Acne scars can be treated by a variety of methods including chemical peels, surgery and lasers. Depending on the depth and severity of scars, scar types and patient factors; our specialist Dermatologists will tailor an individualised program for optimal results.
Dermatologists usually combine several different treatment modalities to achieve optimal results. This includes TCA Cross, Fraxel (1550nm), fully ablative lasers (erbium, CO2) and fractional lasers (erbium, CO2).
There are also new non-laser treatments for early acne scarring which include Infini (radiofrequency needling), Dermapen needling, and eMatrix (radiofrequency).
Acne scarring results from injury to the deeper dermal layers of the skin. Acne scars most commonly occur as a result of intense inflammation such as rupture of the pilosebaceous unit or oil glands. This inflammation disrupts the evenly ordered structure of collagen which results in acne scarring.
To repair the scarring, one must remodel old collagen and rebuild new collagen, restoring the even structure of the skin. This forms the basis of scar revision.
The first concept to grasp is that acne scars lie deep in the skin. This means that superficial treatments like microdermabrasion cannot reach the depths required to treat acne scarring. In order to effectively cure acne scars, we must treat the dermis to remodel collagen.
Laser treats scarring by a process called collagen or dermal remodelling. This process involves breaking down old collagen and letting your body’s immune and recovery process ‘remodel’ or ‘refresh’ the old with new collagen.
Fractionated laser resurfacing uses two methods to breakdown collagen. Firstly, collagen is physically broken down by controlled destruction of old collagen. Secondly, controlled heating of the surround tissue denatures, or breaks down the collagen scars surrounding the treatment areas. This controlled heating is what differentiates lasers form old-fashioned skin needling (Dermapen).
Fully ablative lasers, as the name suggests provides controlled and precise destruction of the upper layers of the skin, peeling away acne scars layer by layer. This technique is best for superficial or shallow acne scars, and most commonly used after deeper scars have been raised through a technique called subscision.
The best method for acne scar revision is not necessarily laser treatment. As specialist Dermatologists we are taught to revise scars based upon acne scar type, skin type and downtime of the patient.
Here are some examples of other techniques that are used ahead of lasers for acne scars:
Laser however can be the best method for treating box-car scars, mild atrophic scars, and raised ice pick scars. Most patients will have a mixture of acne scars, and hence why laser is just another method in our tool kit for getting the job done. 90% of the time, it’s the experience of the operator, and not just the tools!
Finding a specialist skilled in all aspects of acne scar revision will give you the very best results possible.
Specialist Dermatologists will choose certain lasers based upon your acne scar type and downtime as well as your skin type.
Westside Dermatology has one of Australia’s largest selection of laser machines, so patients are always matched to the best laser- procedure for their scars. We do not use one particular laser over the other we will always tailor a program based upon the above factors.
Fracionated laser treatments (Fraxel, ProFractional, CO2, eMatrix (radio frequency)) produce hundreds of tiny but deep micro-columns of energy into the areas of scarring. Each column is the diameter of your hair shaft. Laser ablates the scars and old collagen, but also leaves areas of your skin untouched, forming the basis of Fraxel/fractionated laser treatments.
For every micro-column the laser emits, it leaves the surrounding tissue unaffected and intact. This fractionated treatment allows your skin to heal much quicker than if the entire surface was treated at once as the untreated area heals the wound by removing the treated skin and replacing it with new tissue.
The advantage of treating skin this way is that there is less downtime and less side effects whilst still obtaining significant acne scar improvements. This type of scar treatment is also safe in darker skin types such as in Asian skin.
With deeper scars, CO2 lasers can be used as a form of fractionated laser resurfacing. With this technique more heat is injected into the dermis, and more collagen stimulation is achieved, however due to the extra heat it increases the downtime; approximately 7-10 days.
The choice of what fractionated device is used, is based upon your skin type, scar type, and downtime.
Laser procedures are performed at Westside Dermatology in one of our four Queensland Health accredited laser theatres.
We conduct laser procedures at a SPECIALIST MEDICAL LEVEL, much like minor day surgical procedures. This ensures the highest level of safety, comfort and sterility for every patient.
Your laser experience will be in this order:
At Westside Dermatology, your laser session is conducted to the highest specialist medical and operational standards.
The procedure is well tolerated as we ensure that patients are comfortable during and after the procedure. We always use a topical anaesthetic cream, which is placed on the treated area at least 60 minutes prior to the procedure. In some patients, a nerve block using local anaestheic is required. In major cases of scar revision we provide further pain relief.
As a guide, most patients rate laser revision of scars as 2/10 on the pain scale which means; ‘minor, well tolerated.’ After the procedure, the pain mimics that of a severe sunburn reaction.
Immediately following the procedure you may experience mild to moderate redness and a sensation resembling sunburn.
Your recovery process depends on many factors including –
Depending on the intensity of laser treatment, we may arrange for post–laser follow-ups to ensure that you are healing as expected.
Recovery time will be discussed with you at the time of planning during the initial consultation.
As a guide of recovery times –
Recovery time will be discussed in great detail with you well before the procedure. Your laser dermatologist will inform you of the best compromise between results and down time.
Noticeable results can be obtained in just one treatment, although the number of treatments varies from patient to patient. Some patients seek the minimal downtime advantages of very conservative treatments and choose to extend their therapy over several sessions. Others desire more rapid results and are able to tolerate longer downtime, and thus pursue a more aggressive treatment program.
The number of treatments will also depend on the scar type and skin type. Patients with severe acne scarring may need more treatments compared to mild to moderate acne scar patients.
Your treating dermatologist will give you a guide as to the number of treatments best suited for your scarring.
As a guide, we recommend 2-4 laser treatments for optimal results.
Treatments should be spaced at intervals between 4-10 weeks and no shorter, as results are best seen 3 months after each procedure, this is due to the fact that collagen production may take 3 months to finish remodelling.