This is a before and after of an acne patient who had cystic acne treated with a vitamin A derivate called isotretinoin. He is now having treatment for the acne scars.
Acne is a very common condition treated by dermatologists. Unfortunately if acne is not treated it can leave scarring. This scarring is usually because of the heat related to the pus and inflammation due to underlying deep cysts. We do not know why some patients have a tendency for cysts, but there is a strong genetic tendency. Over the last 25 years I have been treating cystic acne. Sometimes I have seen cystic acne in the fathers and then in the children in the next generation.
Our treatment for acne falls into a few groups. There are antibiotics that have anti-inflammatory effect together with creams. There are a lot of good keratolytic creams and peels that help clear the surface pores of the skin. The ultimate treatment is a vitamin A derivative called isotretinoin which has deeper anti-inflammatory effects.
How long was the patient on this treatment for?
The patient was on these tablets for 5 months which completely turned around his acne. Considering the amount of cysts and pus he had, his scarring has come out really well as it could have been much worse.
How are we going to treat acne scars?
The acne scars will initially be treated by light treatment such as medical microdermabrasion and glycolic peels. The next step would be Viva which is a radiofrequency device aimed at causing deeper tightening of the underlying collagen. The radiofrequency works through micro entry at different points so that there is very little removal of the outer lays. This makes the treatment much safer and can be used in olive-skin people as well.
When can the treatment be started?
Viva can be started soon after isotretinoin. Deeper laser resurfacing always needs to be delayed about 12 months due to the effects of the tablets.
Discover Acne Scars Treatment Advantages!
It is always difficult to predict the amount of improvement. Some patients can get 90% and others only 10%. It always depends on what type of scarring there is. Ice pick scars do not respond well as they are quite deep and almost like tunnels. Sinuses and thickening also do not respond well. The best results are seen with gently sloping scars where we can mold them in with skin tightening.
Are other treatments required with acne scarring?
Yes. Dr. Lanzer would also look at using a filler to try and elevate depressions. Acne can cause damage of the collagen so that there is depression such as in the cheeks and chin. These enhance the scarring and a filler will soften and improve things. Dr. Lanzer will also use fillers with the patient’s own fat and stem cells. The fat is derived by micro liposuction. Once the fat is purified it is injected under the skin. The stem cells can be stored in Dr. Lanzer’s specialised bank and used at a later date.
What are the long term results of having had severe acne and acne scarring?
Dr. Lanzer has found that patients who have had acne scarring tend to age quicker. It is due to the damage of the elastin and collagen. These patients often do require earlier anti-aging treatments.
Are any creams effective for acne scarring?
Yes, there are a number of creams, particularly those that contain vitamin A and C that have been shown to improve the skin texture and tightening. Dr. Lanzer is developing a new range of creams that will also be of assistance for skin repair.
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