound" created would then start to activate my skin's natural healing process of restoring the collagen and elastin to the skin.
Mariesa would then move the tip around my face to make sure she was covering the entire surface, except for my beard, which we both decided wasn't probably the smartest place to treat (I don't have scarring there and there is a risk in men of hair reduction if you do). Depending on the part of my face that Mariesa was treating, the needle depth, watts, and pulse duration would also change.
"When selecting needle depth, we keep in mind that different areas of the face have thinner skin than others," Mariesa told me after one of my treatments. "For example, your forehead has thinner skin than the cheek, therefore we would select a shorter needle depth [for it]. Also, we want to distribute the radio frequency heat at different depths in order to stimulate collagen regrowth from multiple layers of tissue," she said.
The pain would also vary depending on the area of my face being treated. I found that the forehead and under the eyes (where skin is thinner) hurt much more than my cheeks. I wouldn't call this procedure "painless," but I am also a guy, and guys are generally horrible with pain tolerance. Either way, the pain is quick (as you only really feel it during the procedure, and not after) and totally bearable (with Percocet, of course) while the procedure is going on. On a scale of 1 to 10, I'd rate it somewhere around a 4.
Since she knew she was treating me for my scars, Mariesa would usually do a second or third pass over them, making the entire procedure take 20 to 25 minutes or so. All in all, with the numbing cream, about 1 to 1.5 hours from start to finish.
Afterwards, Mariesa would rub a healing cream and sunscreen on my face, and I'd be good to jump in an Uber, doing my best on the streets of the Upper East Side to avoid the What did you just have done? look that is way too prevalent that far uptown.
Immediately following my treatment, I looked like a strawberry for the first hour or two, and my face felt hot, like I had just spent too much time in the sun or had a sunburn. Immediately following that, the redness went down for me and I began to get puffy. The puffiness lasted for the next two to three days, but it was not really noticeable to other people. And if it was, Jane, Marci, Jamie and Caitlin kept quiet about it.
By the fourth day, I would get tiny, needle-thick scabs forming in box shapes where the tip had touched my face. I would then start to slightly flake as the new and improved skin began to break through. From the fourth day until about 10 days after the procedure, I would be slightly flaky, but again, nothing that was really noticeable unless you were very close to my face.
During the time that you're healing from EndyMed Intensif, or any microneedling really, it's important that you stay out of the sun and wear sunscreen (I wear 30 regularly anyway, so I up'd mine to a 60) for about a week. Since it was summer when I had this treatment, I will admit I wasn't probably as careful as I should have been, but I didn't run into any problems mainly because I habitually put on SPF 60 every two hours when I was exposed to the sun.
Mariesa also recommends waiting "at least 7 days before starting to use your usual skincare regimen or until the healing process is completed (i.e. no more redness, puffiness, etc.). If you're using retinol products, I would add on a few more days after healing is completed before that."
The results have been pretty dramatic, in my opinion. Though my acne scars have not completely vanished after just three treatments, they are noticeably reduced. I used to see two huge craters in my face, and now I see a shallow depression there, which gives me hope that if I keep up with another round of treatments, I'll be in a really good place.
I even photographed myself in the harshest light of all today — a recessed light with a white light bulb (courtesy of the xoJane offices, where bad lighting is aplenty), and as you can see, with the light directly hitting my scars, they are just barely visible.
- Do you have any acne scars that bother you?
- Have you tried a microneedling treatment?