Acne Scars - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Acne Scars or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Scars & Acne Scars
A breakthrough in scar treatment
Combining PicoSure® laser with the new Infini high intensity fractionated RF micro-needling technology provides our patients incredible results that could not be achieved before.
Picosure stretches and softens the "knots" in the damaged scar tissue. The RF micro-needling treatment follows two weeks later, breaks the “knots” further and starts the process of collagen regeneration, which takes 3-6 months. The desired results are usually achieved in 2-4 treatments and downtime is minimal.
Results are visible 4 weeks after treatment, yet the scar surface becomes more even with the rest of the skin, and the overall skin texture improves to further reduce the contrast between the scar and the surrounding skin over the following 3-6 months.
Scars can now be treated!
Scar treatments are among the core procedures performed at our practice.
To benefit the large number of our acne scar patients, we operate the most effective lasers for scar removal. Our experience enables us to combine lasers, punch grafts,photodynamic therapy, fillers and peel treatments to offer you the most efficacious and cost effective solution for your condition.
Now Serving Abington, PA
We are pleased to announce that Ringpfeil Advanced Dermatology has expanded to Abington, PA (19001). This new location allows us to make our advanced scar treatments, including PicoSure:registered:️️ and Infini RF, more accessible to patients. Contact us at 610.525.5250 to book a consultation at the location most convenient for you.
Book a consultation with Dr. Ringpfeil to learn what treatment plan is most suitable for you. This consultation is covered by most insurance plans.
Treatment Options
| Infini RF | CO2 laser | Picosure laser | Fractional CO2 laser | Fraxel (TM) | TCA Peel | Photodynamic Therapy | Subcision | Fillers | Punch grafts | |
|---|---|---|---|---|---|---|---|---|---|---|
| Ice pick scar | + | +++ | + | ++ | + | +++ | - | - | - | ++ |
| Box scar | +++ | ++ | +++ | ++ | + | + | + | + | ++ | ++ (if small) |
| Rolling scar | +++ | + | +++ | + | + | - | + | +++ | - | - |
| Large pores | + | +++ | + | +++ | + | ++ | +++ | - | - | - |
| (uneven) Texture | +++ | +++ | +++ | +++ | + | ++ | +++ | - | - | - |
| Days downtime | 1-3 | 7-14 | 0 | 4-7 | 4-6 | 5-7 | 2 | 7-14 | 0 | 7 |
| # Treatments | 2-3 | 1-2 | 3-4 | 1-2 | 4-8 | 1 | 4-6 | 1 | 1 | 1 |
| Lasting results | permanent | permanent | permanent | permanent | permanent | 1-2 years | permanent | permanent | 6-18 months | permanent |
| Total Price | $1500-$2000 | $3000-$6000 | $3000-$4000 | $1500-$2000 | $4000-$6000 | $500 | $2000-$3000 | $500 | $300-$800 | $185-$2000 |
Scar Treatment
True acne scars can only be improved by removing the top layers of the skin and letting the skin build a new surface, combined with maximum collagen production from underneath. This can be best achieved by CO2 laser resurfacing. The laser assures precise depth of abrasion, thereby minimizing complications that were common with dermabrasion (not microdermabrasion), such as permanent pigment change.
Deep pitted scars require punch grafts 4-6 weeks prior to the laser procedure for maximum fill. Nowadays, fillers can be used to bolster scars. Often, acne scars may be preventable if acne treatment is started early.
Treating Tummy Tuck Scars
Asian Skin - Treating Acne Scars
Do you use the Variable Pulse YAG Laser? And if not why not? Thanks for your input, it’s overwelming how much info. is out there!
The Variable Pulse ND:YAG Laser is not appropriate for treatment of acne scars.
I understand that the cosmetic technology available at this time must be overwhelming for a layperson. The choice of laser depends on the condition and skin type to be treated. It must also depend on the experience of the laser surgeon. Laser technology has made a tremendous impact on the ability to correct cosmetic concerns but is not without risks. A variable pulse Nd:YAG laser can be used for a host of conditions including hair reduction in all skin types, blood vessel treatment, redness reduction, skin rejuvenation, wrinkle correction and others. The downside of an Nd:YAG laser is its lack of specificity to treat some of the above conditions and most of the time, more efficient and specific lasers are used by advanced laser surgeons to achieve goals safely and quickly. A complimentary consultation with our aesthetician can help you better understand treatment options that are appropriate for you.
Dr. Ringpfeil,
I had cystic acne as a teenager that left me with pitted scars as well as overall uneven skin texture. There seem to be so many options. I need your assistance in locating a surgeon who has a great deal of experience with punch grafting and subcission. I will then come to you for the laser treatment. Do you use the Fraxel type laser system?
I greatly appreciate your help!
We perform punch grafts and subscision as needed several weeks prior to resurfacing by CO2 laser. In fact, I do not use Fraxel technology as it has not met expectations over the past 4 years since it entered the market even when 4-8 treatments were performed. The company that makes Fraxel has since developed a CO2-Fraxel combination system because Fraxel alone could not deliver results. However, we use the flagship of CO2 laser technology, the Ultra Pulse by Lumenis. Until today, the Ultra Pulse is still the most robust and versatile CO2 laser on the market, which is especially important for the outcome of scars.
I have suffered with moderate to severe acne since my teenage years. I am now in the process of trying to remove as much of the scaring as possible. I did some research, and found that punch techniques should be done before skin resurfacing with a laser. However, the local doctor that I have seen wants to do an Erbium laser resurface before any punch excisions. He says that after the resurface,depending on the results, he can then do any punch excisions and spot treat again with the erbium laser.He says that doing it the other way could make some of the scaring worse. Do you agree?
Newer laser technology has been able to dramatically reduce the need for punch grafts, which in the past were often necessary to address deep ice pick acne scars. When indicated, punch grafts are typically done at least 4 weeks before the resurfacing procedure. They must be followed by resurfacing as they are otherwise quite obvious. Under certain circumstances, it may be reasonable to resurface acne scars first and then punch graft only the very few remaining deep lesions, followed by spot resurfacing.
Dr. Ringpfeil:
I am 27 and acne has always been a huge issue. I have tried Differin Gel, Jan Marini products, Doxycycline, HCTZ, Proactive and Retin-A. All have which failed. After getting pregnant my skin seemd to calm down but I do suffer from some harsh breakouts. I have suffered from cystic acne as well leaving me with awful scars. I have some scars that look like white lumps (not keloids) others look like “craters” and others look like “ice pick”. I would love to minimize the appearance of these scars. I use entirely to much make up to try to camaflouge these issues but I think it makes it more noticeable but I do not dare to leave my home without makeup. It is very embarrassing. Since I have such a variety of different scars would one type of treatment be sufficient for all? Would I have to get my current acne under control before proceeding with scar treatment? Also since acne is a “medical condition” would any of the treatments for active acne and acne scar treatment be covered by insurance? Do you think a TCA peel would be appropriate treatment? What is the down time for “punch excision”? Thank you so much for your time.
Acne and acne scars can be difficult to handle and often lower self-confidence. Acne treatment is important and it is also a prerequisite to some type of scar correction as some treatments such as TCA, resurfacing etc could temporary flare acne. Medications used for acne treatment are typically insurance covered and so are the office visits. The treatment of acne scars is currently not covered by insurances. Unfortunately, insurances explicitly exclude acne scars from coverage. The choice of treatment depends on your skin, your scars and financial means. TCA is one modality for severe scars. Often, punch excisions are usually used as a pretreatment for other, more extensive procedures. You should be evaluated for your needs.
Dr. Ringpfeli,
I am considering coming in and performing treatment to cure my scars. I have used peels in the past with no improvement. I am in graduate school and find that acne scars are preventing me from landing the job. I have south asian skin and different types of scars and discoloration. Have you treated tan skin and are there any practical solutions for my acne scars? Thank you
Scar treatment has much improved over the past years, mostly due to improved laser technology. We have successfully treated many individuals with acne scars and “Asian” skin, as well as other more tan skin types such as Mediterranean, Central American and the darker South American. The type of treatment that will work best for you can be determined during a consultation, and may include several technologies. However, at this time, there is no cure available for scars; in other words, it is still not possible to trade scars for normal skin. The best technology will give you about a 50%-70% improvement.
Hello,
I am interested in acne scar removal, but I recently learned that I am pregnant. Are there any risks to having any of these procedures done while pregnant?
Acne scar treatment comprises a host of different procedures.
Microdermabrasion and glycolic acid peels are allowed during pregnancy. They carry no to minimal risk. TCA peels and laser treatments are elective procedures that carry some risks, and therefore are not performed during pregnancy. Filler injections are also not usually carried out during pregnancy.
Hello,
After many years of acne I have scarring all over both cheeks which I hope to improve. I want to do as much as I can for better skin texture and am wondering if it is usually necessary for people to take off work/stay home after having treatment. Do you feel that people are often happy with their results? Do you have any examples of before ad after photos? I know you can’t totally fix the scarred skin but I am hoping for a visible improvement. Also, I live about 4 hours away and would like to just get a consultation first. How long are your appointments? Thank you so much!
CO2 laser resurfacing reduces acne scars by 50% which means quite some reduction in scars and significant improvement in texture. Most will take off one week after treatment but there are some who may get away with as little as 5 days. A consultation is a must before CO2 laser resurfacing and we provide a new patient appointment for this reason. Most additional questions before the actual procedure can be dealt with over the phone but occasionally we have to ask that an additional consultation be scheduled.
Follow up after 7 days is routine. If any signs of infection occur, in-office evaluation within the first week is mandatory. Therefore, this procedure requires you to be in close driving proximity to the laser surgeon’s office for one week which should filter into tyour decision making when you select the treatment site.
hello, I have an acne scar that had been on my nose forver and it looks pumpy. Do you think Laser treatment can help to remove it?
Unfortunately, your description does not allow me to judge if it can be treated by laser. Please make an appointment for evaluation.
I have some healed scars on my legs but the scars won’t go away I’ve tried everything can u help me
By definition, a scar is a permanent reminder of an injury that our body has sustained. In the skin, it occurs after an injury that affects the border between the upper layer of the skin (epidermis) and the lower layer of skin (dermis). Injuries that are contained within the upper layer of the skin do not form scars. When the skin has not been traumatized from the outside but from acne breakouts or other rashes that cause severe inflammation in the lower layer of the skin, pigment changes could occur in the affected area. These changes are called post inflammatory hyperpigmentation or hypopigmentation. They can last many months and rarely years. Many people confuse the latter with scars because they take so long to resolve.
Modern technology has turned around treatment for scars. Significant improvement can now be achieved in many scars with the use of several lasers and other treatments. Post inflammatory hyperpigmentation can also be tackled. Please set up an evaluation so that we can tailor a treatment regimen to your needs.
I have scars from previous cosmetic surgeries (liposuction). Is there a form of laser surgery that would effectively remove or lighten these scars? They are not raised. Thanks!
Most scars improve without any additional help over time showing their final appearance by about 2 years. Laser treatments can remove the red color from most scars regardless of their age and can be performed as soon as 2 weeks after a procedure. The average number of treatments needed ranges from 2-6 and they are typically spaced 4 weeks apart. However you should keep in mind that redness will have faded naturally from most scars by 6 months. If a scar is darker than the surrounding skin, and the darkness is predominantly due to a brown pigment deposition, treatment can be very difficult.