The Toronto Acne Clinic

SCAR TREATMENTS

Acne scarring is a difficult problem to correct. Our surest advice is to seek treatment early to prevent acne scar complications.

The type of scarring you experience, as well as the degree, and severity depend on a number of factors.

The more severe the acne lesions the more severe the scars.

The longer the acne process goes untreated the more severe the scarring.

Picking your pimples increases your risk for developing scars.

Scarring appears in various forms and depending on the type and severity of the scars, different treatments are recommended.

Keloid scars

Keloid scars most often occur on the trunk, arms, and earlobes. These scars tend to be wide and raised above the skin. These scars cannot be surgically removed - otherwise they come back looking larger. They cannot permanently be treated (cured).

Kenalog injections into the scar on a monthly basis has been proven successful in flattening the scar. In addition, the use of silicon gel has also been effective in the treatment of keloid scars.

Depressed scars

Depressed scars are a common end point after prolonged or severe acne flaring. A large crop of acne lesions that heal with pitted scars tend to leave the face with an undulated or wavy look. There are numerous ways to classify and describe the different scars left by previous acne. Rolling, boxcar, ice-pick are terms that describe some of the scars we encounter. Various treatments are ideally suited for different types of scars The most successful treatments for depressed scars to date involve facial resurfacing, laser resurfacing and facial recontouring using filler materials. Surgical treatments included, scar excision, and subcision. Subcision involves the use of a surgical probe to separate the scar tissue from the skin, which will raise the skin and flatten the scarred surface.

FACIAL RESURFACING

Facial resurfacing with a CO2 laser or with classic dermabrasion involves very aggressive treatments, prolonged recovery periods, and higher risks for infection. In addition, they are not suited to all skin types. Despite the risks these treatments remain the gold standard for all facial resurfacing procedures.

Newer lasers described as "non-invasive" stimulate the dermis level of the skin to produce more Collagen and Elastin to smooth out the scar.

The Toronto Acne clinic employs the 1064 Yag Laser. and Smoothbeam Laser. Laser, both non-invasive lasers, to stimulate skin regeneration

Less aggressive techniques such as Micro-dermabrasion, Clay peels or Glycolic peels. involve gentle treatments with very low risk of complication and recovery times of about 2 hours. Typically 12-18 treatments are needed to achieve results in most patients with moderate scarring.

FACIAL RECONTOURING

Some severely pitted areas are best recontoured or filled for optimum results. Several new hypoallergenic injectable skin volume enhancers that last up to a year now offer safe solutions to scar treatment. Because they are not made from animal product they will not cause allergic reactions seen with collagen® or Hylaform®.

They are produced by bacterial fermentaion a process that uses our own DNA as the template for production (the same way human insulin is made). Restylane®, and Juvederm® use Hyaluronic acid to fill skin gaps. Hyaluronic acid is normally present in our skin and thus provides a natural way to improve deep scars.

Non animal stabilized hyluronic acid (Juvederm and Restylane) typically last 12-18 months with one injection. Safe, non-allergenic, and long-lasting, it is our preferred choice for facial recontouring.

The most common complication of treatment is mild swelling, redness and bruising at the injection site. The degree of swelling and redness will vary from individual to individual. Recovery times vary from 24-72 hrs.

Newer longer lasting fillers available today include products with Calcium Hydroxyl-apotite crystals (Radiesse®) and those made with Poly-L-Lactic Acid (Sculptra®). Artesense (PMMA mixed with collagen) typically last 3-5 years but requires multiple touch-ups and re-injections to achieve this property. Once injected into the skin the PMMA beads are in place permanently and can only be removed surgically if complications occur.