Acne Treatment

Serving Albany, Saratoga Springs, Schenectady, and Troy, New York

View Our Acne Treatment Before & After Photos

Acne is one of the most common skin conditions seen by skin care professionals.  It presents in a variety of forms from pimples like white heads and black heads, to nodules and pustules.  Treating acne early can help to control the condition and limit the risks of long term scarring.  The scars it leaves behind can be very significant and contribute to poor self esteem.  Fortunately, there are many treatments available to improve on the scars caused by acne that have been tremendously beneficial to a lot of people.

As of the current time, there is no universal accepted classification of acne scarring. Commonly used terms include:

Ice-Pick Scars are narrow, sharp, deep scars that extend into the dermis or subcutaneous layer. When light hits the skin, they appear as little pock marks.

Boxcar Scars appear as round or oval depressions. They are shallow or deep with a flat base and are wider than ice-pick scars.

Rolling Scars are more gradual hills and valleys (undulations) of the skin surface that occur from the pull of deep (dermal) scar tissue. The surface skin can look like relatively normal looking skin.

Preoperative evaluation is crucial in determining which method of scar therapy is correct for the patient. A preoperative evaluation consists of the following: a comprehensive patient history, a determination of the type and extent of acne scarring, and A Fitzpatrick skin type classification.  Acne should be in remission, and the client must be off Accutane for 6 - 12 months.

Determining the patient’s goals and expectations is essential. Because each method of scar therapy has different complications, warnings and contraindications, a through and realistic discussion should precede a commitment to particular therapy. Also, it is imperative that before and after photos are taken to evaluate the results of treatment. 

Treatment Options

Ablative and Non-Ablative Lasers Non-ablative laser resurfacing is a kind of treatment that heats the skin but does not cause it to peel. This modality works best on rolling, undulated acne scars. The common lasers for this purpose are in the mid-infrared spectrum and include the Smoothbeam laser. With this device, the skin is first cooled with a burst of refrigerant followed by a series of short laser pulse. The pulses cause collagen contraction and stimulate new collagen formation.  Ablative lasers peel the skin in addition to heating it up.  Ablative lasers are especially important in improving irregularities in the surface texture of the skin.  The skin surface can be carefully planed to even out lumps and pumps. The lasers also produce thermal contraction of the dermis, shrinking pores and filling in defects.

Fractional Resurfacing Somewhere in between ablative and nonablative laser treatments falls yet another category called fractional laser treatments. This approach uses tiny microbeams to create deeply penetrating zones of healing, but only a fraction of the skin is treated with  each session. This reduces the down time although a series of treatments is necessary. Fractional resurfacing is the future of laser acne scar treatments. We currently provide two forms of fractional therapy, Fraxel-Restore (erbium)  and CO2 fractional.

Chemical Peels and Dermabrasion Procedures such as chemical peels and microdermabrasion generally supplement other acne scar therapies.

Subcision or Punch Techniques There are multiple ways to surgically remove the most severe acne scars. The punch technique uses a cylindrical blade that cores out or “punches” the severely scared tissue. The remaining defect is either closed on itself or filled in with a skin graft taken from somewhere else on the face. Dermal grafts are another option in treating atrophic acne scars. This method consists of removing a strip of skin and transplanting it to replace lost dermis. Finally, subcision is a process designed to treat bound-down or tethered skin such seen with atrophic scars or rolling scars. It is accomplished by inserting a needle under the skin and undermining the scar, which breaks and detaches the scar bands leading to the depression.

Fillers often accompany other treatments like subcision.  Materials called fillers, can be injected under the surface of the skin to help raise depressions and smooth out surface imperfections. Many materials can be injected including, collagen (cosmoderm/plasty), hyaluronic acid (Restylane, Juvederm), or one’s own fat in small quantities  (microfat transfer). 

Treating acne scars can be challenging.  Individual patients respond differently and may need multiple therapies. Patient satisfaction is greatly improved by setting realistic expectations, and one can expect a 50% to 70 % overall improvement.