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Magic of Hands by Dr. Ravi Mahajan Amandeep Hospital
Magic of Hands by Dr. Ravi Mahajan Amandeep Hospital
Tattoo Removal
Tattoo Removal

Acne

FAQ for acne scar treatment:

 How early should one start acne scar treatment?

 We encourage patients to undertake acne scar treatments as soon as there is evidence of scar formation. This is because early scars are much easier to treat compared to older scars. Scar remodelling can occur at any age, however the earlier you address

scars, the better the result.

Can I do anything to decrease scarring?

  1.    First of all, if you have active acne, seek medical advice. Secondly, develop a simple, non-abrasive skin care regime.  This involves simple cleansers, and moisturisers and a light moisturiser. Remember to use sunscreen on a daily basis . Never squeeze pimples. Trauma from popping pimples can cause scarring. Prescription creams can effectively treat your acne.

 Can I undergo laser treatment if I have dark skin?

 Treating darker skin types with acne scarring is much more difficult than treating fair skin patients, however effective treatments are possible.The use of sunscreen before and after acne scar treatments is very important, especially in darker skin patients.

Can dermal fillers and dermal grafts help acne scars?

Yes. Dermal grafts and dermal fillers are ideal for atrophic scars. Atrophic scars include saucer shaped acne and chickenpox scarring,depressions. Fillers provide an almost ‘instant’ fill for these areas, with minimal downtime for the patient. Most fillers last between 6- 18 months.  The preferred method is to treat with Fractional laser, as this stimulates your own body to produce collagen, then fill what is left with a dermal filler. This produces the best results.

Do I need to treat acne before I undertake scar treatments?

Yes. We do encourage patients to treat active acne before or during acne scar treatments. Treating acne is very important as this prevents further scarring.

FAQ on CO2 Laser

What type of acne scars respond best to the CO2  Laser?

Deep atrophic scars, box-car scarring and shallow acne scars in skin type 1 and 2 are ideal candidates for CO2 .How does this CO2 laser differ from  Fractional lasers?.CO2 lasers differ from other fractional laser systems in the power and wavelength.Fractional Lasers remove columns of skin, however the power and delivery system do not heat the dermal collagen to any large extent. In cases of deep and severe acne scarring, dermal heating and collagen remodelling is paramount for scar improvement. In summary, for certain types of acne scars, we do need the power and heat of a CO2 laser to deliver results that no other laser can deliver

What skin types will suit CO2 lasers?

CO2 lasers are safest in fair skin types. The majority of Caucasian patients will suit CO2 lasers, providing your sun exposure is minimal.

What does CO2 treatment for acne scarring involve?

 It  consists of various steps:

Step 1

Consultation, mapping, medical history taking, planning .This is the most crucial step in acne scar treatment. During the consultation your Specialist will identify, photograph and map your acne scars. This process will determine the best way to improve your acne scars. Remember, a tailored program of scar revision is the absolute best method with the highest success rate.

Your doctor also examines your skin type, and obtain a full medical history. Based upon planning  you are given an estimate of the down time, and expected outcome of laser treatments.

Step 2

Anaesthesia and scar treatment

On treatment day, scars are marked out prior to laser resurfacing. An anaesthetic cream will then be applied.Treatment time will vary between 30 minutes to 45 minutes, depending on the areas treated.

Step 3

Post treatment dressings

After the procedure you will be dressed in a special ointment .

Step 4

Post CO2 laser follow up and recovery

CO2 laser patients are reviewed by the treating specialist after one week.

 What is the recovery time of CO2 lasers?

This will vary depending on the level of treatment. Your Specialist will assess your scar type, skin type and discuss downtime with you. The recovery time will vary in different patients but an average recovery time is 5-7 days.

Remember, everyone will have a different scar type, skin type and scar depth, an in depth assessment will give an accurate indication of the downtime.

As reinforced throughout this website, acne scar treatments at a specialist level is not a cook-book procedure, a carefull assessment of  your acne scar, skin type and down time is needed to come up with the best solution possible.

 Are there any other scar treatment options apart from lasers?

Absolutely. Remember the best scar treatments are based upon scar types and NOT what treat is in the office of the physician. Some scars are best treated with non-laser methods.

Deep ice pick scars are best treated with TCA CROSS chemical peels

Acne associated with scarring is best treated with non-laser RadioFrequency .

Atrophic scars are best treated with dermal fillers and dermal grafts

How long do I need to wait before getting laser treatment if I am on Isotretinoin?

 It is normally  recommended to give  a washout period of at least 3 months after stopping isotretinoin

Why choose a Specialist for acne scar treatments?

 Specialist in acne scar revision will not perform a treatment based upon what laser they have in their practice, however will recommend a treatment based upon scar type and skin type. This makes all the difference in safety, outcome and costs!

 Advantages of CO2 Laser?

CO2 lasers  provides a flexible method of acne scar revision. This laser can be adjusted to various depths and coverage, as well as the advantage of full ablation mode for shallow scar

Its preferred choice for treating rolling scars- and severe acne scarring in lighter skin types, providing patients can have a downtime of over a week.

FAQ on light therapy

 How safe is  Blue and Red LED Phototherapy?

Phototherapy is one of the safest methods of acne treatment. Low-level light treatment using either the blue wavelength or red wavelength targets acne- forming bacteria without the use of irritating creams, chemicals or nasty tablets. Treatments are painless and easy and over in less than 15 minutes. 

 What are the advantages of Phototherapy?

 The advantages of phototherapy are -

 What are the disadvantages of phototherapy?

 The disadvantages of phototherapy are This treatment is NOT suitable for scarring acne

What types of phototherapy treatments do specialists use to treat acne?

 Essentially 2 wavelengths are optimal for acne treatment – blue and red.

Blue wavelength at 405nm  and Red light at 630 nm

Wavelength of light

 

Bacteria destroying peak

Depth of penetration into acne e    acne lesion

Blue light phototherapy

 

Higher- peak at 405nm

Shallow depth of penetration

Red light phototherapy

 

Lower – peak at 630nm, best for mild scar revision

Deeper depth of penetration

 How many acne blue- red light phototherapy sessions will I need?

 In general patients will require at least 4-5 sessions to see an improvement. Sessions can be conducted twice a week. Ideally 8-10 phototherapy treatments are performed.

Each acne phototherapy session takes 15-20 minutes to perform, and treatments can be conducted ever one to two weeks.

Red light phototherapy can also be used to treat mild and early acne scars.

Is acne phototherapy painful?

No! As phototherapy is not laser, no heat is generated, treatments are entirely pain free. You only require eye protection to be worn during the treatment session.

FAQ on Chemical peels:

How do chemical peels treat my acne?

Chemical peels work in 3 ways to help improve acne -

  1. Exfoliate the skin surface
  2. Reduce inflammation
  3. Decrease counts of bacteria involved in acne, Propionibacterium acnes

 What types of acne respond best to chemical peel?

  1.       Comedonal acne (“black-heads” and “white-heads”).
  1.      Inflammatory (pimples and cysts) – salicylic acid peels are particularly useful in this setting.

 How are chemical peels performed?

 Are there any side effects from chemical peels?

 Various side effects are:

What is the recovery period from acne chemical peels?

Can chemical peels treat acne scars?

 The alpha/beta-hydroxy acid peels used for acne will provide some improvement for mild acne scarring.  For more severe scarring, once your acne has been cured by your dermatologists, stronger TCA peels and TCA CROSS procedures can be utilized with excellent results, based on scar and skin type.

 Can chemical peels be combined with other acne treatments?

 In the majority of cases your specialist dermatologist will also prescribe you a Vitamin A cream in conjunction with your peel program. This cream, in conjunction with chemical peels, is designed to help prevent acne and blackheads.

 How do we combine phototherapy with peels?

The  combination program combines the latest in phototherapy and chemical .This program is suited for mild to moderate cases of acne.Ideal candidates for this program include whitehead and blackhead acne, and patients with very mild, early scarring.

FAQ on DERMAPEN for acne scars:

  1. What should I expect during a Dermapen treatment?
  2. Step one - assessment

This is an essential step in the correct management of acne scars. Atrophic and rolling scars respond best to Dermapen.

Step two - mapping and photographs

Similar to a laser procedure, your doctor  maps and photographs all acne scars prior to treatment- this ensures that Dermapen treatment areas are pre marked, and results can be followed up.

Step three - pre procedure anaesthetic cream

This occurs on the day of the Dermapen procedure. This provides excellent pain relief, and is applied 30-60 minutes before each treatment.

Step four - Dermapen treatment

Dermapen skin treatment uses a special delivery system to move needles across the acne scars. Depending on the depth and type of acne scars, the treatment depth and amount of ‘passes’ will vary. Dermapen produces grid and cross hatch like areas within the acne scars, each hole that punctures your skin will lead to collagen remodelling.

Step five - Post treatment follow up

For cases of extensive acne scarring and deeper settings, your specialist nurse my elect to schedule a follow up visit 24-48 hours after the procedure to ensure you are healing as expected.

How long does it take for a Dermapen treatment?

The Dermapen procedure takes between 20-25 minutes to perform, depending on the size of the treated area.

Is Dermapen treatment painful?

No.  A special formulation of numbing cream, applied 60 minutes before your procedure. This ensures that your Dermapen treatment is comfortable. In the ‘shallow mode’ you will feel NO PAIN, in deeper settings, you will feel slightly prickly, but this is very well tolerated.

 What will my skin look like after a Dermapen treatment?

After the treatment, your skin will be red and swollen for 2-5 days. The ‘downtime’ will depend on your type of acne scars and the depth of treatment. Your Specialist will give you an accurate assessment of downtime prior to the procedure.

 How many Dermapen treatments will I require?

Most patients will require 4-6 Dermapen needling sessions. Each session should be spaced between 4-6 weeks apart.

How does Dermapen compare to treatments such as Fraxel and other lasers?

The 3 factors are the most important in determining the outcome of scar revision.

Unlike laser treatments, Dermapen skin needling does not involve heating the dermal layers of the skin. Dermapen needling does however , break down collagen scars, and can help reduce atrophic and rolling acne scars. Essentially Dermpen is like fractional laser without the heating of the dermis.

Bottom line, all things considered, lasers are more superior compared to Dermapen for most forms of acne scarring.

 What is the advantage of Dermapen

 The advantage of Dermapen skin resurfacing is the cost- treatments

Treatment

Treatment time

Number of treatments needed

Downtime

Ideal scar severity

Projected scar improvement

 

Dermapen

15 min

4-6

3-5 days

Mild –to moderate scarring

++

 

Chemical peels

15 min

4-6

Hours

Mild

+

 

RadioFrequency

15 min

4

0-2 days

Mild to severe

+++ (early scars)

 

CO2 Laser

30 min

3-5

3-6 days

Mild to severe

++++

 

TCA cross

30 min

2-3

5-7  days

Mod

++++

 

FAQ on fat transplant

Why choose fat transfers for scars?

 Microlipoinjection therapy is effective in treating deep contour defects caused by scarring from nodulocystic acne

What you should know about fat transfer?

The doctor will mark injection points on the scar before cleansing it with an anti-bacterial agent. A topical numbing agent, ice or a local anesthesia is applied to keep the patient comfortable during the injections. Fat is removed from another part of the body, usually the buttocks, abdomen or thighs. The fat is then processed and cleansed before being injected beneath the scar with a very small needle. The entire procedure usually takes about one hour.

 How to prepare for the procedure

Before the procedure, a dermatologist will review the patient’s medical history. This is the time for the doctor and patient to discuss expectations, potential risks and outcomes of the procedure. 
Patients also will be required to:

What to expect after the procedure?

Most patients can immediately return to work after treatment. Minimal pain may occur after a few hours. Ice packs are applied at 10-minute intervals for six hours following the procedure. Patients may experience one or more of the following reactions at the injection sites:

FAQ ON DERMAL FILLERS FOR ACNE SCARS”

 What type of scars are best suited for dermal fillers?

 Rolling,depressed and box car scars.. What to expect during the procedure?

First the doctor and patient will have a discussion about which scars will be filled. Often patients have certain scars in particular that disturb them more than others. After the discussion of which scars will be treated, the skin will be cleaned with alcohol, ice will be applied to the area briefly before treatment, the doctor will inject using a very fine needle and then pressure with gauze will be applied.

What to expect after the procedure?

You will be given an ice pack to hold in the areas that are treated. Treated areas may be red, swollen, and bruised for the first 2-7 days. DO NOT get a facial or massage for 1-2 weeks after your dermal filler procedure. AVOID strenuous workouts and alcohol for the 24 hours if possible. If bruising occurs, Another trick, drinking pineapple juice is suggested to help bruising resolve faster. Bruising can be covered by make-up.

 How long will it take for me to recover from dermal filler treatment of scars?

 Fillers are associated with very little downtime. Patients can go to work immediately after filler treatment. In some patients, bruising may occur, however this is usually mild and will dissipate over a few days.

Dermal fillers can be that ‘lunch time fix’ of acne scars everyone is wanting.

Does the process of dermal filling for acne scars hurt?

This is one of the most well tolerated procedures in acne scar revision! The use of a special numbing cream prior to filler and the fact that most fillers also contain local anaesthetic  make it an almost painless procedure.Filling can take less than 30 seconds to complete, depending on the number of acne scars.

 How long will the results last?

 The results can last from between a few months to a year using fillers such as Belotero, Restylane, Juvederm, and Perlane, etc. However, with a combination of laser treatments such as the fractional non-ablative and very effective chemical peels, this can help dramatically reduce the appearance of acne scars with improvement in overall skin texture and healthy, happy skin.. Should I go for permanent  fillers for my scars ?

 Permanent filler have a greater rate of complications such as lumps, and also infections so they are not preferred

 Is there anything more permanent than using a dermal filler?

If you are in a hurry to fill up scars, then dermal fillers is the first choice- instant filling, with minimal down time. The flip side is that you may require a top up every 12-24 months.

If you are not in a hurry to get your scars filled, a more permanent solution that can reduce scars by 50-70% is a series of fractional laser treatments.  Fractional laser stimulates your own collagen producing cells to make collagen. In another words - you make your own collagen. This process takes time, as most patient will require 3-4 Fractional laser treatments to their acne scars.  In some cases, filler can then be used to fill up the remaining scars. This process is probably the best, as less filler will need to be used compared to filler alone.

Another method of using permanent filling is a process called Dermal Grafting- here we use your own collagen harvested from the back of your ear to fill up the atrophic scars. Dermal grafting has its advantages and disadvantages

 Will my skin type be suitable for dermal fillers?

Yes. Dermal fillers are compatible will all skin types, and can be an ideal treatment for atrophic scars in darker skin patients.  As dermal fillers target the loss of collagen deep in the skin layer, it spares any epidermal damage and reduces the chance of post treatment darkening of the ski

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RM Aesthetics
Adj. Amandeep Hospital, GT Road, Model Town Amritsar, Punjab 143001 IN
Phone: +919501102935 Website: http://www.rmaesthetics.com

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