Acne & Acne Scars
Acne is an extremely common skin condition that can occur at any point in any person’s life. Acne is, very simply, a clogged pore (or hair follicle) that can appear anywhere on the skin: the face, back, shoulders, chest, and even the arms or legs. Pores can get clogged with a mix of dead skin cells and sebum (the oily substance produced by the oil glands that helps keep our skin from drying out).
While typically these dead skin cells rise to the surface of the skin to become sloughed off, in the case of a pimple, the dead skin cells stick together and become trapped in the pore. Sweat and dirt can also become part of the mix. When bacteria, which normally live on the skin, enter the pore, the result is an infected red, swollen, inflamed pimple or cyst.
Sometimes, due to hormones, these oil glands can go into overdrive, producing excess amounts of oily sebum. This is common during the teenage years or during times of hormonal fluctuations (e.g. during menstruation, pregnancy, and even menopause). Acne is often genetic.
An individual acne history can vary. It can range from mild, moderate to severe. No matter what the severity of your acne is, evidence is often left in the form of scars. Scarring occurs as a response to damage in the skin’s epidermis and dermis. When damage occurs, the body responds by attempting to repair the damage. Fibroblasts cells are sent to repair the damage by producing new collagen and elastin. However, the new collagen and elastin released do not form the same pattern of the skin that had existed before. This results in changes/scars in the skin’s texture and tone.
Scarring
Scarring can occur in the form of any of the below or a combination of the below:
Pigmentation
Darker/lighter spots
Ice Pick Scars
Scars are deep, narrow pits that extend into the dermis
Boxcar scars
Scars are deep, round or oval depressions with steep vertical sides. Wider than ice pick scars, boxcar scars give the skin an uneven, pitted appearance.
Keloid scars
Are a more severe type of raised scar. They can send out raised, lateral shoots that expand much farther than the wound itself, and can continue to grow long after the original wound has healed. Some people are more prone to developing keloids. It's like the skin doesn't know that the wound has healed, and continues to produce collagen.
Rolling scars
Scars appear as wave-like depressions. The skin itself looks uneven and craggy.
Treatments
We know that patients feel more confident with clear, beautiful skin. This is why we work with each patient to customize a long-term, effective treatment plan. There are different procedures that can improve the look and texture of your skin. Your options depend on the type of scarring you have. Most people have more than one type of scarring on their skin, so you might need a few different treatments to see the best results. Unfortunately, over-the-counter products simply aren't powerful enough to give any significant improvement.
Dermal Fillers
Dermal Fillers are injected into the scar, helping to raise depressed areas of the skin leaving it more even with the surrounding skin surface. Dermal fillers are fast, simple procedures compared to other types of acne scar treatments. The drawback is the results aren't completely permanent, but new dermal fillers can last for 18 months to 2 years.
Chemical Peels
There are two types of skin exfoliation: chemical and physical. Physical exfoliation involves massaging something that has a slightly abrasive texture over the skin in order to manually remove debris. Depending on your skin, this kind of exfoliation should be done at home anywhere from 2 times a week to daily.
Chemical exfoliation/peels contain an acid solution that does away with dead skin and pore-clogging impurities on contact. They cause a controlled injury to surface skin cells. The strength of the peeling solution will determine the level of injury to your skin. After the skin is injured, it will peel off and new cells will replace the old ones. Stronger peels will cause a deeper injury and thus require more downtime to heal. Since brand new cells replace the old, expect the skin to look more even, glowy, and fresh.
Chemical peels are also helpful in removing hyperpigmentation and darkening caused by acne flares. We have had great success with many of our patients in using the VI Peel for acne-prone and aging skin. The VI Peel is a medium strength peel that is excellent for hyperpigmentation, dull-looking/aged skin and superficial acne scars.
As for how soon you can expect to see results, it depends on a couple of different factors, namely, type of peel, how often you use it, and your specific skin type. Generally, we recommended to have a peel every four to six weeks for best results.
IPL - Intense Pulsed Light Therapy
IPL is used to treat a number of different conditions, but it is very effective in the treatment of sun damage, pigmentation, and the redness caused by acne. IPL is effective as a full facial rejuvenation and is often referred to as a “photofacial” or “photorejuvenation”.
IPL can improve the overall “look” of the scar by reducing the redness and making the overall skin tone more even. IPL can help improve types of epidermal changes from acne scarring and is also used as a treatment for active acne lesions.
IPL treatment should cause no more than minor discomfort and generally only a cooling gel is required for the treatment. There may be some temporary redness immediately after this type of acne scar treatment which will resolve within a few minutes leaving you to return to your normal activities. A typical session takes about fifteen minutes and is very gentle with no “down time”.
IPL is repeated on monthly intervals and depending on the amount of sun damage, acne scars or redness, will take between 4 and 6 sessions to fully treat your condition. For best results, we often recommend switching off every month with a chemical peels and IPL treatments.
Surgical Referral
If after trying the above treatments or if it’s deemed that none of our office treatments will be successful for you, then we might recommend a surgical consultation for treatment.