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Post-treatment of severe acne or large rashes may leave uneven or indented scars as acne heals.
Further, acne scars are difficult to treat at home, so many people visit a dermatologist, but may concern long downtime and redness after treatment.
In this issue, Dr. Sang Ju Lee, the Yonsei Star Skin & Laser Clinic will present cases of acne scar treatment using Skin Booster Therapy and POTENZA.
- INDEX
Types of acne craters (02:42~)
There are three types of acne craters: ice pick, boxcar, and rolling, and actual acne scars often have a mixture of types, making it hard to assess treatment. Conventionally, treatment methods include punch excision for the ice pick type, subcision therapy for the cross therapy rolling type, and size-specific treatment for the boxcar type.
Treatment of acne craters(03:15～)
The treatment of acne scars is divided into three stages, which we call the C, A, and R approaches.
1.Cut
2.Augmentation(Augmentation of treatment effect)
3.Resurfacing(Smoothens the skin surface)
The first step is to excise the affected area (Cut) using a subcision, punch, or other treatment method. In the 2nd stage, the indented area is filled with a skin booster, in the 3rd stage, the uneven skin surface is smoothened out with a laser or RF device.
Cut(02:00～)
First of all, if the type of acne scar is a boxcar or a small ice pick scar, punch therapy is used. For a rolling scar with gently sloped sides, it can be treated with subcision or filler.
Augmentation(Augmentation of treatment effect)(02:38～)
Next, for the augmentation of deeply indented acne scars, the patient’s own blood can be used. For example, plasma gel is injected after dipped in the patient’s blood, which is inexpensive but has the disadvantage of short duration of effect. Recently, non-self-derived products have become available, such as collagen, hyaluronic acid, and polymers, often using PLA polymers. Conventional RF therapy had limitation in restoring scars to their natural shape, but applying PLLA after CO2 fractional laser improved scars.
Skin Booster Treatment(5:13~)
Recently a procedure in which PLLA is applied after treatment with a CO2 fractional laser or RF device is called the “Skin Booster”. Hyaluronic acid, PLA, amino acid preparations, and polymers are used as skin boosters, but mainly PLA polymers are used. When using polymers, they should be made into fine, rounded particles, 25-50 µm in size. The reason for processing to this size is to avoid phagocytosis as well as to ensure a long-lasting effect. We also use PLLA because among PLA, PLLA is reported to be more effective in collagen production and more sustainable.
Resurfacing (Smoothens the skin surface)(17:10～)
Lastly, resurfacing, which can be performed with lasers, RF devices, or HIFU, we mainly treat with CO2 fractional lasers and RF devices. Resurfacing should go through stages of skin bleeding and osmosis to improve symptoms. The ablation procedure is a good choice for those seeking results, but has the challenge of downtime and redness. Furthermore, many patients wish to have treatment while going to work, so downtime needs to be shortened. So, in order to treat with the shortest possible downtime, we use CO2 fractional laser and needle RF.
Potenza(20:24～)
POTENZA is effective for acne inflammation and acne scars. In the past, acne inflammation had to be improved before the acne scar treatment step could be initiated. However, with POTENZA, acne inflammation and acne scars can be treated at the same time. There have been cases in which simultaneous treatment has been effective in preventing acne inflammation and recurrence. It is also effective in wrinkles, skin firmness, and sagging, as well as in acne treatment.
Summary｜Procedures for treatment of acne craters (18:13～)
PLA is used in skin booster treatments, and PLLA is the most effective of the PLA products. When used with laser or radiofrequency devices, we use PLLA products with fine, rounded and safe particles. The size of the particles should be within 50 µm, and the instruments used are CO2 fractional laser and needle RF. Microneedling treatment uses POTENZA, which allows for shorter downtime. The pumping tip can be used together, and both monopolar and bipolar are available for a wide range of treatments.
