Acne Scar Reduction with Dr. Kulak at the Naderi Center for Rhinoplasty & Cosmetic Surgery
Acne scars reach deeper than the skin, impacting not only one’s appearance but their self-confidence and self-esteem as well. There are many options to remove or reduce the appearance of acne scars and reveal your beautiful skin, including dermabrasion, chemical peels, laser procedures and surgery. Laser resurfacing repairs skin damage, reduces wrinkles and fine lines, and lessens the severity of skin irregularities like acne scars, blemishes, enlarged pores, and uneven skin tone. Dermabrasion and chemical peels resurface your skin for a natural, rejuvenated, refreshed appearance. For some patients, scar revision surgery may be the best solution.
Recovery from scar revision generally takes seven to ten days. Treatment in multiple stages may be required, and sometimes multiple treatments over long periods of time obtain the best result. Some swelling and bruising may occur after treatment, and the area of the scar may appear red at first. Most patients generally return to work within one to two weeks. Recovery from resurfacing options typically require one to two weeks.
Dr. Jessica Kulak is a fellowship trained facial plastic surgeon at The Naderi Center for Rhinoplasty & Cosmetic Surgery, practicing in Chevy Chase, Maryland and Northern Virginia. Dr. Kulak is an “aging face specialist” with a practice dedicated almost exclusively to rejuvenation of the aging face through a variety of surgical and minimally invasive techniques. She has co-authored a “Chemical Peel” chapter in a prestigious medical textbook.
Consultation with Dr. Kulak for Acne Scar Reduction
During consultation, Dr. Kulak will explain the benefits associated with each scar revision procedure based upon your unique skin analysis. Acne scar improvements may require multiple treatments over long periods of time. A combination of treatments may be suggested. Dr. Kulak will also advise you on the best skin care regimens.
Acne Scar Reduction Procedures
Acne scare reduction procedures are generally performed under monitored anesthesia care or local anesthesia. With monitored anesthesia care using low dosage medications the patient remains responsive without assisted ventilation.
Dr. Kulak’s suggested procedures which may be performed in combination include the following:
- Z-plasty: Z-plasty is a plastic surgery technique that can make acne scars less noticeable by realigning the scar to fit into your natural skin folds or creases. This technique may be followed by a skin resurfacing procedures once the acne scar has healed.
- Dermabrasion: Dermabrasion is an abrasion technique performed in a hospital setting. After applying a local anesthetic, often with general anesthesia or sedation, a wire brush scrapes away the outer layers of skin. Scabs will form, creating new skin. Recovery is dependent upon the abrasion depth. Your face will be red and sensitive for a week or more.
- Chemical Peel: A chemical peel is an acid solution which removes your skin’s top layer. Dr. Kulak will determine the most appropriate peel intensity for your skin. Deep wrinkles, scars and discolorations are improved, leaving skin radiant and younger looking. VI Peel is the most common in-office peel performed by The Naderi Center Facial Plastic Surgeons.
Mild and medium peels address small wrinkles and skin discolorations, refreshing your facial appearance. The phenol peel is the strongest, used to address acne scars. Application to the entire face creates a bleaching effect which is unsuitable for darker skins. Lighter peels may be performed in office with local anesthesia and sedation, taking only a few minutes. Deeper peels require anesthesia performed at the hospital and are applied in zones. Healing time is generally three to five days or about one to two weeks for deeper peels. Redness that can be covered with makeup may remain longer.
- Laser Resurfacing: Laser resurfacing employs either the carbon dioxide (CO2 laser) or the Erbium laser. The CO2 laser impacts the skin with intense waves of light at the 10600 wavelength on the light spectrum, stimulating healing. Side effects include pain, swelling and itching, and redness may persist for a period of time. The Erbium laser recovery period is more rapid than the carbon dioxide laser with a more shallow penetration depth. Anesthesia is required for both laser procedures, with multiple treatments spaced months apart with the fractionated lasers such as FRAXEL.
Scar Revision Recovery
Scar revision recovery generally takes seven to ten days or more. Some swelling and bruising may occur, and the area of the scar may appear red at first. Most patients can return to work within 1-2 weeks.
Acne Scar Reduction FAQs
Why does acne scarring occur?
The healing process after the skin inflamed by the acne lesion creates fibrosis. Repeatedly picking lesions causes repeated trauma and increased inflammation. Squeezing can drive infectious material deep into the wound, again increasing inflammation. Fibrotic repair of the lesions leads to the textural changes associated with acne scarring. Acne scarring lesions are located deep in your skin. Most human hairs are about 100-200 microns into the skin. Acne lesions normally extend between 800-2000 microns (.8mm-2mm) into the skin.
Can I prevent acne scarring?
Preventing acne scarring is your first line of defense. Scarring occurs during the inflammatory and healing stages of the lesion. Topical or oral medications from your physician can help. Over-the-counter treatments are inadequate for severe acne. It is important not to inflame acne lesions by picking or squeezing the lesions.
What is a Fraxel Laser?
A Fraxel laser targets both the surface and the deeper layers of the skin. The fraxel repair remodels the collagen associated with acne scars by blending scars with the surrounding skin in both texture and color. Fraxel restore lasers works best for mild to moderate acne scarring. Deeper acne scars respond better to fractionated CO2 lasers. Three to five laser skin treatments are typically needed for an excellent although not perfect result. Fraxel laser before and after images will help you understand the long-term impact of this skin laser treatment.
The Fraxel laser passes through the top layer of the skin, reaching into the dermis below to create thousands of tiny “microthermal” zones deep into the skin that stimulates the body’s wound healing response. The body responds by producing new collagen, which refreshes the outer layer of the skin or epidermis as a result. This fractional laser treatment is especially effective for acne scars.
What can I expect during a Fraxel laser procedure?
Discomfort is typically minimal. An anesthetic cream is applied one hour before the procedure, and a strong anti-inflammatory is taken such as Toradol. A powerful cooling machine cools the skin during the procedure. The skin may have the sensation of a light sunburn for an hour or two after treatment. Cold packs are applied after the procedure.
A Fraxel treatment will temporarily make your skin more UV-light sensitive. Following full facial laser treatments, the skin should be protected from UV light for four to six weeks
Most patients return to normal activity two to four days after treatment with makeup. You can anticipate two to three days of moderate swelling and redness which then looks like a tan for a week. Expect to be “camera ready” in seven to ten days.
What is the best laser treatment?
Erbium lasers will tend to produce about 30-150 microns of ablations in the full forms and about 600-800 microns in their fractional forms. The fractional version of these lasers can provide an improvement in acne scarring. The fractional Erbium lasers are for more superficial scarring than a C02 laser with more heat, which is necessary to induce remodeling of the tissue not ablated.
Are deep ablative devices better?
CO2 lasers are the gold standard in revising acne scarring. The newest devices are fractionated. Underpowered lasers must employ long laser pulses to direct the same amount of energy into the tissue as a short pulse with a properly powered laser.
Long pulses can lead to excessive tissue heating and side effects such as discoloration and even scarring. Underpowered devices are cheap to build and more affordable to purchase and are common in the med-spa industry. Devices that are able to penetrate 2000 microns or more into the skin are the only devices that can reach the entire scar region.
Jessica Kulak, M.D. – Facial Plastic Surgeon in Virginia
Dr. Jessica Kulak is a fellowship trained facial plastic surgeon at The Naderi Center for Rhinoplasty & Cosmetic Surgery, practicing in Chevy Chase, Maryland and Northern Virginia. Dr. Kulak’s focus is the face. Her experience with acne scar reduction and the techniques and treatment that produce the best results for each unique patient significantly enhances her patient’s aesthetic outcome.
The Naderi Center for Rhinoplasty & Cosmetic Surgery Offices are located in Chevy Chase, Maryland, (301) 222-2020; or Herndon, Virginia, (703) 481-0002.
Hospitals: Procedures performed at the INOVA system hospitals include Fair Oaks Hospital, Loudoun Hospital, Fairfax Hospital, or at Suburban Hospital in Bethesda Maryland.