I was wondering if anyone had tried thermage for acne scarring? My doc said it was an option for me and all the reviews I've read are for wrinkles or aging skin. If anyone has done this or another treatment for scarring I'd love to hear about the results. Thanks!
Does Thermage Improve Acne Scarring?
Doctor Answers 4
Thermage and acne scarring
Thermage does tighten skin and you can see a little improvement in acne scars but it is not as effective as laser treatments. Lasers, especially the fractionated ablative CO2 laser can break up the old scar tissue and stimulate new collagen which helps lift up the scars. Deep scars may need to be subcised or even excised before laser treatment. You may also need some filler. Please consult a board certified dermatologist or plastic surgeon to discuss your treatment options.
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Acne scarring best treated with Fraxel or with fillers
Thermage gives overall tightening of the skin. The problem in acne scarring is not loose skin, but a depression in the skin. Fraxel is the name of one type of fractionated resurfacing laser, which is the best treatment for acne scars because it triggers the skin's healing mechanisms and can resurface the skin and smooth the scar. Non-ablative fractionated resurfacing can do this without any downtime, but you will need several treatments (exactly how many will depend on what your scars look like). Ablative fractional resurfacing will give you results in fewer treatments but will require one to two weeks of downtime.
Some acne scars can also be effectively treated with a little bit of filler (collagen or hyaluronic acid) injected into the scar. This raises the level of the scar so that it is even with the rest of the skin. This may be a good option if you only have a few scars, but the downside is that it is temporary and you will need to come in for treatment every few months.
Thermage is not the best for acne scarring, but Fraxel
Thermage uses radiofrequency to generate heat. This causes tightening of the collagen fibers of the skin but also stimulates generation of new collagen fibers. The result is skin tightening. Acne scars are permanent 'divots' in the skin.
I have had my best results using a Fraxel laser. This is a laser that is considered fractional therapy. It has replaced the carbon dioxide laser allowing patients to carry on with their personal and professional lives 24-36 hours after treatment. I have used the carbon dioxide laser which treats acne scarring very well but the associated downtime is the downside. I recommend 6 Fraxel treatments spread out 2 weeks apart. More treatment sessions are required since the energy of the laser is 'fractionated' versus all of the energy in one single treatment(carbon dioxide laser. After the each treatment, my aesthetician applies a special facial mask that decreases the reddness post treatment.
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Thermage not effective for acne scars
Acne scars are a result of permanent tissue damage and the only way to lessen their obviousness is to level the surrounding skin and/or "pump up" the scar floor from beneath. A fractional laser has minimal downtime and right now, is the treatment of choice for acne scars. On the other hand, if you have isolated scarring, temporary fillers could be a solution -- possibly combined with subcision, but the fillers do break down over time so you would need repeat treatments. The more permanent fillers are used for deep tissue support so these not a common option.
Some of the newer fractional CO2 lasers are giving fairly good results, but there is downtime -- which most people don't want. Deep scarring would likely require multiple treatments of any of the various fractional lasers.
Take time to do your homework and learn about the options. You'll always get better results in the end if you understand how scarring develops and how the skin reacts to the different treatments.