Acne is a frustrating skin condition that affects children, teens and adults. In addition to causing physical pain and emotional distress when it pops up, acne can lead to scarring and skin color changes that haunt those affected by it for the rest of their life. The best way to prevent permanent damage caused by acne is to prevent acne breakouts completely. There are many over the counter creams and face/body washes that have been used with limited effectiveness. Prescription strength creams, washes and oral medications require a visit to a board certified dermatologist and can cost hundreds of dollars. On this website will soon be able to find a special acne control kit that I have personally assembled for you as an alternate solution to empower you. I welcome you to try it in your own home.
Once the acne outbreaks are controlled and stable, scaring can be improved and mitigated through several beside procedures such as micro-needling, excision, subcision, lasers, chemical peels, and more. These operations are performed under local anesthesia and can be used alone or in combination to produce dramatic improvements. Descriptions of these procedures, all of which should be preformed by an experience professional, can be found below. I offer each of these acne scaring solutions as part of my practice in Southern California.
Micro-Needling: Micro-needling is a method that uses tiny needles that puncture the skin at a depth of 1-2 mm thousands of times stimulating collagen production, thickening of the skin and repair of the scares. Micro-needling is generally effective on boxcar scares, ice pick scares and rolling scares.
Punch excisions: Punch excisions are intended to remove scar tissue surgically using the punch biopsy method. The healthy tissue is then sewn together with stitches placed very carefully in each layer of the skin. Punch excisions are very effective for ice pick scarring.
Subcision: Subcision is a method used to detach the scar tissue of the epidermis from the underlying dermal tissue flattening any depressions that exist. This is done with a large gauge needle that is used to probe the scar parallel to the surface of the skin. Subcision is more effective for thick fibrotic scars such as box-car scars.
Dermal fillers: Dermal fillers are used to raise the skin and create a more even and smooth surface. They are most effective for areas with boundaries that are wide, soft and pliable as opposed to those that are rigid and fibrous. The filler, typically composed of hyarulonic acid, can be applied using several different techniques. Areas that contain high amounts of underlying fibrosis should not be treated with fillers due to the possibility of uneven deposition of said fillers. These areas should be treated with subcision prior to the use of fillers if appropriate.
Chemical peels: Chemical peels such as those containing trichloloacetic acid (TCA) are used in a very precise and controlled way to damage the skin in a fashion to promote healing of scar tissue and a healthier appearance of the skin. Deep chemical peels can be used to treat deep acne scars.
Laser resurfacing: Laser resurfacing can be a very effective treatment for atrophic acne scarring. Fractional lasers are particularly safe compared to non-fractionated lasers, and can produce dramatic results with minimal down time. Fractional photothermolysis (FP) laser technology creates microscopic areas of photothermal damage between areas of intact skin, allowing rapid regeneration of the skin. The photothermal damage that is introduced to the skin causes regeneration and a tightening of the skin. Another option, Non-ablative fractional lasers, produces similar improvements and require less post operative care, but requires a higher number of treatments.