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Find a Brooklyn Doctor at Practice Dr. Sergey voskin, MD on ZocDoc |
Acne Scars 
There is considerable variation in types and degrees of acne scarring from one person to another but the emotional turmoil this condition causes is shared by all. For many years the only treatment options for acne scars were much too invasive and only minimally effective. Today with lasers like the Cooltouch, Vbeam and Fraxel and dermal fillers such as Restylane and Radiesse, we have treatment options that require minimal or no downtime, and results that we only dreamed of years ago. Laser treatment for acne scars Lasers have become the treatment of choice today for acne scars. Lasers work by stimulating collagen production in the skin, thereby smoothing out scars. This can be accomplished in a non ablative fashion (without removing tissue), ablative fashion (vaporizing or removing outer layers of skin) or in a microablative (microscopically removing tissue). The microablative or fractional method of resurfacing skin which the Fraxel laser uses has revolutionized the treatment for acne scars has become the gold standard today. Below please find details on all of the available technologies at AA used to treat acne scars below: Non Laser Treatments for Acne Scars Non laser related treatments for acne scars consist of dermal filler injections, fat transfer, dermabrasion and surgery. Filler injections are the most popular of these options and this involves the use of specialized products to stretch or fill out the scars or to replace volume loss under the skin to make the scars look better. Treatments for redness in acne scars and blemishes The Pulsed Dye laser (Vbeam laser) and Cooltouch/coolbreese are very helpful in treatment of acne scars and blemishes, targeting the tiny blood vessels that give these marks a red color. Whether the scars are flat, raised or depressed, the energy from these specialized systems can make these annoying marks less visible. How does Fraxel work? The Fraxel laser produces thousands of tiny columns of microscopic treatment zones deep in your skin. The Fraxel laser is so precise that this energy penetrates the non-living, protective barrier of the skin, called the stratum corneum, as if it were a window and leaves it completely intact. For every micro thermal zone the laser targets and treats intensively, it leaves the surrounding tissue unaffected and intact. What are the indications of Fraxel and the benefits one can expect? In addition to being FDA approved to treat acne scars and surgical scars, Fraxel laser is also approved for facial rejuvenation, for the removal of sun and age spots, wrinkles and melasma. What areas of the body can be treated with Fraxel? Fraxel can be used on the face, neck, chest, hands and arms. What is the treatment like? We begin by imaging your skin with specialized cameras to establish your baseline image. The face is then cleansed and a topical anesthetic is applied for 45-60 minutes. During the treatment, the hand piece of the laser is guided across the skin’s surface in a precise and predetermined fashion, based on the specific goals of the treatment. A special cooling device will blow chilled air across the skin as it is being treated. There may be some slight discomfort at times, which patients describe as a prickling sensation but the treatment is generally well tolerated. This portion of the procedure takes approximately 30 minutes. The skin is cleansed before you leave and a sunscreen/moisturizer is applied. What will I feel and look like following the treatment? Most patients experience a sunburn type sensation following the treatment which lasts for ninety minutes. No pain medicine is required. The skin will have a pinkish tone for several days and mild swelling that may last a day or two. These are completely normal signs and reflect the healing process that is underway. There is no oozing, crusting or bleeding. Some flaking may occur but extensive peeling is not expected. The skin may develop a bronzed appearance which may last for a few weeks. Moisturizers are helpful post treatment and the use of sunscreen (30-60 SPF sun block) is very important. Will I have to limit my activities following the treatment? You can resume normal activities right away, though you will have some redness for about two days. Makeup can be applied the day following treatment. Sunscreen use is very important and needs to be used on a daily basis, rain or shine. We recommend a 45-60 SPF sun block. How many treatments are recommended? The number of treatments required depends on the type and extent of acne scarring. This will be best determined at time of consultation. The range of treatments is 3-6, normally spaced 2-4 weeks apart. Results become apparent after the second treatment and continue for a period of six months after the last treatment. Are there any complications? Due to the controlled and predictable nature of this laser, side effects are very uncommon. As with any laser there are the risks of temporary or permanent discoloration, scarring, bruising, etc., but with the Fraxel laser, these are very remote. The laser can be used in all skin types, but it has to be used with more caution in patients with the darkest skin types. Are there things I need to do in preparation for the Fraxel treatment? It is recommended to be tan free for this procedure and we may request that you stop using topical retinoids like RetinA or Differin for about two weeks before the first treatment. In patients with a history of cold sores, we usually start antiviral agents like Valtrex or Famvir. What treatments can be done in conjunction with Fraxel? A few of the more common procedures performed in combination with Fraxel are Vbeam pulsed dye laser, Sapphire Abrasion, Gentlewaves photomodulation, and filler treatments. Vbeam laser is used to treat the red color of the acne scars. GentleWaves may reduce some of the post treatment redness. What is the difference between the older Fraxel 750 and the newer Fraxel 1500 SR Restore? The new Fraxel SR1500 Restore is a more powerful, more precise and more comfortable resurfacing laser. Depth of penetration has increased by 40% with the new Fraxel SR1500. This means that acne scars can be even more effectively smoothed. Please make sure your doctor is using the newer laser. What is the difference between Fraxel Restore and other technologies claiming they provide fractionated treatments? Fraxel refers to the treatment provided by Reliant’s Fraxel Restore laser. Cooltouch Laser for Acne Scars The Cooltouch Laser is a well known NdYag laser that has several applications, the most well known being the treatment for acne and acne scars. The Cooltouch is a non ablative laser which means that it does not remove any of the skin surface during the treatment and thus is gentle and requires no downtime. After a series of Cooltouch treatments the acne scars will improve and the skin’s surface will become smoother. What Are The Indications for Smoothbeam Treatment?
How does Cooltouch work and what is the treatment like? The procedure involves the delivery of a special wavelength of laser energy deep below the skin to the level of the dermis, stimulating collagen and smoothing the skin’s surface. The treatment is preceded by the application of a topical anesthetic for about thirty minutes. During the procedure the skin is protected by a simultaneous cool spray called cryogen. The procedure is tolerated quite well and no downtime is required afterwards. Tanning must be avoided before and after the treatment. What Are the Advantages of Cooltouch Laser Treatment? The advantages of Cooltouch treatments are that the treatments are gentle, safe and require no downtime. They can be performed on all skin types and will not only result in improvement in acne scars, but in acne reduction as well. How Many Treatments Are Required? 3-6 treatments are necessary, depending on the severity of the scars. These are performed at monthly intervals. Can I Have Cooltouch Treatment If I Have Dark Skin? This treatment can be used effectively on dark skin. You may be given special skin treatment regimen by our office. What treatments can be performed in combination with Smoothbeam? Sapphire abrasion and Vbeam pulsed dye laser treatment are often used in conjunction with the Smoothbeam laser. Patients seeking care for the treatment of acne scars should also read about the Fraxel laser for acne scars. Vbeam Vbeam Pulsed Dye Laser for red acne scars and stretchmarks What can be treated with the Vbeam? The Vbeam laser, recognized for its long record of safety and efficacy is not only used to treat red acne scars and stretch marks but it also improves Rosacea, spider veins, broken capillaries, vascular birthmarks, cherry spots and acne. Red Acne Scars The "red" left behind in acne scars is a result of tiny broken capillaries at the site of the healed acne lesion. This redness is more common to "newer" acne scars and is hard to conceal, making the evidence of acne more pronounced, even after it has healed. Lasers which target these broken capillaries cause the small vessels to coagulate and be reabsorbed by the body. This effectively removes the redness. The Vbeam laser is often used in combination with other lasers whic smooth out the acne scars, such as the Fraxel or Smoothbeam laser. What is the treatment like, does it hurt and is downtime required? The Vbeam laser treatment is quite comfortable and though no topical anesthetic is required, it may be used. The skin is protected during the treatment with a cold cryogen spray which precedes each pulse of the laser. Most patients will experience a small amount of redness and swelling in the skin for about 24 hours after the treatment, but this should not interfere with any planned activities at home or work. How many treatments are required and at what interval? We generally provide a series of 2-3 treatments, spaced 3-4 weeks apart. Can you combine the Vbeam treatment with any other therapies? Yes. A popular technique alternating between Intense Pulsed Light therapy (Photofacial) treatments and the Vbeam. Each technology has its own attributes, and when used in combination this may further enhance the results. What precautions should be taken before and after treatment? Avoid exposure to the sun and tanning of the areas that are to be treated throughout the course of treatment. Immediately following the treatment, the area may be slightly swollen, sensitive and warm and cool compresses are helpful. Non Laser Treatments: Dermal Fillers Non laser treatments for acne scars The following are some treatment options that can be performed in conjunction with laser therapy: Filler injections Fillers such as Restylane, Juvederm and Radiesse are substances that can be injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Filler treatments do not work as well for ice-pick scars. Cosmetic benefits from filler injection usually last about 6 months. They can be performed in conjunction with laser treatments for optimal results. Fillers: Restylane is the most well known dermal filler in the United States, known for its safety, efficacy and longstanding results. Restylane is made out of Hyaluronic acid which closely resembles the same substance that occurs naturally in the body. Restylane will immediately soften lines and wrinkles seen with aging (such as the nasolabial folds) and enhance natural features such as the lips or cheeks. Restylane is injected with a very fine needle during a comfortable procedure that requires no downtime. Because Restylane does not contain any animal-derived ingredients, no skin test is required. Restylane lasts 6-12 months. Autologous fat transfer Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to elevate depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring from nodulocystic acne. Because some of the fat is reabsorbed into the skin over a period of 6 to 18 months, the procedure usually needs to be repeated. Dermabrasion Dermabrasion is a very aggressive option that may have great results under certain circumstances but its use is limited by the significant risks associated with treatment and extensive downtime. Under local anesthetic, a high-speed brush or fraise is used to remove layers of skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; for example, it may make ice-pick scars more noticeable if the scars are wider under the skin than at the surface. Dermabrasion has a significant risk of causing changes in pigmentation that require additional treatment. Skin Surgery The use of surgery for the treatment of acne scars is uncommon today. Some ice-pick scars may be removed by "punch" excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus elevating a depressed scar. These treatments have varying amounts of success and should be limited to only those scars which are most appropriate. Their use is limited. Microdermabrasion Microdermabrasion is a gentle skin resurfacing treatment that can rejuvenate and restore the natural glow to the skin, without the need for downtime. This technology has become a standard of care in aesthetics due to its predictable and safe results. The skill of the operator and the specifics of the device being used effect the outcomes. What is Microdermabrasion and what layer of the skin does it work on? Microdermabrasion is a general term for the application of tiny rough grains or crystals (aluminum oxide, sodium chloride or sodium bicarbonate) and suction to buff away the surface layer of the skin. Your skin is made up of two main layers, the epidermis and the dermis. The epidermis is the layer closest to the outside world. It's a set of skin cells on top of another layer of cells that are in the process of maturing. The topmost layer is called the stratum corneum. The stratum corneum mostly acts as a barrier between the outside world and the lower skin layers. It keeps all but the smallest molecules from getting through. When you put lotions or creams on your skin, some of the moisture passes through the stratum corneum, but some can’t penetrate it. This layer is home to many minor skin imperfections like fine wrinkle lines and blemishes. All of the action in microdermabrasion takes place at the level of the stratum corneum. What are the indications for treatment?
Non laser treatments for acne scars The following are some treatment options that can be performed in conjunction with laser therapy: Filler injections Fillers such as Restylane, Juvederm and Radiesse are substances that can be injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Filler treatments do not work as well for ice-pick scars. Cosmetic benefits from filler injection usually last about 6 months. They can be performed in conjunction with laser treatments for optimal results. Autologous fat transfer Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to elevate depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring from nodulocystic acne. Because some of the fat is reabsorbed into the skin over a period of 6 to 18 months, the procedure usually needs to be repeated. Dermabrasion Dermabrasion is a very aggressive option that may have great results under certain circumstances but its use is limited by the significant risks associated with treatment and extensive downtime. Under local anesthetic, a high-speed brush or fraise is used to remove layers of skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; for example, it may make ice-pick scars more noticeable if the scars are wider under the skin than at the surface. Dermabrasion has a significant risk of causing changes in pigmentation that require additional treatment. Skin Surgery The use of surgery for the treatment of acne scars is uncommon today. Some ice-pick scars may be removed by "punch" excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus elevating a depressed scar. These treatments have varying amounts of success and should be limited to only those scars which are most appropriate. Their use is limited. Treatments for Redness: Pulsed Dye laser Vbeam Pulsed Dye Laser for red acne scars and stretchmarks VBeam Laser The blue area is the Cryogen spray cooling and protecting the skin. What can be treated with the Vbeam? The Vbeam laser, recognized for its long record of safety and efficacy is not only used to treat red acne scars and stretch marks but it also improves Rosacea, spider veins, broken capillaries, vascular birthmarks, cherry spots and acne. Red Acne Scars The "red" left behind in acne scars is a result of tiny broken capillaries at the site of the healed acne lesion. This redness is more common to "newer" acne scars and is hard to conceal, making the evidence of acne more pronounced, even after it has healed. Lasers which target these broken capillaries cause the small vessels to coagulate and be reabsorbed by the body. This effectively removes the redness. The Vbeam laser is often used in combination with other lasers whic smooth out the acne scars, such as the Fraxel or Smoothbeam laser. What is the treatment like, does it hurt and is downtime required? The Vbeam laser treatment is quite comfortable and though no topical anesthetic is required, it may be used. The skin is protected during the treatment with a cold cryogen spray which precedes each pulse of the laser. Most patients will experience a small amount of redness and swelling in the skin for about 24 hours after the treatment, but this should not interfere with any planned activities at home or work. How many treatments are required and at what interval? We generally provide a series of 2-3 treatments, spaced 3-4 weeks apart. Can you combine the Vbeam treatment with any other therapies? Yes. A popular technique alternating between Intense Pulsed Light therapy (Photofacial) treatments and the Vbeam. Each technology has its own attributes, and when used in combination this may further enhance the results. What precautions should be taken before and after treatment? Avoid exposure to the sun and tanning of the areas that are to be treated throughout the course of treatment. Immediately following the treatment, the area may be slightly swollen, sensitive and warm and cool compresses are helpful. Aesthetician Services: Aesthetician Services: The professional aestheticians at VOSKIN have been carefully chosen for their extensive experience and know how in the field of skin care and their ability to relate to our clients. The aestheticians will first evaluate your skin and then recommend a treatment program using the most advanced technologies and procedure available. Microdermabrasion: Procedure uses tiny particles that pass through a vacuum tube to gently exfoliate the aging skin and stimulate new cell growth. Because of the superficial nature of this technique, patients with mild skin damage are the best candidates. Multiple treatments are required to achieve desired results. Microdermabrasion is often performed in combination with other laser and aesthetic procedures to enhance results. MicroPeel: Three step process includes a mechanical or enzymatic exfoliation of the skin, alpha hydroxy acid chemical peel and a cooling cryogenic therapy step. The goals of therapy are similar to that of Microdermabrasion; improvements in skin texture, reduction in photo damage and acne control. Customized Facials Professional facials are an essential part of an effective skin care regimen. They serve to nourish the skin, counteract signs of aging and combat acne. At Reflections, we offer facials for every skin type and problem. Our aestheticians will be happy to perform a complimentary consultation and recommend the perfect facial for you. Chemical Peels Chemical Peels are used for the treatment of fine lines, skin discoloration and age spots, as well as for dull skin texture and mild acne scars. A chemical solution is applied to the skin in a controlled manner to remove outer layers of aged and sun-damaged skin. After healing, new skin is generated that is smoother and fresher in appearance. A variety of peeling agents can be used to produce light, medium or deep chemical peels, depending on the amount of skin damage present. Deep chemical peels are becoming less common in favor of laser and IPL modalities which can achieve similar results with less downtime and discomfort and more precision. Topical Remedies Choosing the right skin care products is an essential part of every effective skin care program. The products utilized may include a group of agents called Retinoids, of which Retrinal, RetinA, Renova and Avage are examples. Skin Care lines at D&A have been chosen for their sound medical and scientific basis and reputation for quality and safety. The skin care regimen has to be custom designed for each patient and is based on skin type, skin conditions present and goals of therapy. |
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