Jason Emer, MD, FAAD, FACS
Acne Scars On Darker Skin: Why Dr. Emer Layers Three Treatments In One Session
How Dr. Jason Emer treats acne scars on melanated skin using micro droplet silicone, deep Profractional laser and superficial Contour TRL, with strict pre and post care protocols.
Dr. Jason Emer MD · FAAD · FACS
The practice's own photographs
Patients of the practice, from Dr. Emer's published before and after gallery. Each case is one patient. Individual results vary.
Deep acne scars on melanated skin require micro droplet silicone to fill the deepest depressions, Profractional laser to remodel tissue underneath in millimeters, and Contour TRL to resurface the top layer, each calibrated for Fitzpatrick type four and darker skin with strict pre and post care protocols.
Your plan starts with Dr. Emer.
Schedule ConsultationReserve online. West Hollywood and New York.
From the filmed session
What Dr. Emer did · RE:SKN
Placed into the deepest scars to raise the floor of each depression and smooth the surface before laser remodeling.
“When we did our micro drop of silicone, we're able to really get a nice smoothing of this. So now we need the surface to remodel itself and that's what we're doing.”
Dr. Emer, in the film
Deep fractional erbium laser going straight through the superficial layer in millimeters, remodeling tissue underneath. This step is bloody because the laser penetrates multiple layers.
Superficial blade of erbium laser resurfacing the top layer, delivered after the skin is wiped completely dry. Settings are calibrated for speed and depth on ethnic skin.
“On ethnic skin, you have to be very careful with how deep and how quick you deliver energy within the tissue. Every millisecond counts.”
Dr. Emer, in the film
Skin prepped with chemical peel and products including retinol, hydroquinone, tranexamic acid or kojic acid, layered specifically for melanated skin.
Why patients fly in
Silicone fills the deepest scars, Profractional remodels tissue underneath in millimeters, Contour TRL resurfaces the top layer. Each modality works at a different depth, all calibrated for melanated skin in one session.
“We're doing multiple modalities at different depths, not just with lasers, with injectables.”
Laser depth and speed settings are adjusted for Fitzpatrick type four and darker skin. Deeper energy delivery requires slower passes; every millisecond of energy delivery matters.
“On ethnic skin, you have to be very careful with how deep and how quick you deliver energy within the tissue. Every millisecond counts.”
Blood from the Profractional step must be wiped completely dry before Contour TRL, because any fluid left on the skin absorbs and disperses laser energy unpredictably.
“You have to make sure that it's dry because then it alters how deep you can go within the tissue because then there's a supportive layer of what is blood either absorbing energy.”
Patients send photos and videos every day for up to two weeks so Dr. Emer can monitor healing and catch any sign of fungal or bacterial infection before it becomes a problem.
Chemical peel and layered skin care with retinol, hydroquinone, tranexamic acid or kojic acid before treatment. Antibiotics and antivirals, personalized skin care regimen and daily monitoring after.
“You won't heal properly after this type of treatment if you don't have the proper postcare protocols.”
THE THINKING BEHIND THE TREATMENT
Follow Dr. Emer’s approach through the stages described in this case.
Back to the video ↗The combination that requires a different protocol at every layer.
The patient in this video has Fitzpatrick type four skin and deep acne scars. That is exactly why Dr. Emer built this multi-layered approach: micro droplet silicone to fill the deepest depressions, Profractional laser to remodel tissue underneath, and Contour TRL to resurface the top layer.
Each modality works at a different depth, and each one is calibrated for melanated skin.
“So our goal is to really smooth with the outcome. When we did our micro drop of silicone, we're able to really get a nice smoothing of this. So now we need the surface to remodel itself and that's what we're doing.”DR. JASON EMER · FROM THE VIDEO
Each modality works at a different depth, and each one has to be calibrated for melanated skin. The Profractional goes deeper into the tissue in millimeters, remodeling the layers beneath the surface. That step is bloody, because the laser is penetrating through multiple layers. The final layer is Contour TRL, a superficial erbium laser that resurfaces the top of the skin.
By the time the Contour TRL step happens, the blood from the Profractional has to be wiped completely dry, because any fluid left on the skin absorbs and disperses the laser energy unpredictably. Every millisecond of energy delivery matters on darker skin.
“On ethnic skin, you have to be very careful with how deep and how quick you deliver energy within the tissue. Every millisecond counts.”DR. JASON EMER · FROM THE VIDEO
Three treatments, one session, one plan / Patient story
The combination that requires a different protocol at every layer.
The patient in this video has Fitzpatrick type four skin and deep acne scars. That is exactly why Dr. Emer built this multi-layered approach: micro droplet silicone to fill the deepest depressions, Profractional laser to remodel tissue underneath, and Contour TRL to resurface the top layer.
Each modality works at a different depth, and each one has to be calibrated for melanated skin. The Profractional goes deeper into the tissue in millimeters, remodeling the layers beneath the surface. That step is bloody, because the laser is penetrating through multiple layers. The final layer is Contour TRL, a superficial erbium laser that resurfaces the top of the skin.
By the time the Contour TRL step happens, the blood from the Profractional has to be wiped completely dry, because any fluid left on the skin absorbs and disperses the laser energy unpredictably. Every millisecond of energy delivery matters on darker skin.
The patient in this video has Fitzpatrick type four skin, and the scars are deep. That combination is exactly why Dr. Emer built this multi-layered approach: micro droplet silicone to fill the deepest depressions, Profractional laser to remodel tissue underneath, and Contour TRL to resurface the top layer.
Each modality works at a different depth, and each one has to be calibrated for melanated skin. Settings that work on lighter skin types can cause serious harm on darker skin if the physician is not experienced in treating ethnic skin tones.
Dr. Emer starts with micro droplet silicone placed into the deepest scars to raise the floor of each depression. Then he uses Profractional laser, which goes deeper into the tissue in millimeters, remodeling the layers beneath the surface. That step is bloody, because the laser is penetrating through multiple layers.
The final layer is Contour TRL, a superficial erbium laser that resurfaces the top of the skin. By the time this step happens, the blood from the Profractional has to be wiped completely dry, because any fluid left on the skin absorbs and disperses the laser energy unpredictably.
Every millisecond of energy delivery matters on darker skin. The laser has to move at the right speed for the depth and the skin type, or the risk of hyperpigmentation or scarring goes up.
How a session is built
Each modality works at a different depth, and each one is calibrated for melanated skin.
Placed into the deepest scars to raise the floor of each depression and smooth the surface.
Goes deeper into the tissue in millimeters, remodeling the layers beneath the surface. This step is bloody.
A superficial erbium laser that resurfaces the top layer. The skin must be completely dry before this step, or the energy disperses unpredictably.
Patients send photos and videos every day so Dr. Emer can monitor healing and catch any sign of infection before it becomes a problem.
The treatment, explained
Also called acne scar laser, acne scars darker skin, acne scars ethnic skin, Profractional laser, Contour TRL, fractional erbium laser, erbium resurfacing, micro droplet silicone, silicone for acne scars, laser for melanated skin, Fitzpatrick type 4 laser.
Signature procedures
Peptides / biologic optimization
Peptide and biologic protocols for recovery, body composition and longevity, with epigenetic testing. RECODEX™ peptides are available to purchase through the practice after consultation.
Why Dr. Emer
Settings that work on lighter skin types can cause serious harm on darker skin if the physician is not experienced.
Dr. Emer built his reputation on outcomes that require precision: acne scars on melanated skin, revision work after failed treatments elsewhere, and protocols that other dermatologists travel to learn.
He personally performs every procedure in his practice, and he has spent two decades calibrating laser settings, injection depths, and recovery protocols specifically for Fitzpatrick type four and darker skin tones. That experience is what makes the difference between a result and a complication.
The skin is prepped with a chemical peel and products that include retinol, hydroquinone, tranexamic acid or kojic acid, layered specifically for melanated skin.
Antibiotics and antivirals are part of the protocol, and the skin care regimen is personalized based on how the patient is healing.
Patients send photos and videos every day so Dr. Emer can monitor healing and catch any sign of fungal or bacterial infection before it becomes a problem.
Every before and after is unfiltered, because Dr. Emer wants patients to see the reality of the protocol and the results.
Asked plainly, answered plainly
Each modality works at a different depth. Silicone fills the deepest scars, Profractional remodels tissue underneath in millimeters, and Contour TRL resurfaces the top layer. Treating all three layers in one session is more effective than treating one layer at a time, because the skin remodels as one system. The protocol is built for melanated skin, with settings calibrated for Fitzpatrick type four and darker skin tones.
The skin is prepped with a chemical peel and products that include retinol, hydroquinone, tranexamic acid or kojic acid, layered specifically for melanated skin. Without pre care, the risk of hyperpigmentation or poor healing goes up. Pre care is part of the protocol, not an upsell.
Dr. Emer monitors healing for up to two weeks to catch any sign of fungal or bacterial infection before it becomes a problem. Daily photos and videos are part of the protocol. This is not optional, because the treatment will not heal properly without the right post care and monitoring.
No. Settings that work on lighter skin types can cause serious harm on darker skin if the physician is not experienced in treating ethnic skin tones. On melanated skin, you have to be very careful with how deep and how quick you deliver energy within the tissue. Every millisecond counts. This is not the type of treatment to experiment with.
Blood from the Profractional step must be wiped completely dry before Contour TRL, because any fluid left on the skin absorbs and disperses laser energy unpredictably. If the skin is not dry, the energy delivery changes and the depth becomes inconsistent. On darker skin, that unpredictability can cause hyperpigmentation or scarring.
Profractional is a deep fractional erbium laser that goes straight through the superficial layer in millimeters, remodeling tissue underneath. This step is bloody because the laser penetrates multiple layers. Contour TRL is a superficial erbium laser that resurfaces the top layer. The Profractional remodels the tissue, the Contour TRL resurfaces the skin.
No. Dr. Emer does not use AI or filters on before and after photos. The results are unfiltered because he wants patients to see the reality of the protocol and the results. Daily photos sent by patients during recovery are also unfiltered, so healing can be monitored accurately.
Antibiotics and antivirals are part of the protocol. The skin care regimen is personalized based on how the patient is healing, and patients send photos and videos every day for up to two weeks. Post care is not optional, because the treatment will not heal properly without the right products and monitoring. The specific products and timeline are set at consultation.
A consultation with Dr. Emer covers your skin type, your scar depth, and whether this multi-layered approach fits your plan.
Schedule ConsultationWest Hollywood and New York City