Acne scars are best prevented by early intervention of active acne. Unfortunately, many patients will develop scars after a a relatively brief bout of severe acne. Acne scar therapy is difficult – no two acne scars are alike and every patient requires highly individualized therapy. Acne scar therapy is best performed by a formally trained dermatologist.
New technologies are available for patients with established acne scars. These include:
- Surgical Subcision
- Punch Excision
- Non-ablative laser therapy
- Laser for Persistent Post-Acne Redness
- Ablative Fractional Laser Resurfacing
- Silicone Injection
Combination Acne Pearl Fractional & Silicone Injections
No photoshop manipulation / Photo of Derm.ca patient
Subcision is a very elegant surgical technique whereby a very thin scalpel is inserted into the skin to “release” thick collagen of the acne scar that is pulling down the skin. This is ideal for “golf ball dimple” type scars. The results can be dramatic. The risks of the technique include nerve injury, infection, scarring and hematoma. It should therefore only be performed by a highly experienced dermatologist.
The results can be dramatic but often other therapies are required for the final result. At Derm.ca, subcision is typically performed several weeks before resurfacing laser. This greatly improves the results of resurfacing laser as laser is usually not effective for deep scars.
This technique removes “ice-pick” type scars and scars that are deep so that the edges of the normal skin flanking the scar can be brought together for an even, smooth surface. This can be used on chicken pox scars as well. As with subcision, The risks of the technique include nerve injury, infection, scarring and hematoma (an expanding collection of blood that must be evacuated surgically). It should therefore only be performed by a highly experienced dermatologist. As with subcision, this is typically performed several weeks before resurfacing laser at Derm.ca. This greatly improves the results of resurfacing laser; as laser is usually not effective for deep scars.
Non-Ablative Laser therapy
The Nd:YAG laser is an excellent device for treating mild acne scars. This is a non-ablative laser – i.e. there is no cutting of the skin surface. There is thus no oozing or bleeding and therefore there is no “downtime” – you can back to your usual activities immediately after the laser session. However, multiple sessions are usually required to produce noticeable improvement in acne scars. The Nd:YAG laser is an “expert” laser and it is very “finicky”; if there is too much laser energy delivered, burns and scars can result. If there is not enough laser energy delivered, there is no benefit. This is because scar improvement requires superheating of collagen in the deeper layer of the skin (the dermis). There is a very narrow “Goldilocks” zone of too much or too little heat. As with ablative / fractional lasers, the results correlate with the training and experience of the operator. The Nd:YAG laser should only be used in a dermatology capacity, in the opinion of Dr. Alanen.
Ablative / Fractional Laser Therapy
By definition, ablative and fractional lasers cut the skin and their benefits can be envisioned as “controlled” scarring whereas the process of acne is “uncontrolled” scarring. At Derm.ca, two different systems are used, Cutera Pearl and Pearl-Fractional Lasers for treating acne scars. The Pearl Laser works on superficial, surface irregularities whereas the Pearl-Fractional Laser treats the mid to deep dermis. The Pearl-Fractional laser. The risks of any ablative and fractional laser procedure include burning, worsening of scarring, therapy-related redness and pigment alteration. As with the Nd:YAG laser, patients need to be mindful of the training and experience of their physician. Ask lots of questions. Fractional and ablative lasers can produce dramatic results for patients with acne scars, but usually not without other therapies; we typically combine these procedures with subcision before laser and an anti-redness laser.
No referral required, please call the office directly 403.457.1900.