37 year old female with rolling acne scars. Should I try dermapen, lasers, or facelift? (Photo)
Doctor Answers 4
Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen
Rolling acne scars
Facelift for acne scars?
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ACNE SCAR TREATMENT | DR DANIEL CHANG RECOMMENDS COMBINATION APPROACH
Thank you for your question.
Acne scars are common, but with advancement in technology, you do not have to live with it.
Acne scars are the result of the breakdown of collagen and elastin in your dermis. They frequently occur at sites which were acne prone in the past, namely your temples, cheeks etc.
Acne scars are 3 dimensional, hence submitting a photo will not do justice to your scar. It requires real time examination (touch and animation), combined with lighting from various angles. That is why you may notice your scars differently in the bathroom mirror and in the dressing table mirror.
Dr Daniel Chang’s 3 STEP ACNE SCAR Treatment Formula:
1- Control acne
2- Treatment – Fractional laser + skinboosters ( to promote collagen growth)
3- Maintainence with lasers ( to optimise collagen stimulation)
STEP 1: CONTROL YOUR ACNE. (Refer to this page on acne for more information)
Achieving good control of your acne is the important principle towards helping your acne prone skin. This prevents new scars from forming, which is a big step forward. Dont be too worried about your existing acne scars. Focus on prevention first.
STEP 2: Treatment based on scar type. Below are the 4 main types.of atrophic scars.
Ice pick scars => can be treated with TCA CROSS, Fractional and Microneedling
Rolling and box scars scars => are best treated with a combination of RF Microneedling, PRP, fractional lasers and subcision
Hypertrophic scars can be treated with
- Intralesional steroid
Atrophic scars -> A combination approach is what I would recommend to improve the appearance of such scars.
- Laser Resurfacing +/- RF microneedling
- Dermal fillers – Skinboosters – Please refer to my Page on Skinboosters
- Intralesional saline – ( Latest evidence from Journal of Dermatology Sept 2016)
Fractional C02 used to be the industry gold standard for treatment of acne scars. Current studies point towards combination therapy, as I have outlined above. In addition, As collagen takes 3 months to grow, multicentre studies show one would require at least 4 sessions to see results. 1 session is unfortunately not enough.
New technology includes air dissection. Being a new treatment, I do not know of any randomised controlled trials regarding its safety and efficacy at present. Most studies are anecdotal. So time will tell.
You have rolling atrophic scars, so the combination approach above would help you.
I hope you find this helpful.