A Collagen Remodeling Procedure
Since atrophic scars result from a loss of collagen, this phase of treatment consists of procedures meant to induce collagen growth. Examples of treatments that can induce collagen growth include traditional ablative laser resurfacing, nonablative fractional laser resurfacing, ablative fractional laser resurfacing, chemical peels, dermabrasion, and skin microneedling with platelet-rich plasms .
Traditional ablative laser resurfacing
This uses either of a 2940 nm erbium:yttrium aluminum garnet laser or 10,600 nm carbon dioxide laser. It is the most effective, but most aggressive procedure that may not be tolerated by all patients. These lasers target water, causing the precise ablation of the epidermis and dermis leading to thermal injury which promotes collagen remodeling. This procedure is rather invasive and requires multiple weeks of down-time.
Nonablative fractional laser resurfacing
As an attractive alternative to traditional ablative laser resurfacing due to less down time , this is a highly effective treatment. Most commonly, the 1550nm or 1540nm NAFR lasers are used to ablate a narrow microscopic column of skin instead of ablating the entire surface. However, the results are more limited and require multiple treatments.
This skin procedure involves the use of tools to remove the epidermis or part of the dermis. This procedure is highly operator-dependent and meticulous, but it allows the doctor to etch scar edges precisely.
How Do Acne Scars Form
Acne scars are a result of inflammation in the skin surrounding a pimple. The body responds to a breakout as an injury, blood is rushed to the area to try and repair this wound, when the pimple is fully alleviated, a lingering stain in the form of dark red or a brown spot may remain. Most textural damage such as ice pick and box car scars that resemble small to large holes in the skin tend to be related to cystic acne or acne vulgaris. The inflammation is much deeper and more severe in this type of acne that it actually eats away at the collagen fibers below, when it fully heals the result is a devastating divot in the skin.
Types Of Acne Scars: Atrophic
When the skin is unable to repair tissue properly, it forms an atrophic scar a depressed region that is often pitted. Cystic acne, not whiteheads or blackheads, is what often leads to scarring.Atrophic scars are divided into the following three types:Ice pick scar: The most common atrophic scar, small, deep V-shaped indentations that appear on the cheeks. Typically 2-mm wide, with a sharp border that continues to the deep dermis, ice pick scars are difficult to remove.Boxcar scar: A wider indentation than ice pick scars, boxcar scars are round-oval depressions with strongly defined outlines. At up to 4.0 mm broad, they can be more difficult to remove than ice pick scars.Rolling scar: The broadest of the atrophic scars, a rolling scar lacks definite boundaries, and therefore is the most difficult to remove.
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Why Do We Get Acne Scars
Scars appear because your body tries to repair your acne. How your body responds to a wound determines the amount of scarring you will get.
Acne scars are the result of inflamed acne lesions. These lesions penetrate through your skin, damaging the tissues beneath it. This may leave a mark or pit behind.
Acne scars take on two primary forms. One in which a scar develops where there is a loss of tissue resulting in an indentation on the skin surface, or the other form in which a scar, a raised one, develops on the skin surface. This type of scar indicates that your skin is doing its normal function well. In the process of helping the acne heal, your skin creates collagen. When theres too much collagen, then there are chances that raised scars develop.
Did You Know?
While smaller blemishes can still scar your skin, its the big ones that mostly do the damage as they tend to extend deeper into your skin. Deep nodular or cystic breakouts are more likely to destroy your skin tissues and leave scars.
Filler For Acne Scars
Dermal fillers are injected into the skin to raise depressed areas of acne scars or stimulate the skins natural production of collagen. Material used for filler can include silicone, hydrogel or sometimes fat from other parts of your body depending on what your dermatologist suggests.Dr. Steve says: I think filler is a good tool for those bigger scars that are indented, so you can fill it and it props up the skin.
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What Are Pitted Acne Scars
Pitted acne scars are also called atrophic acne scars. They are the hollow, indented marks formed on the skin after a severe acne breakout. They look sunken compared to the other areas of the skin. They affect the skins texture and may become permanent if not treated soon. They are caused by a sudden loss of collagen that occurs during the skin healing process.
But what causes pitted acne scars? Keep reading to know.
Acne Scarring Treatments Recommended By Stratum Clinics
Acne scars are one of the most frustrating skin concerns to deal with. While there are a number of over-the-counter treatments and guides about how to get rid of acne scars, they dont always work for everyone. There are different types of scars and each type requires a different treatment approach. Some treatments work better for certain types of scars than others, so it is important to know what type of scar you have before starting any treatment.
Fortunately, our team of experts have put together a list of the seven best treatments for reducing or removing acne scars.
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So How Do I Get Rid Of Acne Scars At Home
1. Use a retinoid.
While retinoids can help prevent acne scars, theyre also a great option for treating them if youre already dealing with them. Using a retinoid in your skin care routine will stimulate collagen production to fill concave scars and soften the edges. All of this will improve skins overall texture.
For her patients, Dr. Henry likes Epiduo Forte, a prescription medication that combines a retinoid with benzoyl peroxide to fight acne and improve skin tone and texture. But if youre looking for an over-the-counter retinoid option, she recommends one with between 0.5 and 1 percent retinol, like PCAs. Dr. Zeichner is also a fan of retinoids, and recommends Differin Gel to help boost cell turnover which results in a more even skin tone, texture, and pigmentation.
However, if you have sensitive skin and tend to react to active ingredients, like benzoyl peroxide, salicylic acid, and retinoids, then its best to avoid products with those ingredients, says Dr. King. For post-inflammatory hyperpigmentation in sensitive skin types, I would recommend avoiding any products that are irritating the skin enough to cause inflammation and potentially additional post-inflammatory hyperpigmentation because this will be counterproductive, she adds.
2. Up your exfoliation game.
3. Glow with vitamin C.
What Is The Recovery Period Following This Treatment
You dont need to plan a significant amount of downtime after this treatment. Most people are able to return to work or school the next day following their treatment. Usually, it only takes 3 to 10 days for your skin to renew itself after the treatment. During this time, you might see significant initial results followed by gradual improvement.
Certain measures, like avoiding sun exposure and going without makeup for a few days after your appointment, will help your skin adjust to the Laser Acne Scar Removal treatment quickly. Washing your face daily and keeping the treated area moisturized are also recommended ways to care for your skin.
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How Much Is Laser Acne Scar Removal In Nyc
On average laser acne scar removal in NYC costs $850 per session. Patients usually need three or more treatments depending on the severity of the acne scars. We also offer a world-class chemical peel called the ViPeel which costs $450 per treatment. Purchasing a package of treatments comes with a 10 percent discount off the entire package.
How Laser Acne Scar Removal Works
A topical anesthetic is applied for approximately 45 to 60 minutes to numb the skin prior to treatment. Then 3 or 4 passes of the Fraxel Laser are performed over the treatment area. The procedure takes about 15 minutes depending on the size of the area being treated. Most patients find the procedure quite comfortable and are pleasantly surprised that they can resume their regular activities immediately following the treatment.
Following the Fraxel Laser treatment for acne scars, the skin typically takes 3 to 5 days to regenerate. Once the acne scars are removed and will not return. If your acne comes back, however, there is a possibility that new acne scars could develop, and additional laser treatments may be necessary. If you have acne-prone skin, we recommend a series of ViPeels and other highly effective treatments to keep acne under control.
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Volume Replacement For Acne Scarring
In many cases, volume loss occurs under the skin as a result of acne, particularly with cystic acne. Replacing volume with dermal fillers can aid in treating scarring.
Dermal fillers are a quick and effective means of replacing volume loss to improve scarring. By injecting these dermal fillers underneath scarring, they help to replace lost volume, and lift the skin towards its normal level.
Alternately, fat can be transferred from the abdomen, hips or thighs, and be injected underneath the areas of scarring. As well as providing additional volume to the area, fat contains stem cells which help in the skin regeneration process. Fat transfer can be combined with skin needling or laser resurfacing in the same session to synergise the treatments.
Things To Try When Acne Wont Clear
The following tips from dermatologists can help you get started.
1. Give an acne treatment at least 4 weeks to work.Using a new acne product every few days may seem useful, but that approach can worsen acne. Acne treatment needs time to work. Using a different product every few days can also irritate your skin, causing new breakouts.
If a treatment works for you, you should notice some improvement in 4 to 6 weeks. It can take two to three months or longer to see clearing.
If you notice improvement, keep using the treatment. Even when you see clearing, youll want to keep using the acne treatment. This helps to prevent new breakouts.
When to see a dermatologist about acne?
Seeing a dermatologist can help prevent acne from worsening. You can benefit from seeing a dermatologist when acne:
Causes acne cysts and nodules
Hasnt cleared with treatment you can buy without a prescription
Makes you feel uncomfortable, and you want clearer skin
2. Attack the different causes of acne.If you dont see improvement after 4 to 6 weeks, add a second acne product to your treatment plan.
This approach can help attack the different causes of acne. Bacteria, clogged pores, oil, and inflammation can all cause acne.
Benzoyl peroxide decreases P. acnes bacteria
Retinoids, such as adapalene gel, unclog pores and reduce oiliness
Salicylic acid eases inflammation and unclogs pores
Wont clog pores
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How To Identify Deep Scars
Here are the common characteristics of deep scars:
- Tissue Depth Or Depression: Flat, thin scars have an indentation that extends vertically to the deep dermis layer of skin or subcutaneous tissue.
- Loss Of Tissue/Skin Volume: These round to oval depressions have sharply demarcated edges and a width of 1.5 to 4 mm. Fibrotic indentations result in shadowing and a pitted appearance.
- Discolouration Of Skin: Acne may result in post-inflammatory hyperpigmentation. Some acne scars may vary in colour from pink, tan, skin-coloured to dark brown.
- Undulating Appearance: Often, these scars have a horizontal orientation with sharp margins or depressed tracks. Skin appears uneven due to the loss of critical rebuilding tissue without collagen.
An Initial Treatment Phase
The goal of this phase is to treat scar erythema and treat individual scars that may be resistant to collagen remodeling procedures. Treating erythema is important as the redness accentuates the scar and makes it more noticeable.
To target erythema, the treatment of choice is the pulse-dye laser. Typically, it requires three to four treatments spaced out every month.
To treat individual scars that may be resistant to other treatments, typically a surgical approach is preferred. Ice pick and narrow boxcar scars respond to the chemical reconstruction of skin scars technique where a high-strength trichloroacetic acid peel solution is placed at the base of scars with the goal to promote dermal remodeling.Rolling acne scars are typically treated with subcision, a procedure in which a small needle is inserted under an acne scar with the goal of releasing the fibrosis tissue that teethers the scar and causes the depression.
Finally, another option to treat difficult ice pick and boxcar scars is to surgically remove them by punch biopsy.
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Acne Scar Laser Treatment & Removal
In London and Surrey
Dr Hussein is recognised as a national authority in the management of acne scar treatment. He teaches and lectures regularly on the subject. He specialises in the use of a technique called laser resurfacing for the improvement of acne scarring. Both fractional and fully ablative laser resurfacing are used in conjunction with the methods below to obtain the best possible improvements in acne scarring. This laser resurfacing is performed with surgical-grade CO2 and Erbium YAG lasers. Most clinics use low power CO2 and non-ablative lasers. These devices do not have the same capability as the lasers that Dr Hussein uses in his practice.
Dr Husseins pursuit of excellence and commitment to the state-of-the-art in cosmetic dermatology and laser surgery leads him to invest in only the best laser equipment to get the job done. The best equipment combined with his specialist knowledge in cutaneous laser surgery makes him one of the UKs leading doctors in acne scar management.
He also uses multiple adjunctive techniques such as:
- Full Field Subcision of acne scars under local/tumescent anaesthesia
- Punch Excision of acne scars
- TCA CROSS
What Is The Best Way To Get Rid Of Acne Scars
I wish acne was a bit less difficult to deal with. I just mean a smidgeon. When you believe youve gotten rid of the red pimples, they leave a large dark pink blue scar that makes things worse.
Acne scars on the face, chest, and back are fairly common, if thats any comfort. Acne scars affect the majority of acne sufferers, and they are nothing to be embarrassed of. Its just an indication of the bodys normal healing process in response to a wound. And, dont worry, if you want to, you can get rid of acne scars.
It will take some time, but it will be well worth it. Lets see what natural therapies are available to assist you get rid of acne scars.
Quick disclaimer: These home cures are completely safe, non-comedogenic , and effective. Take note of what Im about to say. But first, lets figure out whats causing your scars. Because, as I have said, every solution begins with the cause.
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Cost Of Laser Treatments For Acne Scars
According to the American Society of Plastic Surgeons , on average, ablative laser procedures cost around $1,960 nonablative procedures, $1,200. You may pay more or less depending on the region of the country you live in.
Aside from the procedure itself, be prepared to pay for related expenses such as anesthesia and prescription medications to manage discomfort after your procedure. Some dermatology practices offer financing, which can make paying for laser treatment more manageable.
How Long Will The Effects Of Laser Acne Treatment Last
One of the most common questions about laser treatment for acne scars is whether the results will be permanent. If youre paying for private treatment to get rid of your scars, then you will want to be sure that the effects will last as long as possible.
- Ablative laser acne treatments should produce permanent results, but the effects of the treatment will depend on the severity of the scarring and how well your skin heals. Additional treatment is rarely needed for this type of laser therapy, but the scar can sometimes re-appear.
- Laser resurfacing can produce permanent results, especially when the scarring is mild. It can take some time for the full effects of the treatment to become apparent as collagen is produced, but once these are visible they will usually be long lasting. In some cases, further treatment sessions may be needed in the future.
- Laser acne treatment can help with some kinds of pigmentation changes caused by acne. The effects should last for a long time, but they arent always permanent. The discolouration can sometimes return after many months. This is the least permanent type of laser treatment, although it can have long lasting effects for many people.
It usually takes multiple sessions to complete the laser treatment. You may need to wait weeks or months to see the full effects of the treatment. Since you are committing a substantial amount of time to the treatment, you will want to know beforehand how long the effects will last.
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What Causes The Scarring
When you have a serious acne breakout, the damage to your skin can go very deep. Your body repairs itself with collagen, a protein that is responsible for the structure and shape of your skin. Collagen is also responsible for keeping our skin wrinkle-free while we are young. Sometimes, the collagen in your body can completely heal the affected area without leaving behind a noticeable difference in the color or texture of your skin. In the case of acne scars, the healing process was incomplete. In this situation, visible changes to your face remain.
Sometimes, acne breakouts can lead to scabs. Eventually, these scabs will fall off revealing new skin underneath. This skin might be the same color as the skin around it, or it might be a different color. When it is a different color, you have a scar. Fortunately,laser acne scar treatment can help your body finish the healing process it started.