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Advanced Acne Therapies by Eric Hartwell
There are over-the-counter treatments for acne, prescription topical lotions, oral contraceptives and cosmetic surgery. How do you know what is right for you? As always, ask your doctor. Sometimes, prevention or treatment of acne is not possible and severe scarring occurs. This scarring can take place on the face, chest, neck, back and shoulders, wherever the individual was acutely acne-stricken. It is physically and mentally scarring, affecting one's life permanently. Doctors have developed a codification system for acne scarring that will assist a patient in treatment and diagnosis. The names used are ice pick, boxcar and rolling acne scars. Icepick scars are the most common and are deep and narrow, descending extensively into the dermis and/or subcutaneous layers. Boxcar scars resemble classic chickenpox scars and can be superficial or deep, round pits with sharp edges in the skin. Rolling scars give the skin a rippled texture and appearance resulting from folds in the subcutaneous layer of tissue.
There are varying degrees of cosmetic procedures available to help correct and rejuvenate skin damaged from scarring.
Microdermabrasion: This treatment is similar to a chemical peel and achieves exfoliation of the skin. Crystals are blown onto the skin through a hand-held device which polishes the surface of the skin. The crystals and the exfoliated skin cells are vacuumed away, unclogging pores and improving the complexion. This process is not permanent and requires a series of treatments for best results.
Scar Revision: Ice pick and boxcar scars can be effectively treated with this therapy. These procedures are done with local anesthesia to remove scar tissue. Surgical excisions are made, in the form of a punch and suture procedure. The circular scar is replaced with a linear suture scar which can be further treated. Subcision cuts can also be administered using a sharp instrument that weakens the base of the scar. There are no sutures with this procedure and further treatment with dermal filler substances can be administered.
Resurfacing: Ablative Laser Treatments and Dermabrasion are therapies that affect the surface layer of the skin, causing the skin to reproduce younger skin that forms new collagen. A wire or brush strips the surface unevenness of the skin. This is a mechanical procedure that is most effective for substantial scarring and can be combined with fillers or excision procedures.
Dermal Fillers
- Fat, hyaluronic acid derivatives, collagen and polytheyl-methacrylate microspheres with collagen may be injected to renew scar depth and smooth out the skin. This is not a permanent correction and continued injections are necessary.
Laser and light therapies are able to penetrate the dermis and subcutaneous layers of skin and leave the surface of the skin unharmed. Laser treatments damage the sebaceous glands, rendering less sebum production. Propionibacterium acne is affected by light therapy, reducing inflammation and destroying the bacterium. Skin texture is improved and appearance of scars is lessened. These therapies can be used for both active acne and scarred tissue.
Blue light therapy- An ongoing series of painless low-intensity blue light is applied to the skin where blemishes and scarring have occurred. These sessions last about 15 minutes and can change the pigment of the skin and cause swelling and dryness.
Pulsed light and heat energy therapy- Sebum production is decreased by shrinking the sebaceous glands with light and heat. Heat and green-yellow light is administered to mild or moderate acne. Redness of the skin can occur.
Diode laser treatment- This is a potentially painful treatment, destroying sebaceous glands in the dermis while not affecting the epidermis. Analgesics may be applied to lessen the pain of this treatment beforehand. Swelling and redness occur post-treatment.
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