Acne is a very common skin condition. It is estimated to affect 80% of 11 to 30 year olds and, while the aim is to treat the condition before the skin becomes too damaged, this is not always possible. As such, the after effects of acne can be as damaging as the condition itself. Acne scarring can be a result of any type and any severity of acne. Picking and squeezing spots can also damage surrounding skin and increase the risk of scarring. Acne scarring can be distressing for patients, leading to lack of self-confidence and even depression. Here at The London Dermatology CentreTM we offer a number of treatments to aid patients in improving their scars and becoming more confident in their appearance.
The type of acne scarring you have will influence both the treatment you need and the success rate of that treatment. The most common types of acne scarring are ice pick scars, rolling scars and boxcar scars. Ice pick scars are small, narrow, deep holes in the skin surface, normally less than 2mm wide. These scars make the skin look as though it has been punctured with a sharp object such as an ice pick (hence the name) and can resemble a large empty pore. Ice picks scars are the most obvious type of acne scarring and are unfortunately the most difficult to treat. Rolling scars are broader than ice pick scars and cause shallow indentations in the skin. The rounded, sloping edges of the skin indentations causes an uneven, rough appearance. This type of scarring is due to damage beneath the skin surface; bands of scar tissue form below the top layer of skin giving the skin surface a ‘rolling’ appearance. Boxcar scars are similar to rolling scars but have sharply defined edges and can often resemble chicken pox scars. This type of scar commonly affects the cheeks and temples. Other, more rare types of acne scarring include atrophic scars and hypertrophic or keloid scars.
The ProFractional laser is a revolutionary technology that is particularly effective at treating patients suffering from acne scarring. Created by Sciton, the ProFractional laser has been used to great effect by Dr Sunil Chopra to achieve excellent resurfacing results with minimal downtime. A small laser beam vaporises thousands of pinpoint areas of the top layer of skin. The surrounding untreated skin promotes rapid healing. During the healing process new collagen is formed which can plump the skin to correct imperfections. The benefits of ProFractional include increased patient comfort, shorter healing times, and tunable results that range from subtle to dramatic. The ProFractional laser can be used on all skin types and can treat most areas of skin. The most popular areas are the face and neck. Immediately following the procedure you may experience some mild redness and a sensation resembling sunburn. This should subside within a few days.
Fraxel is a treatment that uses fractional laser technology to treat minor to severe skin damage. The Fraxel laser is an effective treatment for scarring, sun spots, wrinkles and other signs of aging. The laser targets both the superficial and the deeper layers of the skin giving a smoother, fresher and more youthful appearance. The Fraxel treatment is carried out by one of our highly trained specialists. During your initial consultation the specialist will discuss the procedure with you and come up with a personalised treatment plan. For the best results it is recommended that patients have 3 to 6 sessions of Fraxel treatment. Each Fraxel treatment will take between 20 to 30 minutes.
Fraxel treatment uses patented fractional technology to target damaged skin with microscopic laser columns that penetrate deep into the skin. The laser treats only a fraction of the tissue at a time leaving the surrounding tissue untouched. This stimulates your body's own natural healing process, replacing the old and damaged cells with fresh, glowing, healthy skin. The microtrauma created by the laser stimulates the production of collagen which plumps the skin and helps to reduce imperfections. Depending on the level of the treatment, you may experience redness or swelling after the procedure. This should subside within 1 to 4 days.
The Clear + Brilliant laser treatment is most often used to help prevent the signs of ageing and to reduce the appearance of open pores. For less severe acne scarring, Clear + Brilliant can be an ideal treatment as its gentle laser means minimal downtime. The treatment provides a refreshing boost to skin. Firstly, a local anaesthetic will be applied to the affected area 30 minutes prior to treatment. Then, the Clear + Brilliant treatment will be carried out by one of our highly trained specialists. The laser treatment itself takes between 20 to 30 minutes. During the treatment you may feel a slight warm sensation. After the treatment there will be redness on the treated areas. This will begin to subside within a few hours, lasting up to 48 hours.
The laser used in the Clear + Brilliant treatment is non-ablative meaning that the laser heats up the target tissue target tissue without actually destroying it. This is what makes the Clear + Brilliant treatment and other non-ablative lasers much less invasive than ablative laser treatments such as the Sciton ProFractional laser. Clear + Brilliant works by creating an array of microscopic lesions across the surface of the skin from the heat of the laser. These microscopic lesions are surrounded by large areas of healthy skin to help promote quick healing with little to no downtime. The healthy skin helps promote quick healing of the tiny lesions within a matter of days, revealing the healthier, smoother skin below. The damage to the skin stimulates the production of collagen which helps to plump and smooth out imperfections in the skin such as acne scarring.
Microdermabrasion is a very effective treatment for giving you fresher, younger looking skin. It is used to improve the appearance of fine lines, black heads, acne scars, stretch marks, age pots, large pores, pigmentation and sun damage. Microdermabrasion is a method of deep exfoliation through the application of special medical grade crystals. These tiny crystals are used to buff away the top surface layer of skin. The very top layer of skin is made up of dead skin cells and underneath it is a layer of fresh, maturing skin. This dead layer of skin cells is the home of several minor skin imperfections such as fine wrinkles and acne scarring. The special crystals used in the microdermabrasion procedure break down the very top layer of skin stimulating the production of new collagen and exposing the newer, healthier skin below.
During the microdermabrasion procedure a special tool is used to shoot a stream of tiny crystals at the skin and at the same time the vacuum in the tool head sucks away the used crystals and the dead skin. The vacuum pulls a small section of skin to be worked on towards the tool and brings many of the impurities closer to skin’s surface making them easier to remove. In the first hour after treatment there will be some mild swelling and redness. These side effects should only last a few hours.
As the dead top layer of skin has been removed, the skin is temporarily much better at absorbing topical lotions. Many patients therefore use this opportunity to combine the microdermabrasion treatment with the application of a Hydrating Vitamin Serum that will be optimally absorbed. The serum applied will be delivered deep within the skin, delivering antioxidant protection, an extra boost to collagen production and some essential hydration.
Microneedling refers to both the Dermaroller treatment and the DPM8; it is also known as collagen induction therapy. Microneedling is a minimally invasive procedure used to rejuvenate the skin. It is most commonly used for the reduction of scars such as acne scarring, hypertrophic scars and surgical scars. It is also used for fading stretch marks, reducing fine lines and tightening sagging skin.
The Dermaroller is a mechanical device that contains a wheel of microneedles. The Dermaroller is rolled over the skin in order to create a controlled area of trauma in the skin’s top layer. As each microneedle punctures the skin a small channel is formed. This stimulates the production of collagen and elastin in the deeper layers of skin. The microtrauma also leads to the formation of new capillaries (small blood vessels) reducing the appearance of scars and improving the texture of the skin.
The DPM8 is similar in that it uses microneedles to create a controlled area of trauma but instead of a mechanical device it is a smaller electronic device that resembles a pen. The DPM8 uses the same principal as the Dermaroller but instead of the rolling action, the DPM8 is moved backwards and forwards across the skin as the microneedles automatically go in and out of the device around 1000 times a minute. After the procedure your skin may be slightly red. This can last up to 4 days depending on the depth and intensity of the treatment you have.
Like with microdermabrasion, the top, dead layer of skin is removed and so the skin is temporarily much better at absorbing topical lotions. Any product applied to the skin during or immediately after a Dermaroller or DPM8 treatment is very easily absorbed into the skin, rendering it much more effective than with a traditional topical application.
An alternative to laser therapy is the TCA skin peel. TCA or Tri-Chloroacetic Acid is a non-toxic chemical that has been used in skin peels for more than 20 years. This particular skin peel is often used to treat sun damage, melasma and some skin imperfections such as mild acne scarring and fine lines. When applied to skin at a high concentration, TCA stimulates collagen formation. During the treatment the TCA will be applied to clean skin. The TCA causes the top layer of skin to dry up and peel off over the following days to one week. Once the old skin has peeled off, a new layer of healthier undamaged skin is revealed. Stronger concentrations of the TCA peel can be used to remove further, deeper layers of skin. For the best results it is recommended that patients undergo a series of 2 to 3 TCA peels. After the peel your skin will be a light yellow colour for 1 to 2 hours. This colour will fade and be followed by some slight redness lasting for 2 to 3 days. Following a skin peel you should avoid all sun exposure. You will be more sensitive to sun damage for 4 to 8 weeks afterwards.
For more information regarding the treatment of acne scarring please contact us on 020 7467 3720.
Content by Dr Sunil Chopra and Rebecca Perris