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CosmeticSkin.com is providing free Acne Scar Treatment Consultation to individuals between 19 and 31 during June 2008
Although acne often is a chronic condition, even if it lasts only during adolescence, acne can leave life-long scars. Acne scars typically look like "ice pick" pit scars or craterlike scars. Dr. Rapaport uses multiple treatments on each patient to successfully treat acne scars. His "Multi-Lift Technique" exemplifies how important it is to treat each scar not with just one method but with with different modalities. This ensures an individualized approach to treatment with each patient for optimal success. Specific dermatological procedures to minimize acne scars will be determined by Dr Rapaport based on:
- your age, overall health, and medical history
- severity of the scar
- type of scar
- your tolerance for specific medications, procedures, or therapies
- your opinion or preference
Subcision (aka Subcutaneous incision) is a technique in which a depressed acne scar is lifted to the skin surface with a surgical instrument such as a tiny scalpel or needle. The deep portions of the scar are released and the surface elevates with the wound repair process. Several treatments are usually necessary and are performed under local anesthesia to eliminate discomfort. Subscision followed by Fraxel™ laser has had great results for acne scar patients. Ask Questions
This procedure causes bruising which fades after about 1 week. The risks of subcision include bleeding and the formation of subcutaneous nodules. Bleeding can be controlled with proper use of anesthetics and bandaging, and the subcutaneous nodules can be treated with injection of corticosteroids into the nodule. |
Good for most kinds of scars
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| TCA CROSS (chemical reconstruction of skin scars) is a method in which trichloracetic acid is used to spot treat each scar. During the treatment, a high concentration of Trichlorocetic acid is introduced just inside the scar. The resurfacing response that occurs inside the depression stimulates collagen production which eventually causes the scar to rise up and close in on itself. Ask Questions |
Good for mild scarring Ask Questions |
| Restylane® the world's most popular filling agent. It is a clear, synthetic gel made with hyaluronic acid, a natural substance that is found throughout your body and carries little risk of allergic reaction. With its unique ability to combine with water, Restylane® remains in your skin for many months and can be used immediately. Silicone is another filler commonly used on acne scars. It produces a permanent change in the skin. Both Restylane® and silicone are injected into acne scars to raise the surface of the skin and give a smoother look. Juvederm is the newest filler available through Dr. Rapaport's office. |
Good for deeper scars.
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| This surgical method of treatment uses a scapel or punch to remove the scar. Under local anesthesia, the scar is excised and the skin edges are then sutured together. The newly produced scar eventually fades and may not
be noticeable. If it is noticeable, it is more amenable now to resurfacing
techniques.
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Excision is typically recommended to patients with deep pitted scars that are not amendable to the TCA CROSS technique. |
Good for deeper scars like ice-pick scars, boxcar scars. Longer recovery time!
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| This surgical method of treatment uses a scapel or punch to excise the base of the scar leaving the walls of the scar intact. The excised base is then elevated to the surface of the skin and attached with sutures, steri-strips, or skin glue called Dermabond. This method lessens the risk of color or texture differences as can be seen with graft replacement, and lessens the risk of producing a visible scar as can be seen when wound edges are sutured. Ask Questions |
Good for deep scars like boxcar scars having sharp edges and normal appearing bases. Longer recovery time!
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| Using the Erbium:YAG or CO2 laser, the skin is removed layer by layer which eliminates the scar's surface. Simultaneously, heat produced from the laser tightens the skin, which helps to smooth out the scars. This method has a significant recovery time and is used less frequently since the advent of the Fraxel™ laser. Ask Questions |
Good for shallow imperfections in skin Ask Questions |
| Chemical peels are generally used to treat patients with very mild scarring. Different types of acid are applied to the skin in order to remove the top layer so that a smoother layer can surface. Chemical peels don't produce great results for patients who have severe scarring. Ask Questions |
Good for only mild scars
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| Dermabrasion, or surgical skin planing, is a surgical procedure in which Dr. Rapaport removes or "sands" the skin with a rotary abrasive instrument which improves its contour and gives it a smoother appearance. Ask Questions |
Good for ice pick acne scars
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Call now to schedule your complimentary consultation with Dr. Jeffrey Rapaport for acne free, healthy, younger-looking skin. Tel: (201) 227-1555. You can also ask questions by clicking on Ask Questions
Although acne often is a chronic condition, even if it lasts only during adolescence, acne can leave life-long scars. Acne scars typically look like "ice pick" pit scars or craterlike scars. Although proper treatment for acne may help minimize scarring, several dermatological procedures may help to further minimize any acne scars, including the ones given above.
Q: When is scar revision / excision the best option for acne scarring?
A: Scar revision can work really well when the acne scar is deep and sharply demarcated. These scars are commonly known as ice-pick scars. Large depressed scars are also a good candidate for this procedure. Though depressed scars respond well to facial fillers.
Q: Won’t this leave the patient with another scar? Why is this a good option?
A: It is important to understand what makes some scars more noticeable then others. What people don’t immediately realize is that it is not the scar which is noticeable – it is the shadow of the scar. When the scar is protruding or indented or wide it is more noticeable. The goal with scar revision is to substitute those scars with scars that are a fine line – it is much less noticeable. Additionally, after scar excision if the patient elected for additional treatments such as laser the result is dramatic.
Q: But ice-picks are so small. Would the excision lead to a larger scar?
A: You don’t operate on ice-pick scars that are extraordinarily small. The typical ice-pick that we operate on is from 1 ½ mm - 4 mm. The problems with these scars are that they are so depressed that they cast a shadow and require very heavy make-up to cover. A fine line is easy to cover and, again, is less noticeable.
Q: What are the common types of acne scars that you treat?
A: The most common acne scarring in general is wide and superficial scarring which can cover a broad area of skin and these scars for obvious reason have no direct surgical treatment because the problem lies with a very large surface of skin.
Q: How do you treat those types of scars?
A: Those types of scars are generally treated with resurfacing techniques.
Which means we are not removing the tissue because there is too much of it to be removed, but instead we are trying to polish the surface so it will look smoother and more pleasing. Different technologies have tried to accomplish the same goals. These technologies include CO2 resurfacing, Erbium laser resurfacing, and various other modalities including most recently Fraxel.
Q: These lasers are ablative. What is the down-time with these procedures typically?
A: You are looking at about a week of serious down-time meaning raw potentially painful skin and several weeks of redness. What is unique about newer treatments such as Fraxel is that the down-time is less severe. The question is if the results are sufficient.
Q: With these ablative lasers how much improvement can be expected?
A: It really depends on the case. An experienced doctor can give you a realistic idea of how much you can expect to improve. Damaged and scarred skin can be improved but it can never be truly replaced with healthy unscarred skin. In general these treatments give the acne scarred face a much better appearance.
Q: What about Zplasty or Flap reconstruction?
A: One of the biggest issues that determine how noticeable a scar is on the face is the direction of the scar. When a scar follows the direction of normal skin creases it is much less noticeable then when it goes across the normal grooves and creases of the skin. Operations like Zplasty are designed essentially to alter the direction of the scar. |
