How long does collagen take to regenerate and raise depressed acne scars after Pico Focus Laser?

Question

Hi there, I just did my first Pico Focus treatment 2 weeks ago on a small area of depressed acne scars with pigmentation. Since then, I have noticed that my pigmentation has lightened quite a bit but the depression of the scar is still obvious. My next review is spaced 4 weeks from my first treatment hence it'll be in 2 weeks' time. May I ask, is the collagen beneath my acne scars still being regenerated on its own to gradually raise the depression with time and make it less obvious?

Laura Riehm, MD · Answer

Thanks for your question.  Collagen production takes 60-90 days to get ramped up.  Once produced, this collagen will typically lasts 10-15 years.  No one has perfect skin, but you can probably get improvement in your scars. We tell our acne scar patients to do their series of treatments and then wait an additional 3-6 months to see the final results.  With most lasers, you are breaking up scar tissue down deep, trying to get your skin to lay down flatter.  Since your skin is thousand skin cells thick, it takes time to get the repaired cells to the surface.  I hope this helps.

Bernard Tan, MBBS, MRCSB · Answer

Hi there!Typically it takes at least 2-3 sessions of PicoSure focus lens treatment to see a visible result for depressed acne scars. Also, the results come about a month after the treatment.Best wishesDr Bernard Tan

Monika Soni, MD · Answer

No one has perfect skin, but you can probably get improvement in your scars. We tell our acne scar patients to do their series of treatments and then wait an additional 3-6 months to see the final results.  With most lasers, you are breaking up scar tissue down deep, trying to get your skin to lay down flatter.  Since your skin is thousand skin cells thick, it takes time to get the repaired cells to the surface.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Picosure has its place in the management of acne scarring. I do like this laser in only 2 scenarios in the context of scars. Firstly mild and early scars- general rejuvenation. Secondly after ablative laser- as this provides a chromophore rich environment. In the context of moderate atrophic scars, Pico laser does not work AS WELL COMPARED to other methods - see below. Singapore has a paucity of true laser experts, however the team at National Skin Centre are highly recommended.
Acne scar revision comprises of many specialised procedures. For the best results, one should target the acne scar type with appropriate treatments METHODS. Using one or two devices is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Remember, scar revision is a medical procedure that is technical to perform. It is not dependent on the clinic, branch, machine, or laser but by the skill of your dermatologist of plastic surgeon. 
Take for example deep ice pick scars, and narrow box car scars. These are best treated with TCA CROSS and focused angled CO2 fractional laser in low density. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat graft, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 
In the vast majority of patients, different patterns of acne scars will be present. Monomorphic acne scarring (scars of the safe subtype) are extremely rare. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combinations that yields the best results. It is never about the device, it is about the specialist behind the equipment that will deliver the best outcomes. 
Global leaders in acne scar revision will always use manual methods to revise scars, and employ lasers and energy devices as instruments to assist. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

David E. Berman, MD (retired) · Answer

Oftentimes for hyperpigmentation, you will need a series of 3 treatments, sometimes more, spaced a month a part between each session. I feel that for acne scarring you should plan more like 6 treatments, each spaced a month apart. Sometimes we will also do microneedling between picosure sessions. it is very important that you aim for an improvement and NOT perfection. there is zero chance that any treatment can totally improve or eliminate your scarring. However, the treatments, should give you some improvement.david berman md

How long does collagen take to regenerate and raise depressed acne scars after Pico Focus Laser?

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