Acne Scars

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Acne Scars

If you suffered from acne that is now under control, you may still have to face the scars that acne leaves behind. When you have signs of acne scarring, it can affect your self-esteem and feelings of self-confidence. As the scars can create an uneven, lumpy appearance to the facial skin, cosmetics are often not enough to hide the damage.

Long after the acne itself has cleared, you may find yourself embarrassed by the unsightly scars left behind, and you may fear that there is no solution. Acne scarring can range significantly in severity, from pale, surface-level blemishes, to deep red or purple scars that are pitted, also known as “ice-pick scars.” Fortunately, our acne programs have many different types of treatments available that can significantly improve your skin’s texture and improve the appearance of acne scarring. Our staff can discuss all options available and which treatment might be best for you

Acne scars are a direct result of cystic acne or prolonged chronic acne. Reducing the appearance of acne scars has always been difficult. Prior to laser scar treatments, the available choices were mechanical dermabrasion (a wire brush which removes the top layers of skin) or deep chemical peels.

 

Before & After Acne Scars Photos

Frequently asked questions about Acne Scars

Your acne scarring is a result of tissue destruction. Infection that causes inflamed acne destroys that area of skin. Everyone has different response to acne inflammation. Some people scar deeply and others experience only faint scars that are more easily treated. Early treatment of acne will help prevent scarring.

You may have redness from acne that remains obvious for a long time. Redness can last up to a year if untreated. The pulsed light systems shrink and eliminate many of the broken capillaries responsible for this redness.

  • Acne scars, no matter how old or severe can be improved
  • 3 factors determine the ideal type of treatment- skin type, acne scar type and also the downtime
  • Each patient will receive a minimum percentage of improvement with an individually prescribed program
  • We use techniques such as Carbon Laser Peel, PicoWay Laser, Fraxel laser, TCA CROSS, Chemical Peels, Fillers, RF Fractional Resurfacing, RF (RadioFrequency) Microneedling and Microneedling to treat your scars
  • Each type of scar will have an optimal treatment
  • Matching scar types and skin types to scar treatment procedures is the key to success
  • On average, 30-80% of acne scars can be improved with a scar revision program
  • Each program takes between 2-14 months to complete, depending on the severity of acne scars and your skin type

All acne scar revision treatments depending on the acne scar type, downtime, and skin type or skin colour of the patient. Lets briefly discuss these 3 factors so you have an understanding of scar revision.

Identification of acne scars– this is the most important aspect of scar revision. Acne scars can be sub typed into box scars, ice-pick or deep scars, rolling scars, atrophic, hypertrophic or lumpy scars, pigmented scars, and anchored or tethered scars. Each type of scar will have an optimal treatment. Post acne scars are polymorphic and various types of scars usually coexist in the same individual. It is very important that each scar be assessed individually and treated accordingly. The method of the intervention depends on the types of the scars, overall appearance of the face and budgets of the patient

 

Depressed Scars / Atrophic Scars

Examples include –

Ice pick Scars

  • Ice pick scars – best treated with TCA CROSS and combination of Fraxel laser / laser or RF resurfacing and RF Microneedling. Ice pick scars are narrow (less than 2 mm), deep sharply marinated epithelial tracts that extend vertically to the deep dermis or subcutaneous tissue. The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice picks scars seem to make a small, deep, “hole” in the skin. They are the most common acne scars that occur on the cheeks and have a “punctate” appearance. Ice pick scars develop after an infection from a cyst or other deep inflamed skin tissue and its way to the surface leaving a column-like scar. TCA CROSS, or Trichloroacetic Acid Chemical Reconstruction of Skin Scars, uses up to 100% strength TCA in minute doses. These drops are placed precisely into icepick scars to stimulate healing within the narrow scars, resulting in resurfacing of these scars over several treatments.

 

Rolling Scars

  • Rolling scars – best treated with Fraxel and Fractional laser resurfacing & RF Microneedling as well as EndyMed FSR (fractional skin resurfacing). These are distensible, depressed scars with gentle sloping edges. Roling scar are shallow depressions that are best appreciated with a change in surface lighting. They can vary in size and often coalesce with neighboring rolling scars. Rolling scars are shallow, wide (more than 4 to 5 mm) and have a subdermal fibrous tether. These scars are caused by damage under the surface of the skin. They give the skin a wave-like appearance

 

Boxcar Scars

  • Box car scars – can be treated with TCA CROSS and laser resurfacing or RF (radiofrequency) Microneedling or EndyMed FSR (fractional skin resurfacing). Boxcar scars are angular scars with sharp vertical edges, and resemble the scars left by chicken pox. They may be shallow or deep, punched out, wide at the surface and at the base are most often found on the cheeks and temples

 

  • Shallow depressed scars resulting from tissue destruction following inflammation and infection. Treated with Fractional Lasers such as PicoWay, Fraxel 1550 or Microneedling, EndyMed FSR (fractional skin resurfacing) and to a lesser degree with Chemical Peels.

 

Atrophic Scars

 

 

 

 

 

 

 

 

  • Atrophic scars – best treated with Fillers, lasers can only help partially. RF Micronedling can also be a good option.

 

Tethered Scars:

Of the 3 main types of indented acne scars (ice-pick, boxcar or rolling) each might be tethered (anchored) to deeper structures of the hypodermis, and require more invasive procedures to release them from their anchoring scars. This is shown below where a needle is used to release the scars in a procedure known as subcision. This is can be the first step in a series of acne scar treatments where subsequent techniques are used to resurface the more superficial skin and improve its appearance and quality.

  • Tethered scars – Scars that are stuck to deeper layers will require subcision – best treated surgically with subscion by a doctor. It is a minor dermatological surgical procedure that uses a needle or blunt cannula to break these anchoring scars. RF Microneedling can also be a solution for tethered scars.

 

FLAT SCARS:

Brown, Pigmented Scars or PIH (Post Inflammatory Hyperpigmentation)

Taches brunes ou noires sur peau noire

  • Pigmented scars / PIH Post Inflammatory Hyperpigmentation Scars – best treated with Carbon Laser Peel, PicoWay Laser, Medical Facials such as Oxygeneo, Chemical Peels, Microneedling, Clear and Brilliant or EndyMed FSR (fractional skin resurfacing).

Red Flat Scars

Acne Scars — Coach Kimmy's Blog — AES Acne Clinic San Francisco | Acne Treatments for adult and teenage acne

 

  • Red flat “scars” resulting from capillary expansion following any inflamed acne. Treated with BBL, chemical peels and/or MediSpa Facials as well as RF Microneedling.

 

ELEVATED SCARS:

Hypertrophic Scars:

  • Hypertrophic: These are elevated, fibrotic scars, more common in males and frequently seen in the mandibular area of the face and back of the chest. Often the result of severe acne (cysts or nodules), they generally stay within the boundary of the original wound, and may decrease in size over time

 

Keloidal:

  • Keloid scars – raised, firm “hypertrophic scars” – are an occasional response to acne. Keloid scars are not treated with lasers and typically treated with cortisone injections to the scars. These keloids developing in acne lesions. They are seen more often in acne lesions. They are seen more often in males, on the back and chest

 

Downtime of procedure– this refers to the time taken off by the patient due to recovery. Some acne scar revision procedures are associated with a long recovery time, some with no downtime. Examples include-

  • Fillers for acne scars- no downtime
  • RF Microneedling or PicoWay Laser – 12- 36 hours downtime
  • TCA CROSS- 5-7 days downtime
  • Fractional and Fraxel laser- 3-6 days downtime
  • Fully ablative laser resurfacing – 7- 10 days downtime
  • Carbon Peels, Mild Chemical Peels, Facials or Microneedling – none to 1 day

Skin colour of the patient- this is very important as darker skin patients such as ethnic skin, will need more conservative settings compared to fair patients. This is because darker skin patients can pigment or darken with laser treatments and TCA peels a lot easier than fair skin patients.

Most patients will have multiple scar types, and hence several treatment sessions are needed for the very best results. If you are fortunate enough to have scars such as shallow to medium depth box car scars with fair skin type, then you may only require one treatment.

 

FILLER SKIN BOOSTERS

Hyaluronic acid fillers can be used in conjunction with subcision or lasers. Used during subcision, these fillers separate the upper from lower skin and prevent it from re-attaching, increasing the efficacy of each session. Used after lasers, the V2 skinbooster with Redensity 2 with its proprietary nutritious cocktail of aminoacids aids in recovery of the skin and optimizes the end results.

 

 

There are many factors that will determine how successful your treat is, however two main factors play a important part in predicting outcomes. Firstly the type of acne scars you exhibit, and secondly your skin type or skin colour. Most patients will have a mixture of acne scars, and hence different methods are needed to correct these scars. Patients with shallow box car scars in light skin type may only need one or two treatments, whilst darker skin patients with mixed scars may require many sessions over a year. Acne scarring is as unique as you are. Mapping photos are taken before, and after treatment. We undertake acne scar revision in patients who have realistic expectations and goals- namely our aim is to achieve scar improvement and not perfection in every case.

Skin needling and microneedling can be useful for mild and early acne scars, and can be safely performed at home.

Our approach to scar revision is unique, as we find the best method, rather than a device for your scars. Lasers provide much better acne scar remodeling than skin rollers. Skin needling is an entry level treatment for acne scars and gives only modest improvements for mild scars. This would be our Dermaroller our clients can purchase to use at home. Depth of penetration is 0.2 mm. Microneedling however is completely different. We use a medical microneedling device in the clinic, eDermastamp which can improve flat scars and scars that are not too deep. Depth of penetration can up up to 2mm.

We also use a special system that incorporates insulated microneedling with radio frequency. It is the delivery system of INTNSIF that makes this treatment unique. Insulation is the key, as it allows us to deliver the energy deep into the skin where acne scars lie. This is why this system is far, far superior than other RF microneedling systems. We often combine this with PRP. RF Microneedling is a better choice for deeper scars. Depth of penetration for RF Microneedling can be up to 5mm

What is RF Microneedling and how is it different than Fraxel or fractional skin resurfacing?

Despite the similar name, microneedling is not the same as fractionated resurfacing. Many cosmetic clinics use this term to convey that this treatment is the same as using a Fraxel laser, but microneedling uses hundreds of tiny needles that enter the skin vertically. RF microneedling is a form of skin needling; however, the difference is that radiofrequency energy is delivered into the deeper layers of the skin. This energy reforms your collagen and breaks down acne scars.

 

TCA CROSS stands for TriChloroAcetic Acid Chemical Reconstitution of Skin Scars. This technique was invented over a decade ago and still remains as one of the best methods to treat deep acne ice-pick scars, box car scars and enlarged skin pores. Most patients will require 2-4 treatments for best outcomes.

 

Acne scar treatments with TCA CROSS is to treat the deepest scars first. This raises the scars to the same height. Once this is achieved, we often use a laser to remove the majority of scars. Remember, for acne scar revision the rule of thumb is to always treat from the deepest to the shallowest scars. Sometimes we combine TCA CROSS with fractional devices, including fractional erbium lasers in the one session, or TCA CROSS can be the first step. Every acne scar patient is unique, as are the combinations of scar revision programs.

Methods we use to treat acne Scars

Fraxel laser is one of the best lasers in the World. This laser can be used to treat skin pigmentation, wrinkles, acne scars and sun damage. It will give your skin a whole new texture and brilliance to it. Fraxel laser is gentle on your skin, with a recovery rate of 4-6 days. We recommend 1-5 treatments depending on your skin condition. Fraxel is considered a ‘fractional treatment’, meaning that it creates hundreds of deep columns through the skin called microscopic treatment zones. This means only a percentage of the skin is affected during each laser pass, reducing healing time, promoting natural regeneration of collagen, and rejuvenating skin cells. Due to the fact that Fraxel laser works through non-ablative resurfacing, the epidermis, or top layer of skin, is not directly impacted. As a result, patients can expect faster healing after treatment.
A celeb-fave, PicoWay Resolve has quickly become a go-to treatment for correcting fine lines and wrinkles, and improving skin’s texture and tone. The precise heat of the laser stimulates collagen production without damaging surrounding tissues. With virtually no downtime, it’s also more comfortable than more ablative lasers. If you struggle with hard-to-treat melasma, you know this pesky condition cannot be prevented. PicoWay Resolve is one of the fastest and most effective melasma treatments available, often boasting results in just a few treatments.
During this procedure, tiny needles are used to create controlled micro-injuries to the skin in order to produce collagen and elastin, the cornerstones of healthy, firm, smooth skin. eDermastamp also creates superficial micro-channels which allow topical serums to be absorbed more effectively into the skin. The benefits of microneedling are a reduction in the appearance of fine lines and wrinkles as well as younger-looking skin with fewer signs of aging. eDermastamp also has a positive effect on hyperpigmentation, hypopigmentation, acne scars, traumatic scars, and stretch marks and generally creates a fresher appearance or glow to the skin.
TCA is a non-toxic chemical (trichloracetic acid), which has been used to perform skin peels for over 20 years. It is a relative of vinegar (acetic acid.) When TCA is applied to the skin, it causes the top layers of cells to dry up and peel off over a period of several days to one week. When the old skin is peeled off, it exposes a new layer of undamaged skin, which has a smoother texture and more even color. Some clinicians, in fact, still prefer TCA peels for treating sun damage or melasma, usually in combination with other in clinic treatments. TCA peels are most commonly used to reduce brown spots and age spots, to improve the texture of leathery, sun damaged skin and impart more glow, to improve melasma, to treat some types of acne and to reduce fine lines.
14% Salicylic Acid, 14% Lactic Acid, 14% Resorcinol. The Jessner peel is a highly concentrated medium to deep peel that works effectively on all skin types. This treatment aggressively targets hyperpigmentation, sun damage and scarring, while minimizing fine lines, reducing pores and tightening the skin to create a smooth, even texture. Jessner is also proven to be highly effective at targeting acne and rosacea type breakouts. Immediately after your first treatment, you will notice a progressive difference in your complexion, with a radiant, healthy and refreshed appearance.
Resurfacing refers to the ablation or removal of skin tissue so new healthy tissue can be formed. Fractional skin resurfacing means that specific small areas, a fraction of the skin’s surface, are removed in a precise pattern leaving the surrounding healthy skin intact. The small sections of untreated healthy skin that are left intact facilitate rapid healing of the treated areas, resulting in very high patient satisfaction. EndyMed’s unique 3DEEP® technology signifies a new era in anti-wrinkle and skin tightening technology. It is clinically proven to deliver tighter, firmer, lifted skin, safely and effectively with little to no downtime.
Many of our patients are unhappy with deep-set lines around their mouth and jawline. These deep and often static lines are the result of a natural decrease in collagen and elastin, two proteins that are essential in keeping your skin supple, smooth, and lifted. Most of the injectable wrinkle fillers that LSG uses in the office are made from different formulations of hyaluronic acid, a substance found naturally in the body, which is responsible for keeping our skin plump and reducing the appearance of fine lines and wrinkles. The consistency of wrinkle filler products is determined by the specific cross-linkage of the hyaluronic acid molecules, making some products smooth and malleable and others more firm. Our Nurses will determine the appropriate wrinkle filler to address your individual concerns, often injecting with a soft needle called a cannula to minimize bruising and achieve a natural, youthful result.
A chemical peel is a cosmetic treatment designed to vastly improve the tone and texture of your skin, and reduce imperfections & removes the outer layers of damaged skin. As the chemical solution deeply exfoliates your skin and dissolves the damaged tissue, a wound forms on the skin. This causes fresh, healthy skin cells to be brought to the surface. A chemical peel can treat many different skin concerns, including fine lines and wrinkles, hyperpigmentation, sun damage, precancerous skin lesions and mild scarring. While the face is a common treatment area to be treated with a chemical peel, it is also effective when performed on your chest, neck, back, hands, arms and legs.
Dermal Infusion is a non-invasive skin treatment that combines three areas of skin rejuvenation: exfoliation, extraction, and serum infusion. Your technician will best determine a custom blend of serums for you based on your skin concerns and desired results. The Dermal Infusion device has a chamber that is loaded with your custom blend of serums, which are infused into your skin during the treatment. The pen-like instrument has a diamond-tipped head that exfoliates, plus a vacuum that dislodges dirt and debris from pores, while the hidden chamber infuses the serum blend into your freshly exfoliated skin.
HydraFacial™ MD is the celebrity secret to maintaining healthy skin throughout life, but it doesn’t come with a celebrity price tag. Laser Spa Group offers HydraFacial™ MD  that our surrounding communities can take advantage of. The lavish secret for getting deeply hydrated, detoxed, and rejuvenated skin for a brighter, more luminous complexion. Best of all, HydraFacial™ is a relaxing, indulgent facial treatment for your skin. By combining advanced medical technology with a luxurious and invigorating spa therapy, we’re confident that the HydraFacial™ system quite simply offers one of the best facials available.
Every once in a while a treatment is introduced that takes us one step closer to the fountain of youth. The Forever Young BBL Photo-Facial is a big step in that direction and is one of the most advanced techniques available today to slow down, treat and reverse damaged and aged facial and non-facial skin.  This is the most effective and advanced form of photo-facial and photo-rejuvenation currently available due to the broadband light technology. The Forever Young BBL encompasses all of the advantages of the original BBL Photo-Facial procedure along with the newly recognized benefit of delaying skin aging. The treatment targets hyperpigmentation, sun damage, broken capillaries and diffused redness in the skin all while stimulating collagen. Forever Young BBL clients have seen great results on the face, neck, chest, hands, arms and other body parts.
In the world of earthy purifying wonders, charcoal is right up there with clay and mud. It’s been called the holy-grail ingredient and has been purging impurities since ancient times, thanks to its ability to attach to and absorb toxins. ​ In the past few years, charcoal has exploded in the world of skincare. Activated charcoal draws bacteria, poisons, chemicals, dirt and other micro-particles to the surface of skin, helping you to achieve a flawless complexion and fight acne. V Carbon Peel is a unique non-invasive treatment uses activated charcoal for an exfoliating and purifying effect that enhances facial lifting by penetrating deep into the pores. It’s the ideal system for tightening dilated pores and removing dead cells from the superficial epidermal layer for an overall new look. V-Carbon allows to make medium or deep peeling treatments depending on the patient’s needs.
The active ingredient in the Filler family of products is hyaluronic acid. The flexibility, texture, and resilience of youthful skin exist because of the high amount of water it contains. Also known as hyaluronan, hyaluronic acid is a sticky substance that our body naturally produces. The skin, eyes, and connective tissue are the sites where maximum amounts of hyaluronic acid are found. Its capacity to retain water up to almost a thousand times its weight is the key reason why it is used in cosmetic fillers. Apart from hydration, hyaluronic acid is also linked to tissue repair, rejuvenation, and has anti-inflammatory action. Hyaluronic acid also facilitates new cell growth and promotes tightness and volume of the skin.
The key to optimal skin health is a skincare professional. By combining a customized at-home regimen with powerful in-office treatments and targeted skincare solutions, the result is healthier skin with visible improvement in fine lines, wrinkles, and other signs of premature aging. At LSG we offer SkinCeuticals skincare products. SkinCeuticals is an advanced clinical skincare line that offers comprehensive formulas to correct signs of aging, promote healthy skin, and prevent skin damage. Ranging from anti-aging moisturizers and eye creams to acne cleansers, vitamin C serums, and retinol products, our advanced skincare products are backed by science. Physicians and skincare professionals define cosmeceuticals as products on the cutting-edge between cosmetics and pharmaceuticals. Active ingredients in cosmeceuticals are expected to be clinically proven to enhance skincare efficacy.
INTENSIF combines the deep skin tightening benefits of radio frequency and the collagen-producing technique of microneedling. This patented technology delivers thermal energy deep within the dermis to stimulate collagen without damaging the surrounding tissue. The radio-frequency thermal energy is delivered in multiple passes through tiny needles at varying depths to provide a 3-dimensional coverage to lift and tighten the skin from within. INTENSIF is the latest advancement in tightening skin and reducing wrinkles on the face and sensitive neck area. If you’re looking for serious results, without the downtime and risk of surgery or aggressive CO2 lasers that leave you embarrassed to leave the house, INTENSIF is the treatment for you. After INTENSIF radio-frequency treatment, there is no need to hide in the house for weeks. Over time, your skin will begin to look more youthful as wrinkles diminish.
Brought to you by Syneron Candela, PicoWay uses ultra-short, picosecond (trillionths of a second) pulses of energy to target a broad range of skin concerns, while leaving surrounding skin untouched. Because it emits less heat than traditional lasers, PicoWay provides a more comfortable treatment with fast results and virtually no downtime; after treatment, patients may experience temporary discolouration or reddening of the skin surrounding the treatment site.
Carbon Laser Peels are the go-to treatment for celebrities around the world. After originating in South Korea and being embraced worldwide, this treatment instantly produces a “wow factor.” Carbon laser facial is the most advanced treatment for treating acne, pore refinement, dull complexion and pigmentation. At LSG we use the PicoWay Laser, which is the world’s most advanced laser for skin rejuvenation. The PicoWay is passed over the skin using a layer of liquid carbon that penetrates deep into the pores. Laser destroys the carbon taking dead skin cells, contaminates and oils with it. Treatment is very safe, completely painless and highly beneficial with minimal to zero downtime.
Laser tattoo removal is a simple procedure that uses a special laser (a high-intensity beam of light) to safely remove tattoos that a person no longer wants. The darker, contrasting colors used in a tattoo absorb the wavelengths of the laser, effectively breaking its colors into fragments, while protecting the surrounding skin, which doesn’t absorb the laser due to the contrast differences. Throughout treatments, your tattoo gets progressively light and lighter until it eventually disappears altogether. Mild discomfort should be expected, though far less discomfort than was experienced in getting the tattoo.
Experience the 3-in-1 super facial professionals are calling better than Microdermabrasion. Incorporating patented OxyGeneo Technology for unparalleled skin nourishment & oxygenation, see younger looking skin after your first treatment. Get the exfoliation benefits of microdermabrasion plus deep facial rejuvenation with the infusion of essential revitalizing nutrients and healing skin oxygenation from within. OxyGeneo™ treatments are suitable for all skin types – any ethnicity and pigmentation, sensitive skin, and even for those who keloid (scar) and couldn’t otherwise have abrasion treatments.

Products & Treatments we offer to treat Acne

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