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Long after adolescence has passed, millions of people suffer
from the long lasting effects of acne, namely acne scarring. This
might include deep permanent scars, either "icepick,"
or pitting scars, or "depressed," crater-like scars.
Dermatologists are experts in the treatment of acne and acne
scarring, though it would be unusual for "perfect" results.
Nevertheless, scarring can be treated with a variety of techniques
that improve appearance and boost self-esteem. The choice of technique
or combination treatment depends on the type of scarring, the
patient's medical history, and the expertise and lasers or other
equipment available to the physician. |
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| Microdermabrasion |
| Think of a device that sandblasts grime and debris off granite
buildings, and you get an idea of microdermabrasion, with the emphasis
on "micro"! Small particles passing through a vacuum tube
remove the top layer of the skin and are said to stimulate new cell
growth. Frankly, we are not impressed with the long term benefits
of microdermabrasion alone, but it can certainly help when used
in combination with other topical agents such as Retin-A, bleaching
agents, and other rejuvenating creams. Because of the superficial
nature of this technique, patients with mild scarring are the best
candidates, and multiple treatments are usually required to achieve
subtle results. |
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| Soft Tissue Fillers |
| Agents such as Zyderm and Zyplast (collagen derived from cows)
have stood the test of time as safe and effective temporary filler
substances for soft depressed acne scars. The newer human derived
collagens are also very nice fillers, and benefit from the fact
that humans will not be allergic to this material. The new hylan
gels are going to be extremely popular for tissue augmentation,
and should soon be FDA approved. Fat taken from one's hips or abdomen
can be injected back into many locations in the face for correction
of aging changes. Some of this benefit might be permanent. |
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| Excision and Punch Replacement Graft |
| Depressed acne scars may be removed surgically, and repaired with
a small "punch" graft of skin from elsewhere on the patient's
body. These are often made less visible by performing dermabrasion
or laser abrasion subsequently. |
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| Chemical Peeling |
| Mild acne scarring and certain types of acne may be successfully
treated by the application of a chemical peel solution. This allows
new and regenerated skin to appear, improving the appearance of
the condition. |
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| Laser Therapy |
| Many new laser therapies are currently being used to improve acne
scars. The classical lasers still being used for significant scarring
are the carbon dioxide and erbium YAG lasers. These vaporizing (ablative)
lasers will literally vaporize the scars, and tighten the skin,
and can result in very significant improvement of acne scarring.
Potential complications and a long healing process need to be considered.
Non-ablative laser rejuvenation is much newer, and can result in
significant improvement in acne scarring according to some investigators.
These take multiple treatments, and the results can take many months
to be realized. |
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| Dermabrasion |
| Totally undervalued, and often relegated to the museum shelves
is the equipment used for dermabrasion. Sad to say, probably the
best technique for improving acne scarring is often considered "old
hat." In this technique the skin is frozen immediately prior
to being abraded with a rotating wire brush or diamond fraise. The
skin undergoes a "remodeling" process as it heals, resulting
in a smoother and fresher appearance. |
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| Appointments |
| (415) 353-7878 |
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