What is the best way to remove acne scars on my face? Fraxel, Chemical Peels, or something else?
Face Acne Scars - Best Way to Remove?
Doctor Answers 13
Laser resurfacing, possibly a lift
First, I advise my patients to get their acne under control with a good dermatologist. Prior use of Accutane will make the patient more prone to having complications from laser.
Laser resurfacing helps to tighten the skin and reduce the appearance of acne scarring. Fractional laser helps less, and leaves some areas unresurfaced, but has less down time. CO2 laser helps more, but is associated with more down time and prolonged redness, particularly when it is done aggressively. Any laser resurfacing done deeply can cause loss of pigment cells and whiteness which is permanent, or loss of dermal elements, producing a weird, shiny appearance, also to be avoided.
Dermabrasion is an older technique that can "sand" down the skin , making it smoother. There is a technique of superlight dermabrasion done repeatedly, which can also have a beneficial effect on acne without the extended down times of conventional dermabrasion.
Deeper ice pick marks can be removed by direct excision. It is not possible to remove ice pick marks with repeated resurfacing because of the depth of the injury and the limitations of lasers.
In some patients who also have looseness of the skin, tightening procedures such as a facelift can help greatly in additon to the laser resurfacing.
Acne patients should be realistic about their degree of improvement. In most patients with severe acne scarring, it is not possible to remove all signs of acne, just to improve them significantly.
A board certified plastic surgeon can guide you through all these techniques.
Acne scars -- best way to remove?
I think that nothing will "remove" acne scars and anyone who says differently is not being truthful. I think the optimal treatment involves facial resurfacing (which need not require the latest, greatest, most hyped, and most expensive laser since similar results can be obtained by chemical peels) combined with subcission and fillers. These modalities can offer a tremendous improvement in deep acne scars. Good luck!
More than one option
The best way to treat acne scars really depends on the type of scars you have.
Chemical peels and microdermabrasion may help with lighter scars and with discolored scars. You would need a series of these treatments, probably 4-6 spaced every 2-4 weeks.
For deeper scars you may need stronger, deeper chemical peels or laser resurfacing. You need a treatment that is going to reach to the depth of skin where the problem is. Fraxel is the brand name for a type of laser treatment that treates microscopic colums of skin at a time, leaving untreated areas between each zone and allowing for a faster recovery time. This is called fractional resurfacing and there are several brands of lasers that do this. Fraxel is one brand and there are 2 types of Fraxel: one is gentler but requires more treatments, and the other is a little more aggressive but requires fewer treatments to get results.
With any treatment, you should be sure to practice good skin care and avoid sun exposure. And if you are still having acne trouble, be sure to start treatment so that you can minimize the development of new scars.
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Nothing is perfect for acne scars. Remember acne scars are the result of skin scarring as well subcutaneous fat atrophy. So, it is a multi-modality treatment process. Some lasers can be used on the skin to perform surface changes. Some can treat the deep collagen to lay down new collagen. But, sometimes small fat grafts or facial filles can lift the depressed scar as well. Some doctors will even cut out the old scar all together to bring skin and soft tissue fromt he sides together to remove the depression.
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