Brisbane Acne Scar Clinic

Different Lasers for Different Scars

Davin Lim - Tuesday, December 20, 2011

 Dr Davin S.  Lim

Laser and acne scar specialist

 

There are many different acne scar types including ice-pick scars, rolling scars, depressed acne scars, hypertrophic/ keloidal scars and box car scars. Additionally scars can be hypopigmented (lighter than the surrounding skin), hyperpigmented (darker) or exhibit macular erythema (redness after active acne).

Each type of scar will respond to a different type of treatment, including different lasers. Specialists at Westside Dermatology employ the use of different lasers including Fraxel and Fractional lasers for rolling scars, total erbium resurfacing with the Sciton laser for box car scars. Red scars respond best to the V Beam Vascular laser.  

 Hyperpigmented scars (dark scars) respond best to our Revlite Q switched lasers. Raised scars are best treated with V Beam vascular laser, coupled with steroid injections. Optimal outcomes are achieved if the Specialist uses different lasers for specific scar types.

 

Box Car ScarsIcepick ScarsHypertrophic and keloid scarsRolling Scars

Read post…

Microdermabrasion For Acne Scars - The Greatest Myth of Beauty Salons

Davin Lim - Tuesday, December 20, 2011

Dr Davin S. Lim,

Laser and acne scar specialist  

 

Microdermabrasion is the most commonly performed procedure in beauty salons and spas, and is an excellent treatment to refresh skin, decrease pigment, and treat mild black and white head acne. The long term effects of microdermabrasion on acne scars are arguable. Acne scars reside deep in the dermal layers of the skin, beyond the reach of microdermabrasion.  Long lasting effects of scar revision must reach the dermal layer of the skin where collagen and elastic fibres reside. Effective scar revision procedures such as laser, Fraxel, subscision, and TCA cross procedures all target the dermal layers of the skin

Read post…

Does Roaccutane Treat Scars?

Davin Lim - Tuesday, December 20, 2011

Dr Davin S. Lim

Laser and acne scar specialist

 

Roaccutane or Oratane is a Vitamin A drug used for the treatment of severe acne. Dermatologists have prescribed this medication for nearly 25 years. It remains as the most effective method of treating acne. Roaccutane targets the four factors that contribute to acne formation, including:

  1. Inflammation;
  2. Proliferation of P. acnes, the bacteria implicated in acne;
  3. Decrease oil production; and
  4. Abnormal shedding of the oil gland duct.

The effects on old acne scars are minimal, however it is widely accepted that early management of active acne, will decrease scarring.  Roaccutane can only be prescribed by Dermatologists.

For more information on acne solutions, visit Westside Dermatology

Read post…

What Can be Done For Red Acne Scars?

Davin Lim - Tuesday, December 20, 2011

Dr Davin S. Lim

Laser and acne scar specialist 

 

Red acne scars or macular erythema is commonly seen in bad cases of acne or during the process of acne treatments. The redness is secondary to inflammation and new blood vessel formation, and occurs during the scar remodelling phase. Most cases of red scars improve within 12- 18 months, however there are some helpful hints to hasten recovery, and reduce scarring.

Limit sunexposure – always use a high factor SPF sunscreen, and limit UV exposure to a minimum. Avoid scrubs to your skin – exfoliation may irritate your skin. Use a gentle cleanser such as Cetaphil twice a day. Lasers. The best laser to treat Macular Erythema is the V-Beam Vascular laser.

V-Beam laser targets blood vessels more accurately than other lasers. Treatments are relatively painless, with down time of less than 2 days. Laser treatment of Macular scarring can hasten recovery 3-4 times faster than time alone.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Read post…

Creams For Acne Scars

Davin Lim - Monday, December 19, 2011

Dr Davin S. Lim

Laser and acne scar specialist  

 

The internet is filled with a tremendous amount of information on creams for acne scars, but do any of these actually work?   Vitamin A creams (retinoids or retinol) can reduce acne and assist in mild cases of acne scars. These molecules can stimulate collagenesis or collagen remodelling in mild scarring.

The concentration, retinoid selection and delivery methods into the skin play an important role in the efficacy of creams. Over the counter creams claiming to have retinoid molecules are usually too weak to make any difference to scars. Medical grade prescription creams work best, though the limiting factors include skin irritation.   Glycolic acid creams can assist in early and mild scarring.

Higher concentrations work best, but skin peeling can be a problem. I usually suggest a concentration between 10-12 %, every second night application, alternating with a Vitamin A cream.  Vitamin E and Bio Oil lotions can be an effective treatment for early scars, patients will need to carefully balance the usefulness of these lotions against the potential that oils may block skin pores, worsening active acne.

Read post…

Acne Scars Treatments in Dark Skin Patients

Davin Lim - Monday, December 19, 2011

Dr S. Davin Lim

Laser and acne scar specialist  

 

Acne scars are often more severe in darker skin patients including Asian, Hispanic and Mediterenean skin types. These darker skin types have increased risks of pigmentary changes after any scar revision procedure. Skin changes include hyper or hypo-pigmentation: an increase or decrease in skin colour.  

How do I approach treatment of acne in darker skin patients?  The most important factor is getting the patient to achieve sun protection before and after any procedure. In some situations I use a bleaching cream known as Hydroquinone after laser of chemical peels.

The optimal laser for scar revision in dark skin types is the Erbium Fractional system, less heat is generated compared to Fraxel, enabling a greater safety margin. Regardless, ethnic patients will require an additional two to three more treatments compared to fair skin individuals.

Read post…

Ice Pick Scars and Treatment Options

Davin Lim - Sunday, December 18, 2011

Dr Davin S. Lim

Laser and acne scar specialist    

 

Ice pick scars are commonly seen in severe cases of acne. This type of scar responds poorly to even the most modern of Fraxel/Fractional lasers. Ice pick scars extend deep into the dermal layers of the skin, beyond the reach of lasers. Over the years I have employed several very effective methods to treat these scars.  

A simple technique is that of a punch biopsy. Using a 1-2 mm punch kit, each scar is simply excised, and sutured with a fine grade thread. Sutures are removed 5 days later.   TCA cross is another method which I frequently use. Using an applicator, TCA or tricholroacetic acid is instilled into each pick scar.

One treatment elevates the scar line by 20-30%. Depending on the severity of scarring, the depth of the ice pick scars, and the patient’s skin type, 2-3 sessions are performed every 6-8 weeks. Once the scars are elevated, either Fractional lasers or Full resurfacing is then performed.   A combination of punch excisions, TCA cross and laser resurfacing can yield a significant improvement.

 

 

Read post…

Fillers For Acne Scars

Davin Lim - Saturday, December 17, 2011

Dr Davin S. Lim

Laser and acne scar specialist

 

Depressed scars occur secondary to volume loss. This loss of volume occurs in the dermal layers of the skin, and may occur secondary to acne, or chick box.   Several methods can be used to treat depressed scars, including dermal fillers and dermal grafting.  Dermal fillers (Juvaderm, Juvaderm Voluma, Restylane) are synthetic products which add volume to the dermis, lifting scars with only one treatment. They last between 4-18 months, can be repeated at intervals.

 Dermal grafting is a technique which utilizes your own collagen (often taken skin located at the back of the ear). Skin is stripped of the outerlayers (epidermis) by a laser, dermal components are harvested, then introduced into the depressed scars. Dermal grafting is more permanent compared to fillers, however risks include scarring and a ‘foreign body reaction.’

Read post…

Subscision For Acne Scars

Davin Lim - Friday, December 16, 2011

Dr Davin Lim

Laser and acne scar specialist  

 

Subscision is a simple yet effective treatment for bound down acne scars. This procedure takes approximately 2 minutes to perform, with a recovery time of only a few hours. Bruising on the treated site normally lasts 3-4 days, and can be decreased with the application of ice immediately after the procedure.  

What is subscision? This minimally invasive surgical procedure involves scar revision below the scar itself. Subscision is ideal for bound down scars, including certain subsets of depressed scars. It involves breaking ‘knotted collagen’’ below the scar itself.  

How much improvement can I expect with subscision? If the correct scar type is addressed with this procedure, patients can expect an improvement of 20-30% per treatment. Ideally, 1-3 treatments are recommended.  

Is subscision painful? In all cases, I use a local anaestheic of some sort. This may include a cream or local anaestheic delivered via a very small needle. Subscision is well tolerated in the vast majority of patients.

 

Read post…

Home Skin Needling For Acne Scars - Do They Really Work?

Davin Lim - Thursday, December 15, 2011

Dr Davin Lim

Laser and acne scar specialist    

 

Skin needling has become very popular over the years for the treatment of acne scars. Needle lengths vary between 0.5 mm to 1 mm (known as home grade) thru to 2mm to 3 mm known as clinical grade.   The theory behind skin need

ling is to break old acne scars and to stimulate new collagen formation. Home grade kits have very limited effects on acne scars, they simply do not reach down far enough to break up the scars. Clinical grade needles are better, however pain, bleeding and infection maybe the limiting factors.  

 For skin needling I apply EMLA or local anaesthetic cream to the treated area for at least one hour before the procedure. We then use a medical grade roller over the acne scars. A course of antibiotics for 3 days after the procedure reduces the chances of infection.   Since the invention of fractional lasers, I use skin needling a lot less frequently. Lasers are much more effective in treating acne scars compared to skin needling.

 

 

Read post…