Laser for acne scars? (Photo)
Doctor Answers 7
Subcision, Microneedling, & Filling Are Relatively Inexpensive & Effective Approaches For Treating Acne Scarring
As can be seen in the photo provided, indented, atrophic acne scars can present as ice pick scars, boxcar scars and rolling scars and often some general cheek depression and hollowing. And precisely because they seldom present as only one kind, optimal treatment requires addressing all the types of scars with a combination, multimodal approach, rather than a one-size-fits-all one.
Volumizing the cheeks using volumizing fillers, such as Voluma XC or Radiesse Plus, which I use in my Upper East Side Manhattan office (and Stylage XXL and Emervel Volume, which I use in my Israel satellite facility where a far greater number of regulatory agency approved volumizing fillers are available) can provide immediate lift and stretching of the skin--a process that helps to flatten and make more shallow scars, such as rolling scars, and to some extent improve less deep boxcar scars. in my experience, the results using this approach for the past half dozen years typically engenders an immediate "Wow!" reaction.
For more sustained improvement, subcision, a simple and inexpensive procedure for breaking up the tethering bands of abnormal scar collagen below nondistensible scars, has become a standard approach.
Finally, microneedle resurfacing (aka medical microneedling) may be used, if necessary, to better blend the surface color and texture of the scars with the surrounding normal skin. An Editorial Spotlight in the May/June issue of Modern Aesthetics noted, "Microneedle resurfacing has become immensely popular with both physicians and patients due to its remarkable results, brief healing time, and favorable price point. Moreover, it can be used safely in many areas...can also be used safely in patients of all skin types." In another article in the September issue of Dermatology Times, the author, herself a laser expert, wrote, "Unlike lasers that produce heat during treatment, the microneedling device produces micro injuries in the skin without heat; thereby, stimulating new collagen production without the risk of postinflammatory hyperpigmentation."
For more information on any of the above techniques, check out the archives of RealSelf.com and be sure to seek consultation with a board certified aesthetic physician with extensive experience and expertise in all methods of acne scar treatment.
Facial Acne scars
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Hopefully, there is an acne scar revision specialist in you area, because it will be too costly to travel out of town, stay in the hotel and of course the cost of your acne scar treatment itself. Acne scars are usually deep. How deep? They can be 0.1 millimeter or more than 1 1/2 of a millimeter. In skin terms, if you scratch off your skin and did not bleed, just a little flake of old skin came off, most likely, you scratch off only .05 of a millimeter. If you scratched off a skin with a sharp nail, and a layer of skin came off and you see clearly that where it detached, is pretty pink but not bleeding, most likely you scratched off 0.150 of a millimeter. Acne scars are not that shallow. Otherwise, microdermabrasions and maybe some really fine volcanic pumice stone will work. Scars created by acne infection are deep. The infection literally dissolves the skin and dermis so that the end result is ABSENCE OF SKIN AND DERMIS, that we call scars. If there is a powder made of skin that we can sprinkle on the scars and make new skin, that will be an awesome invention. We have not gotten to that level yet. As of now, multiple treatments of various methods are the ideal approach to scar revision. There is a treatment that will instantly raise up the indented scars in one treatment session. This is injected below the dents with a substance similar to a putty. Medically, they are dermal fillers, collagen and silicone. However, they simply raise up the scars, not replace the lost skin. The overall look and feel usually does not look palatable to the eyes. Yes, the dents are raised, but the skin is still not even. You may want to search for a local acne scar revision doctor that will not require you to travel long distances, since you may need to go back a few times for treatment. Good luck.
Erbium and CO2 fractional in the one session will give you a modest improvement, I would then consider RF such as Infini, and subcision for the tethered scars, last of all dermal fillers can volume displace, as well as focally fill the indentations.
Acne scar revision is like orthodontic work- it takes up to 12 months or longer to achieve optimal results with multiple visits.
All the best
Dr Davin Lim
Laser and aesthetic dermatologist
Acne Scars – Combination of Treatments Needed
The best treatment for acne scars depends upon an individual’s skin type, age, ethnicity, sun exposure, overall health and most importantly, the type of acne scars present (ice pick scars, boxcar scars, rolling scars, hypertrophic scars and variable degrees of hyperpigmentation). In order to give you an accurate treatment plan, a consultation is required to properly assess your skin.
An important step for all skin types is sun protection including the use of daily sunscreen, sun hats and sunglasses, all of which help prevent aging and sunburns.
When it comes to acne scar treatments, a combination of treatments are available including cosmeceuticals (medical grade skin care products specific for acne including ZO® Skin Health or ZO® Medical, Skinceuticals® or Glo-Minerals®), advanced laser resurfacing procedures (CO2 laser, Er:YAG laser, Fraxel DUAL®, PicoSure® FOCUS Lens Array), chemical peels (light, medium, deep including the blue peel), dermabrasion, augmentation/fillers, excision and/or subcision, punch techniques, microneedling/rolling, injections (corticosteroids, 5-FU), cryosurgery, electrodesiccation and microdermabrasion.
These are advanced techniques so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.
Acne Scars and Lasers Fraxel, eMatrix, Microneedling
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.