Combination Treatments for Acne Scars
Combination Treatment For Acne Scars
Due to the complex nature of acne scars, a combination approach is often required to achieve the desired results with both immediate and long-term improvement. Depending on the type of scars, one or several treatment methods may be recommended. It is difficult to return your skin to its pre-damaged condition; therefore, it is important to have realistic expectations. Our goal is to improve the scars by 50-75%.
Acne Scar Procedures
Subcision is a procedure that releases the fibrotic strands that tether the scars to the underlying tissue. A small, flexible cannula is moved in a fan-like motion between the superficial and deeper layers of skin to break down the scar tissue. Simultaneously, small amounts of filler are injected to build up the tissue underneath.
Hyaluronic Acid Fillers
Hyaluronic acid fillers are meticulously injected under the scar to plump up the surface to the level of the skin. This provides immediate visible results, and although the filler will dissolve over time, oftentimes there will be long term improvement as the filler stretches the skin associated with these scars. The injections are extremely safe and may need to be repeated every few years
Vascular/IPL Laser Treatments
Vascular/IPL Laser Treatments use non-ablative energy to constrict blood vessels and break down pigmentation thereby reducing the redness and pigmentation associated with some acne scars. As this treatment does penetrate through the surface of the skin, it can be done with very little pain or downtime.
Non-Ablative Fractional Resurfacing
Non-ablative fractional resurfacing with the M22 ResurFX laser creates microthermal channels of injury that penetrate into the deeper layers of the skin to break down scar tissue and stimulate collagen growth. This procedure does NOT cut the surface of the skin, so is only effective for mild pitted scarring. When used in combination with the Vascular IPL laser listed above, it can address redness, pigmentation and superficial scarring together in one treatment.
It is important that acne is under good control before proceeding with any acne scar treatments. If significant acne is still present, additional scarring may occur and therefore the treatments may not be as effective. Due to the risk of delayed healing, fractional laser resurfacing treatments cannot be performed for one year after finishing Accutane.
For patients with darker skin types, there is a higher risk of developing some temporary darkening of the skin (post-inflammatory hyperpigmentation) with fractioned laser resurfacing. To prevent this, we recommend that you start on a topical hydroquinone fading regime a minimum of 4 weeks prior to the treatment. The office can recommend the best product or regime for your skin type.
Ablative Fractional Laser Resurfacing
Ablative fractional laser resurfacing, uses laser energy to create small channels that penetrate through the superficial layers of the skin into the deep dermal layers of the skin. Similar to aerating your lawn, it breaks down the scar tissue and stimulates a healing response that results in tissue regeneration and collagen formation. Through the healing process, it naturally reduces the size of the scar as it closes in the columns of skin and the heat from the laser softens and flattens thickened scar tissue improving overall texture and tone. Because only a “fraction” of the skin is damaged, the healing time and recovery can usually be limited to a less than a week. We have both the Ultrapulse Co2 Deep FX Laser and the SP Dynamis Fractional Erbium Yag in our office, and will determine which laser would be most appropriate based on your skin type, severity and type of scarring