Acne scars

Acne Scars

What it is?

Acne scars are permanent marks left behind on the skin where pimple once was.

Symptoms

Acne scarring are the depressions in the skin and/ or discolouration of part of the skin where a pimple once was.

Causes

Acne scars are generally caused by the skin losing collagen from the inflammation and therefore cannot restore the area properly leaving indents in the skin.

Treatment

Cortisone cream
About treatment
Hydrocortisone is in a class of drugs called steroids. Hydrocortisone prevents the release of substances in the body that cause inflammation. Cortisone cream should not be used if you have a fungal infection anywhere on the body. It is also important to advise your doctor if you are on any other medication or are suffering from any other condition as the cortisone could affect the treatment or make it worse. 

Treatment used for 
The treatment is used for a variety of skin conditions all over the body. Cortisone Cream is used to treat irritable skin, anything from insect bites, eczema, allergies and poison ivy. 

Procedure
Read the instructions, take notice of the side-effects, the treatment can cause. Always apply creams or ointments to clean skin using sterile apparatus or clean hands. Apply a small amount of the cream onto the affected area, do not apply if skin is broken or open. Gently rub the cream into the skin. Apply the ointment as directed by the doctor or pharmacist.

If you are using a moisturiser along with the ointment, apply the moisturiser first, this allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. Ensure you wash the ointment off your hands, unless your hands are the area treated.

Recovery
If your symptoms have not improved after this time (or if they get worse), you should speak with a doctor for advice. Hydrocortisone should not be used for long periods of time or on large areas of the body, especially in children.

If you have eczema or dermatitis, continue to use a moisturiser every day after you finish using hydrocortisone. This will help to prevent a further flare-up.

Results
An improvement in the skin should be evident within a week, if not it’s recommended to speak to your doctor. 

nd:yag laser 
About treatment
Nd:YAG lasers emit pulses of light at 1064 nm and have been the most widely used laser for laser-induced thermotherapy. Nd:YAG is a crystal that is used as a lasing medium for solid-state lasers

Treatment used for 
The Nd: Nag laser can be used to treat skin conditions including aesthetic, irritations and cancerous conditions. This laser can also be used in dentistry procedures. 

Procedure
The procedure depends on the area to be treated and the applicator used. In all laser treatments, the client is required to wear protective glasses. The area may be cleaned or required to be shaven depending on the treatment. The applicator light burst over the skin for a few seconds and then is slowing moved across the skin to ensure the skin has been treated. 

Results
The results are depended on the area treated, however they are generally not immediate. 

Excel V
About treatment
Excel V is a tunable laser system that combines two ultra-precise, laser wavelengths in one device.

Treatment used for 
The Excel V treatment is versatile in treating everything from deep vascular conditions to benign pigmented lesions on the skin surface.

Procedure
The procedure depends on the area to be treated and the applicator used. In all laser treatments, the client is required to wear protective glasses. The area may be cleaned or required to be shaven depending on the treatment. The applicator light burst over the skin for a few seconds and then is slowing moved across the skin to ensure the skin has been treated. 

Results
The results are depended on the area treated, however they are generally not immediate. 

Fraxel Re:store
About treatment
Fraxel Re:store is a fractional laser which is a rejuvenation laser treament for the skin. 

Treatment used for 
Fraxel Re:store treats skin conditions from acne scars, stretch marks, surgical or traumatic scars, skin pigmentation (including melasma), sun damage, and wrinkles.

Picosure – Cynosure
About treatment
Our body already has what it takes to help you look and feel younger. Let PicoSure put it to work for you.

Recent discoveries have begun to reveal the secret language of the body and how cells talk to each other to keep us healthy. Known as cell signaling, this biological communication occurs when cells are injured and release proteins, which are then detected by surrounding cells to trigger a healing response.

PicoSure’s PressureWave™ technology uses a unique wavelength of light (755nm) and a specialized lens to convert laser energy into gentle pressure. This pressure squeezes cells, activating the natural cell signaling processes that create new collagen and elastin without burning or damaging the skin. The Focus Lens Array delivers 20x the energy density of a normal PicoSure pulse to begin activating cell signaling.

Intra-epidermal Laser Induced Optical Breakdowns (LIOBs) form and cause pressure waves that propagate into the dermis, triggering pressure injuries to activate cells.

Cell signaling initiates an enhanced inflammatory healing response that leads to increased collagen and elastin and ultimately revitalizes skin.

Treatment used for 
PicoSure’s unique energy delivery is a breakthrough for patients’ seeking a way to improve their skin and reduce signs of aging but who don’t want to deal with the risks, pain and downtime of traditional laser treatments. Using highly targeted energy, PicoSure gently disrupts the particles responsible for a range of pigment conditions like freckles, sunspots and other discolouration.

But there’s more. With the revolutionary Focus lens, PicoSure harnesses the latest breakthroughs in medical science to improve wrinkles, age lines and even acne scars. Unlike other lasers with similar results, PicoSure doesn’t rely on heat to burn away and destroy skin to force the body to heal.  Instead, PicoSure is designed to activate the body’s natural immune response while minimizing injury and discomfort. Because it uses gentle pressure instead of dangerous, damaging heat there’s no need for a long, painful recovery. In fact, most patients only experience a few hours of mild redness.

With PicoSure, there is no need to sacrifice safety, comfort or convenience for effectiveness. PicoSure does all this on your time. 

Results
The result? Brighter, healthier, younger-looking skin—with virtually no downtime. That’s breakthrough.

Fractora – fractional resursurfacing and rejuvenation CO2 laser (inmoda)
Treatment used for 
Fractora is the most advanced fractional radio-frequency treatment providing anti-aging improvements on skin tone and texture for a more radiant appearance through ablation and skin resurfacing.

Fractora delivers RF energy to the skin through an array of pins producing localized heat and small micro-lesion dots in the treatment area. The gentle heat generated by the Fractora pins in the sub-dermal tissue promotes collagen restructuring for skin rejuvenation and an improved appearance in the skin. The methodical scattering of micro-lesions allows the skin to heal faster than if the entire area was ablated. 

Physicians can offer a versatile fractional treatment that can provide non-ablative to minimally ablative results up to 1 mm in depth.

Fractora can be used in areas that demonstrate fine or deep wrinkles, scars or discoloured red and brown skin tone. The most common areas of treatment are the lower eyelid, upper eyelid, smile lines, cheeks, mouth and neck.

RF energy heats the skin in a controlled schema to remodel deep collagen and improve the appearance of the skin.

Benefits:

  • Fractora delivers improvements in the broadest range of symptoms of aging skin including fine lines, deep lines, texture, pigment irregularities, blood vessels and redness.
  • Fractora offers improvements for aging skin that would normally require two, three or even four different technologies.
  • Ablation of the skin promotes skin resurfacing while untreated skin between the pins promotes faster healing of the treatment tissue.
  • Versatility of parameters allows the user to vary the depth of ablation, coagulation and heating.”

Skin needling for acne scarring
Treatment used for 
Surgical skin needling is an older but very effective method of treating superficial acne scars by puncturing the skin with multiple fine 3mm (long) needles attached to a small rolling pin. This stimulates collagen production and helps to lift up any ‘indented’ or atrophic acne scars. The advantage of this treatment is the fact that it can be used on all skin types including olive and dark skin types. People of Asian, Indian, African, and European background are able to have this treatment with less risk pigmentation changes in comparison to laser treatments post-needling. Also, it penetrates very deeply so that collagen can be stimulated on deeper acne scars. Usually it takes 3 to 7 days to recover from the treatment, depending on the degree of the treatment.

Micro-needling for acne scarring
Treatment used for 
Micro-needling is another form of skin needling that utilises fine needles attached to a stamping device that oscillates up and down to create thousands of micro-injuries to the skin. It generally is a lot less invasive than surgical skin needling (described above), and although it has less downtime, generally requires more treatments to achieve similar results.

Infini is a non-laser treatment that combines both micro-needling with radiofrequency. It is an effective treatment for acne scarring as well as skin tightening and is particularly suited to olive or darker skin types. It has a lower risk of post-inflammatory hyperpigmentation than laser treatments, and the recovery time is significantly less than surgical skin needling.

TCA Cross
Treatment used for 

TCA CROSS is a simple yet effective method of improving acne scarring. It is most commonly used for small indented acne scars. It involves careful placement of high concentrations of trichloroacetic acid into the scar with a toothpick. This stimulates the production of new collagen and remodelling of existing collagen to fill in the acne scar. The advantage of this treatment is that it is localised to the problem only and not the unaffected skin.

Subcision is another technique that is suitable for treating depressed acne scars. The size of the scar usually needs to be fairly large or deep. It involves putting a special needle under the depressed scar. Often acne scars are depressed because the skin is tethered to the underlying tissues.

Chemical peels for acne scarring
Treatment used for 
Chemical peels are another method of treating more superficial acne scarring. Generally, medium to deep chemical peels are required to achieve a significant result, but a series of more superficial chemical peels could help achieve some improvement in milder acne scarring without significant downtime.

Microdermabrasion for acne scarring
Treatment used for 
Microdermabrasion is a technique that can also help, but only extremely slightly, with mild acne scarring. It uses a gentle vacuum to bring your skin in contact with a diamond-coated head that gently abrades the top layer of dead skin. This stimulates collagen production and helps with scarring. Generally, more than 10 treatments are required and the results are usually slight, and certainly a lot less dramatic than the other treatments mentioned here. There is virtually no downtime with microdermabrasion, although there may be some redness that persists for a few hours.

Laser for acne scarring
Treatment used for 
Laser treatments for acne scarring

Laser resurfacing (non-fractional) with a carbon dioxide laser and/or erbium laser is a method of treating acne scarring. These lasers ablate (remove via vapourisation) the top layer of skin and this results in growth of smoother new skin which lessens the appearance of scarring. Also, removing the top layer of skin effectively lowers the level of the ‘normal’ skin down to the level of the indented or atrophic acne scar to create more level skin surface. Laser resurfacing with these lasers not only addresses the issue of acne scars, but also can significantly improve the appearance of sun-damaged (pigmented/wrinkled) skin. Although this is a very effective treatment, there is usually a two week recovery period associated with the procedure. Medicare rebates often apply for the treatment of facial acne scarring with a carbon dioxide or erbium laser.

A more recent advent in the treatment of acne scars are fractional lasers.  Instead of treating the whole skin surface, small columns of laser energy are fired into the skin, and the skin in between these columns is spared. This leads to faster healing times, and less risks and complications from treatment. One of the other key advantages of fractional lasers is their ability to penetrate deeper into the skin than non-fractional lasers. By doing so, these lasers are able to effectively stimulate the production of new collagen. This raises indented or atrophic scars to the level of the normal skin, as opposed to non-fractional resurfacing which shaves the layer of the normal skin down.

One of the first fractional lasers used was the Fraxel laser. This is classified as a non-ablative laser, that is, it does not vapourise any tissue, but instead heats columns of tissue with laser energy. It is this heat energy that stimulates new collagen production in the skin.

  • Fractional carbon dioxide lasers have been an even more recent development that can provide superior results to Fraxel treatments.
  • Fractional carbon dioxide lasers are ablative lasers, that is, they vapourise columns of skin as well as heat the skin. By ablating as well as heating the tissues, more collagen stimulation and new skin formation occurs and it is possible to achieve superior results to non-ablative lasers like the Fraxel.
  • At Victorian Cosmetic Institute we use the Lumenis Ultrapulse fractional carbon dioxide laser with the Deep Fx hand piece for the treatment of acne scars. This handpiece fires very fine columns of laser energy deep into the skin with only a small percentage of the skin’s surface being affected.
  • The recovery period from fractional carbon dioxide laser treatment ranges from 3 to 10 days depending on the intensity of the treatment.
  • The results from fractional carbon dioxide lasers are particularly effective in the treatment of acne scarring in fair skin types. For olive or darker skin types, there may be an increased risk of post-inflammatory hyperpigmentation (darkening of the skin post-treatment), and for these skin types, we recommend Infini radiofrequency needling treatments.

Our Medlite q-switched Nd:YAG laser, which is used also for tattoo removal and pigmentation removal, can also be used at settings to help promote collagen production and help improve mild superficial acne scarring to help raise small indentations in the skin. The advantage of this treatment is that it has only a small amount of downtime in comparison to the above treatments, however multiple treatments need to be performed. Usually, several treatments are required. There have been clinical studies showing the effect of this laser on flattening the topography of scarred skin, and a general overall improvement in skin texture and smoothness. Generally, this treatment is very mild, and not particularly effective in the treatment of acne scarring.”

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