What Is The Best & Most Effective Acne Scar Treatment in 2014?

For craterform, shallow, deep, wide, and box car scars. Since there is nothing for ice pick scars. Reference is here. In 2008, the best we have gives 50-60% improvement. Reference is here. Please show evidence.

Doctor Answers 1

Options for Acne Scars - 2014

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Hi HealthyNeeds. The options for acne scars have not changed significantly since 2008. What would help for us to make a more complete recommendation are some pictures of you.

If you have very deep ice pick scars, then some punch excision may help to get started. After that, you may also consider full and/or traditional CO2 resurfacing, newer fractional resurfacing and traditional dermabrasion.

We will focus on fractional laser resurfacing - but here's the catch. Fractional resurfacing is VERY different from practice to practice. We often see patients that tell us they have already had 4-5 Fraxel laser resurfacing treatments and were disappointed with results. When we ask what anesthesia was used, they indicate topical numbing cream. When we ask how much recovery time, they state 3-5 days. When we ask if they drove themselves home they say "yes", and when we ask if they bled much they say "no". These are all answers that indicate they received a very mild form of fractional laser resurfacing.

In clinical terms, a "mild" laser resurfacing like the one described above would not likely be going deeper than 150 - 200 microns (.2 millimeters). By contrast, we are performing fractional laser resurfacing that can reach depths of 1,200 microns. The depth depends on the type of scars and the area of the face. But the key is that the deeper the resurfacing, the better chance you have of revising problematic acne scars.

To be able to perform a deep resurfacing, the patient needs numbing cream, dental blocks (upper, lower and forehead) as well as spot injected lidocaine where more severe scars are. Patient is also given Valium and Vicodaine for pain and relaxation. Patient has to have a driver and experiences much more profound bleeding in the procedure than in a typical Fraxel procedure.

All this is meant to tell you that it's very likely that you do not need a new technology. Rather, you need a different practice that can perform the procedures in a much different way.

We use the Sciton Profractional for our deep fractional laser resurfacing. Please do not get stuck on the name of the laser, but ask your practitioner how deep they will go, and how they are accomplishing comfort measures. Also ask fro pictures of their actual patients. Good luck.

Los Angeles Facial Plastic Surgeon
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