TCA is an abbreviation for trichloroacetic acid, the chemical acid used by Dr. Green for chemical peels and TCA Cross. Through the healing process, new collagen is formed. This treatment is ideal for use with ice pick or boxcar scars, and the result is an overall more even skin texture and rejuvenated appearance. Determining the most effective treatment for your acne scars should be done in a dermatology office with the guidance of a board-certified skin expert, like Dr.
Michele Green. Due to the complexity and variety of acne scars, multiple modalities of treatment are often required to optimize results. A combination approach is often taken for acne scars, since most patients have a combination of scars. Green may combine dermal fillers, such as Restylane and Sculptra, with lasers such as Fraxel or eMatrix, to restore the skin texture and improve your acne scars.
For deep, narrow ice pick scars, punch excision removes the scar tissue itself, while leaving behind a thin, often linear scar. For this reason, atrophic scars ice pick acne scars and boxcar scars often require a combination of treatments, potentially including laser treatments, chemical peels, or dermal fillers to maximize collagen production for skin resurfacing. Ice pick scars are deep and narrow, often resembling enlarged skin pores in appearance.
Individuals with cystic acne are typically more prone to developing ice pick scars since the inflammation associated with cystic acne breakouts can lead to damaged skin tissue. In order to best treat ice pick scars, a combination of procedures is often required. Punch excision and laser skin resurfacing treatments are two methods that are frequently suggested for treating these acne scars, though there are numerous treatment options available.
An acne scar treatment plan should be customized for each patient, taking into consideration skin type and type of scarring. During your consultation with Dr. Green, she will determine the best laser treatments, dermal fillers, and skin care for you to have the best cosmetic results.
Subcision is a minimally invasive surgical technique for scar revision that ultimately encourages collagen production in the skin. During this procedure, a needle is used to puncture the skin and break up fibrous scar tissue. Breaking apart scar tissue stimulates new collagen production in the skin, resulting in a smoother, more even skin texture.
Green often combines subcision treatments with dermal filler to achieve ideal results. The benefit of using a dermal filler in tandem with subcision for certain types of acne scars is that the hyaluronic acid of the dermal filler provides immediate improvement of the acne scars, while the subcision stimulates production of new collagen at the treatment site.
Fraxel laser treatment is a non-ablative, non-invasive treatment for acne scars. This innovative approach uses fractional laser technology to create micro-injuries in the dermis of the skin, leaving the epidermis intact and surrounding skin undamaged. Through the natural healing process, new collagen is formed. The result is an overall smoother skin texture and reduced appearance of acne scars.
CO2 laser resurfacing treatment is generally used for more severe cases of acne scarring. This is an ablative procedure that effectively removes the top layer of skin, while heating the underlying layer of skin, promoting collagen production. The CO2 laser is a more aggressive treatment than Fraxel, requiring more downtime, and will also result in a smoother skin tone and texture. The VBeam laser is a non-ablative treatment that is ideal for correcting skin redness and treating red and hypertrophic acne scars.
The Vbeam operates at a wavelength that specifically targets skin cells that store the red pigment. These skin cells absorb the heat energy from the laser while leaving surrounding skin unharmed. This laser treatment can be utilized to treat the appearance of acne lesions, broken blood vessels, rosacea, and acne scars which are red. Microneedling is a technique that employs tiny surgical needles to create micro-injuries in the skin.
The eMatrix laser can treat textural issues on skin of any tone and type, making it a powerful tool to combat against stubborn acne scars. Using this laser treatment helps patients with acne scars achieve smoother, brighter, tighter, more beautiful, younger-looking skin. Since sublative rejuvenation has only 48 hours of downtime, this laser treatment can be scheduled with ease.
Microdermabrasion is a non-chemical and a non-invasive procedure improves skin tone and texture by removing the upper layer of dead and damaged skin cells. Microdermabrasion also promotes the production of new skin cells, which have higher levels of collagen, resulting in a reduced appearance of mild acne scars.
This procedure should not be confused with dermabrasion, which requires anesthesia and a significant amount of downtime. The radiofrequency technology delivers heat to the dermis while the microneedles penetrate the epidermis, both creating micro-injuries in the skin. In addition, the area will have skin that is more likely to respond to other therapies, such as Fraxel resurfacing.
Another option is to physically cut out the keloid and suture the skin back together, but this could potentially result in yet another keloid. The Fraxel laser enables New York City acne scars patients to heal rapidly by only resurfacing a portion of the skin at a time, with treatments occurring every few weeks until completed. This gradual method eliminates skin sensitivity that often occurs when traditional laser resurfacing is employed.
Fraxel laser treatment also stimulates collagen production at the treatment sites, allowing your body to naturally fill in pitted scars caused by acne. Rokhsar may recommend scar subcision for the treatment of acne scars.
This procedure breaks up scar tissue and offers significant improvement, especially when combined with a Fraxel laser resurfacing treatment. During the simple, in-office treatment, Dr. Rokhsar utilizes a sterile needle to stimulate collagen growth and breakthrough fibrotic strands, finally minimizing the appearance of the scar.
This minor surgical procedure is used to offer cosmetic improvement for moderate to severe scars anywhere on the body. Depending on the severity of your scar and the amount of correction needed, you should notice remarkable improvement within 3 to 6 office visits. Acne scarring is the result of inflammation in the lower layer of the skin called the dermis which causes the collagen to become deformed or scarred resulting in depressions in the skin.
Acne scars, which are quite common, are classified into a boxcar, ice pick, and rolling scars. Lasers are a commonly used modality in the treatment of acne scars. Laser resurfacing has long been used in the treatment of acne scars. Traditional resurfacing lasers like CO2 or erbium can cause improvement in acne scars but require a long downtime. Non-ablative lasers such as SmoothBeam and CoolTouch do not remove the skin but at best are minimally effective in the treatment of acne scars.
Fractional resurfacing by Fraxel treat acne scars with shorter downtime. Rokhsar has been instrumental in the development of the Fraxel family of lasers, having worked on a prototype device and has discovered its effectiveness for acne scars. Rokhsar has published the first study on the treatment of acne scars with fractional resurfacing and has developed the parameters for use of this laser in the treatment of acne scars on a prototype device.
This laser resurfaces the skin gradually, which allows for rapid healing while eliminating the risk of rawness associated with traditional laser resurfacing procedures. The zones of thermal laser damage serve as a stimulus for collagen production, filling in the pitted appearance of acne scars with your own collagen.
Rokhsar will tailor the procedure for your skin depending on the type of acne scars that you may have. He may recommend subcision for rolling scars as well as combining the Fraxel resurfacing procedure with punch excisions for ice pick scars.
Scars on any body surface area can be treated with the Fraxel laser, although scars on the face respond the best. You will begin to see results a few days post-treatment.
Results are cumulative and it takes a few months to reach peak improvement. Your skin will gradually get better and better as the skin regenerates from the inside out. These lasers are considered safe and effective on all skin types, including African-American, Indian, Latino, Asian, and Mediterranean.
Using agents like Restylane, Juvederm, Perlane, or Radiesse, we can fill in the depressions caused by acne scars. Background: Follicular unit excision FUE is used to harvest follicular units for hair transplantation using trephine punches. The characteristics of FUE punches can impact the success of this technique; thus, many innovative punch designs and devices have been developed. With many options available, it can be difficult for the hair restoration surgeon to know which punch best suits the needs of their patients.
Objective: To provide a comprehensive review of punch shapes and devices available.
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