The last decade has witnessed dramatic developments in the use of lasers for the treatment of mild to severe acne scars on the face. Research has shown that combination therapy of lasers, fractionated RF, chemical peels, and topical therapy can improve the appearance of atrophic acne scars on the skin.
Dr. Raffy Karamanoukian of Kare Plastic Surgery and Skin Health Center in Santa Monica is an expert on the multimodality treatment of acne scars on the face and body. His specialization is geared toward minimally invasive laser and RF techniques to re-contour deep acne scars that have left indentations on the skin. By employing the latest technology in acne scar treatment, Dr. Karamanoukian can resurface skin texture, reduce pore size, and tighten overlying skin to reduce the visibility of acne scars.
The most advanced laser therapy for atrophic acne scars use fractionated technology to stimulate collagen and restore dermal integrity in areas of acne scarring. Fractionated lasers induce new collagen production, filling-in indentations and atrophies caused by cystic acne. Dr. Karamanoukian’s protocols combine these fractionated laser treatments with skin resurfacing to tighten skin and restore normal facial contour.
Our Los Angeles plastic surgery practice employs several additional modalities for acne scars including subcision, blunt cannula subcision, multi-plane tissue tightening, skin resurfacing, release of scar tethering, acne scar surgery, TCA cross, chemical peels, and pore reduction modalities to improve skin complexion.
Dr. Raffy Karamanoukian has performed clinical case studies to compare blunt cannula subcision techniques with needle subcision to determine differential efficacy rates for the improvement of atrophic acne scars.
If you are considering treatment for indented acne scars, please call our Los Angeles plastic surgery patient care coordinators to discuss your options for acne scar treatment. Your consultation will begin with a thorough evaluation of your skin by Dr. Karamanoukian to determine the extent of dermal integrity and your overall candidacy for multimodality acne scar treatment.
CHEMICAL PEELS
There are many different types of chemical peels that can be used to improve acne scars, regardless of your skin type or color. Chemical peels utilize medically-efficacious acid formulations that penetrate into the skin to stimulate and regenerate collagen within the dermal matrix. Variations in chemical peels depend on the strength of the acid and the format of application. Dr. Karamanoukian is a leading expert in mid dermal chemical peels that penetrate deep within the skin to regenerate collagen. These chemical peels are ideal for atrophic acne scars.
If you are experiencing hyperpigmentation with minimally-atrophic acne scars, a lighter peel may be an excellent option for your skin. These lighter chemical peels are ideal for skin discoloration resulting from post inflammatory hyperpigmentation with acne. The goal of treatment is to exfoliate the skin and reduce melanin discoloration that is causing the hyperpigmentation. Most patients will have one to three days of dry skin followed by one or two days of rapid peeling. It is recommended that patient use Elevase Moisture Booster twice daily in order to soften and moisturize the skin.
CLEAR AND BRILLIANT LASER
If you have dark acne scars, the Clear and Brilliant laser may be the solution for you. Clear and Brilliant can help minimize pore size and clear dark acne scars from your skin. Using fractional laser technology, the Clear and Brilliant laser stimulates skin exfolation and collagen formation that can help clear dark PIH hyperpigmentation left over from acne. In addition, the laser treatments leave your skin revitalized and refreshed.
Learn more about Clear and Brilliant Laser in Santa Monica and Beverly Hills
FRACTIONAL CO2 LASER
Fractional CO2 laser can be combined with subcision, fillers, acne surgery, and fractional RF to help recontour deep indented scars. Fractional CO2 remains a gold-standard for acne scar correction.
SUBCISION
There are many different types of acne scars and some can be classified into subcategories based on their depth-to-width ratio. Dr. Karamanoukian performs a procedure known as subcision in order to undermine deep acne scars that exhibit tethering of the dermis with significant loss of dermal collagen and elastin. Subcision is a well-recognized technique that can lift up and smooth contour irregularities caused by new and old acne scars.
In many cases, subcision is used alongside other acne surgery procedures including TCA cross, chemical peels, lasers, and nanofractional RF in order to initiate new collagen formation. Subcision is performed with a beveled micro blade that is percutaneously positioned underneath the acne scar to release surface tethering and indentation. Minimal bruising occurs after subcision with collagen formation continuing for 6 to 8 weeks thereafter.
Candidates for subcision usually have old acne scars with variable surface patterns that exhibit surface indentation and irregularities. Patients must avoid blood thinners such as ibuprofen or aspirin and should maximize vitamin C intake post-procedure.
SUBLATIVE EMATRIX
Atrophic acne scars have significant loss of dermal collagen that must be replaced in order to recontour the skin. Variable contour resulting from deep acne scars can be addressed with a new treatment known as micro fractional laser resurfacing. Sublative Ematrix RF uses micro fractional radio frequency to stimulate collagen regeneration deep within the dermis. This treatment is ideal for all skin types, regardless of skin color and has minimal downtime. Dr. Raffy Karamanoukian is a leading expert in micro-fractional RF and uses this technology daily in order to resurface skin that has been damaged by deep cystic acne.
VBEAM
The Vbeam pulsed dye laser is excellent for reddish brown acne scars left behind from inflammatory acne or deep cystic acne. In fact, Vbeam has been shown to be effective in reducing acne sebum and acne redness in patients with cystic acne, thus reducing acne breakouts.
In our office, we use Vbeam laser as a gold-standard for inflammatory acne, rosacea, deep acne breakouts, and increased sebum. Treatments are relatively innocuous and painfree, with mild redness experienced for several hours after treatment.
VENUS VIVA RF
Venus Viva is one of the newest skin resurfacing treatments available for deep pitted acne scars. Using Nanofractional ablative radiofrequency, Venus Viva is used to resurface the skin, stimulate collagen below the skin’s surface, and reduce uneven hyperpigmentation. In most patients, the dual mode ablative and non-ablative Venus Viva setting allows for the simultaneous treatment of rosacea, acne, and acne scars. The treatments can further improve surface texture, pore size, and skin tightness.
"Deep indented acne scars are usually caused by a loss of dermal collagen. Venus Viva uses Nanofractional RF to stimulate new collagen growth within the dermis without significant collateral damage to the skin." Dr. Raffy Karamanoukian
Deeply indented acne scars can be recontoured with Venus Viva, as the stimulating capacity of fractional radiofrequency allows for collagne stimulation and angiogenesis. In our Santa Monica plastic surgery practice, Dr. Raffy Karamanoukian utilizes a Hidef protocol that employs Venus Viva to reduce deep acne scar indentations, improve skin tone and color, reduce pore size, and even skin topography. The result is smoother skin.
Venus Viva requires a series of treatments for optimal results, typically 3-5 treatments spaced about one month apart.