If you’re constantly being reminded of your teenage years when you look in the mirror, and not in a good way, this blog post may be for you. Acne is the most common skin disorder in the country and affects 40-50 million people. As if suffering with acne itself weren’t bad enough, severe forms of the condition may leave behind scarring that can defy over the counter treatments. Read on to find out what we can do for you.
Not every patient is the same
The first step in the process is a careful examination of each patient’s unique concerns, including their goals and expectations, previous treatments and his or her willingness to tolerate a more invasive regimen or their desire to keep it limited to simpler methods.
Not all acne scars are the same
Pardon my Clark Kent-looking glasses when I jam my face close to yours to examine your skin texture. The glasses are called loupes (like a jeweler’s looking glass) and they only come in that nerdy style, so don’t blame me! I’m determining the best treatment for each particular scar.
My philosophy is this – If the scar is deep enough, lets fill it in with an injectable filler. If the scarring is more superficial, the better strategy may be to “lower the playing field”. This means to lower the surrounding skin level down to the depth of the scar, thus making the surface smoother. This is accomplished with either a laser or chemical peel. For isolated “ice-pick” or very deep scars, believe it or not, it may be best to excise the scar and leave a very superficial scar behind using a circular tool called a “punch biopsy.”
I’ve heard of Juvederm and Voluma. What filler are you talking about?
According to one of the authors of a recent study on this subject, Dr. Ruth Tedaldi, “the ideal agent is one that restores volume, is precise, offers immediate results, is long-lasting, has minimal downtime and is appropriate for all skin types.” The product to which she is referring is called “Bellafill” which has recently been FDA approved to treat acne scars. The study demonstrated good results, with 90% satisfied patients 12 months after treatment.
Which is better – a chemical peel or laser treatment?
If you’ve seen my recent blog post about skin resurfacing, you know the answer to this one. It’s hard to compare apples-to-apples because there are so many different chemical peels and lasers. The way to think about it is this. If you have limited, superficial scarring and want a less expensive, painless treatment with minimal downtime, a light chemical peel, such as the ViPeel, may be the right choice. If you have deeper scars and are willing to accept a higher cost and one week of downtime, a fractional CO2 laser treatment is more appropriate.
Where patients’ become disappointed is when their expectations don’t match the treatment. Patients who expect to get the same results from the ViPeel and the CO2 laser are setting themselves up for a letdown.
OK, I’m considering the CO2 laser. Is it painful? What is the downtime like?
The CO2 laser is done right in the office. Most patients require a “dental” block, meaning using local anesthesia to numb the face prior to treatment. If you can get a ride, we can also premedicate you with a mild oral sedative to take the edge off. The treatment itself lasts only about 15 minutes.
Afterwards, it will look like you got a bad sunburn for about one week. You will likely want to avoid being social and need to stay out of the sun and covered with vaseline during this time. Your skin will heal and you can wear makeup after the first week.