i have googled many times to find out what the best thing for acne scarring.most doctors tell their patients to do some sort of laser.so the patient pays big bucks and gets it done.and of course no results.i hear and read most people did not get results.so why do doctors insist on telling patients that lasers work the best. they do not
Why Are Lasers the Most Talked About for Acne Scars when It Simply Does Not Work?
Doctor Answers (9)
Re: Lasers for Acne Scars
Lasers are essentially tools. The way they are applied for specific patients depends on how skilled the physician is. There are different parameters that can be established. These will determine how much energy is used and how deep the wavelengths will penetrate the skin.
More than one session will be needed for desired results.
I am sure that there are patients who may not have received the results they wanted. However there are others who have. Take a look at this video. You will see that measurably improved according to a digital imaging skin analysis.
In our practice and I’m sure every practice has their own way of treating acne scars. We have laser treatments and or a mini facelift to stretch out the skin. We have Profractional laser treatment and micro laser peels. Those procedures will improve your acne scars dramatically. If you want the least invasive and no down time with mild correction a Vipeel can help with that as well.
Acne Scarring and Lasers
Lasers do work. It just depends on what you are using it for. I personally do not feel the deep acting lasers that heat the deep tissue does much like the wavelengths from 1100-1500. I would do co2 laser resurfacing. Sometimes a multi approaches are the way to go.
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Acne Scars are very difficult to treat. The starting point is to find a surgeon that you trust who may have a variety of options for you. In that manner, the surgeon can combine modalities to create the ideal treatment plan for you. Lasers if used properly can be a vital part of the treatment plan.
What is the best treatment for acne scars?
What is the best treatment for acne scars? This is one of the most difficult questions that can be asked of a physician. In my Salt Lake City, Utah plastic surgery practice I get this question quite often and I have to help my patients understand that there is no single treatment that will correct acne scarring.
I also try to tell patients that no matter which treatment we select to improve the appearance, and no matter how much improvement you see, patients always wish that there was MORE improvement.
Treatments may include:
- ablative laser resurfacing
- excision (cutting or punching out)
- subcision (undermining to release tethering)
- soft tissue fillers or fat grafting
Usually you will need a combination of several of the above to adequately treat acne scars. Lasers are only one of the many treatment modalities, but they are usually very helpful when used in conjunction with the other treatments as well.
Fraxel and Fillers for Acne Scars
I do Fraxel laser resurfacing for acne scars and it works very well, but the settings have to be high. Also fillers like Restylane and Juvederm work great for indentations and are less expensive and don't have any down time. There are lots of options to treat acne scars and it depends on the type of scar, type of skin, and patients ability to tolerate downtime and cost. We make a plan that fits the patients lifestyle and budget.
Treatment options for acne scarring
Lasers have a definite role in the treatment of acne scarring, but I agree that many non-laser treatments are useful. Here is how I approach acne scarring. The first step is to determine what type of scar you have.
For ice pick scars, I recommend CROSS treatments (100% TCA applied into scar in pinpoint fashion). I have done punch excisions and punch grafts but CROSS is much less invasive and usually works well.
For red scars, pulsed dye laser or IPL.
For boxcar scars, consider surgical excision, ablative fractional CO2 laser resurfacing (DOT laser) or medical needling/CIT (collagen induction therapy) with 1.5 mm roller.
For rolling scars, consider subcision, fillers, ablative fractional CO2 laser resurfacing, or medical needling.
For very mild/shallow scars, consider non-ablative fractional laser if someone wants a more gentle treatment.
Often more than one type of treatment is used for a given patient for maximal improvement. Hope this is helpful.
Best Treatments for Acne Scarring
In our practice we do mostly injectable fillers and resurfacing with light electrosurgery to treat most types of acne scarring. We occasionally perform punch excision and punch excision with grafting. My mentor and colleague (and father!) has been treating acne scarring for over 40 years in the manner described above and has never used a laser. We have many patients referred to us who had undergone 4 to 6 laser treatments (mostly non-ablative fractionated lasers) reporting minimal improvement. Ablative lasers may help a little, but in my opinion, acne scarring can be treated very successfully without lasers and it is much more cost effective for the patient. Click on the link below for before and after photos of acne scarring treated with injectable liquid silicone and sometimes also light electrosurgery.
Fractional ablative laser really works when properly done for the right reasons
Fractional ablative laser [CO2, YSGG, ErYAG] really works when properly done for the right reasons. So does full face CO2 or ErYAG laser.
Non-ablative fractional laser, other lasers, "blue light", and intense pulsed light are close to worthless for acne scarring, and most of the complaints you have seen are from people inappropriately treated with those things. A few complaints may have come from people treated with Fractional ablative laser [CO2, YSGG, ErYAG] but at inadequate fluences, or for things like icepick scars which do not respond to laser.
Kevin Smith MD FRCPC Derm Niagara Falls Ontario