Presented by Dr. Philip Young of Seattle: Acne Dark Pigmented Scars in an African American Black Dark Skinned Patient and the unique elements to consider with darker skin types:
I see that you have dark pigmented scars from acne which may include some rolling scars and atrophic scars but maybe possibly not Frank boxcar scars. The challenge is that your skin is dark (darkly pigmented as most African Americans are) and your chances for hypopigmentation and lighter skin is a real possibility using any sort of resurfacing techniques including chemical peels, dermabrasion, lasering, etc. You have to be comfortable with these risks in order to proceed to improve your scars and whether or how you feel about your current scars that you have versus having lighter skin in certain parts of your treated areas. Meaning, are you comfortable of possibly having lighter skin that can be noticeable versus the having the scars you have now. Which would be worse. If your current scars are worse then I would take the risks of the treatment. You may get no hypopigmentation or other complications. The risks are actually probably small. But, likely the better place to start for you first is to fully optimize your skin care and we can help you with that. We have a unique approach with this as well utilizing chemical peels, delicate and thoughtful skin care tailored for you.
Dark skin acne topical skin care approach
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery and our Seattle Bellevue Office
Seattle’s Dr. Philip Young talks about Atrophic Acne Scars in the Forehead and there treatment and the specifics that should be consider with scar revision treatment:
For your atrophic acne forehead scar it basically looks like it is similar to a boxcar scar. Box car acne scars are depressed but no as narrow as a needle which would be more appropriately called an ice pick scar. What you need for your Forehead Atrophic Scar is at least some lasering and maybe even some volumizing with some type of filler or tissue. Because it’s a solitary lesion the other option is considering to excise it . But the challenge with that is that it’s an excisional approach and you will have a new scar although better. Breaking up that linear scar would be a good idea and I would consider doing some sort of pattern to hide the scar. But there are other risks with cutting them out as well. You can have imperfect results depending on how you heal. You can have dog ears which are elevations on the sides of the scars. Also when you excise a scar, the new scar has to be at least 2 times the scars most longitudinal length. If you want avoid cutting them out then I would do a multiple-step approach to improve for your scar and treat multiple layers at one time. We have a unique approach called the Acne Scar Vitalizer Approach. Through this approach we will use 5-7 steps to treat all the layers and this will include resurfacing using newer approaches in utilizing the lasers power. We also combine more methods to treat the deeper layers which shock your scars to get the best results we have ever seen!
Atrophic Forehead Scar Example from Acne by Seattle’s Dr. Philip Young
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
Radiofrequency & Microneedling for Acne Scar Treatment for Acne Scarring in Plastic Surgery
My experience in Plastic Surgery with microneedling & radio frequency is that some of the results have been less than satisfactory on the patients that I’ve seen and that have received this type of treatment for Acne Scarring and Acne Scar Treatment. I personally do not do radio frequency because I have yet to be convinced of the results. I usually wait at least 5 years for new technology to figure it self out, to get a sense for the effectiveness by the general public, and to see whether the hard data shows that it works. This is something that I learned from colleagues. It seems that many patients say that microneedling can help to a mild degree but I have had some patients say that microneedling creates additional scarring. They have come to me with bumps from a micro needling procedure. I have corrected micro needling scars like that many times before. This requires the same approach that I use to treat elevated scars and moles. My approach to acne scarring entail’s treating all the layers of the skin including building up the subcutaneous layer, the dermis as well as working from the top layers. You have to use multiple different types of treatments. I tend to group them all together in a combined approach that takes five to seven steps that’s done in about 2 hours. We call it the Acne Scar Vitalizer Treatment.
Here is a before and After our Acne Scar Vitalizer Treatment:
#acnescartreatment #beforeandafter
Thanks, Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
Share this video on this new and unique treatment for acne scarring. Developed by award winning Dr. Philip young, the Acne Scar Vitalizer Treatment is an Innovative approach that can treat all types of acne scars through a 5-7 step process that is all done in about 2 hours. You can get significant results with just one treatment. In our experience we are getting much better results with just one treatment as opposed to multiple repeated traditional approaches. How do we do this? We do this by combining multiple approaches all done at the same time. By doing so we shock the skin into a reconstructive state . We use our co2 laser in an innovative way to get depressed scars, ice pick scars, and boxcar scars to raise up and we use other methods to treat the deeper layers. This approach was developed over 15 years of constant self-reflective improvement and medical surgical experience . We strongly believe that we can get real results for you in just one treatment.
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
The lasers and fillers sound all promising. These options can have some mild to moderate effects. I have done lasers and other acne scar revision treatment for over 16 years. No one treatment is going to treat all the scars of acne as a single modality. Hence over the past 16 years I’ve developed a combination approach that uses five to seven steps treat all types of acne scars. Fillers are temporary and may not be the solution. They are supposed to only last 6 months to 1-2 years. Also fillers cannot change the scars like other procedures do. I work with fillers many times before for ice packs, rolling, elevated and boxcar scars. Sometimes it can work but a lot of times it can actually make them look a lot worse especially with ice pick scars. And the reason is because the very tough scars or so scarred around them that the fillers tend to go around the scars instead of under them where they need it. I’ve seen that before and have tried that many times. We have a combination approach that uses five to seven steps and it’s all done in about 2 hours and it’s called the Acne Scar Vitalizer Treatment. This was developed over 15 years of experience with scarring and acne scarring.
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
This is an answer for a patient that had red active acne and some scars as well:
“Well the good thing is that some of your scars are really just what appears to be active acne. Sometimes active acne can look like scarring and if you treat it your skin can get a lot better. I think if you control your active acne, I think your skin can be a lot better. You do have scars but they’re not as bad or nearly as bad as I’ve seen. You probably better than 80% compared to other people who have come to me. I would suggest doing aggressive skin care treatments. We can help you with this. After using aggressive skin care, we can see what you have left after you give that a full chance. We can see if some of these marks are really going to turn out to be scars that are permanent. You also want to see if you can control your diet and see what’s triggering the acne possibly. One way to do this is to do a food diary and see what is leading to your acne. I would look for worsening in a 4 or greater than a day period. So introduce new food every 3-4 days to see what could be the cause.”
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
Enlarged pores can act in the same way as ice pick scars. Ice pick scars respond much differently than other acne scars like elevated scars, box car and rolling scars. Ice pick are scars that look like they were made as a cast to make a needle. They are small tight and deep. Box car scars are side more open scars the size of at least more than 3-4mm in diameter. Rolling scars are areas of depressions creating a look of a rolling hillside. In my experience acne scars or more in the Superficial layers of the skin versus deeper layers that other scars involve. Although acne involves all layers of your skin and it can reach into the deeper layers even above your muscles, there’s certain specific treatments that work with certain types of scars. Some scars respond more to work in the deeper layer. Some scars like box car scars respond to certain methods that help ice pick and other methods that help more rolling scars. With ice pick scars you have to create controlled trauma to try to get it to raise up to the rest of levels skin. So there is an answer to try to help ice pick scars and enlarged pores and it’s by creating that trauma and we have done this before and have a lot of experience doing that. Here are links to specific treatments:
This is a questions I answered for a patient recently:
Your acne scars show some volume loss. You scars also show what we call rolling scars and maybe very wide boxcar scars. Any single approach is not likely to give you the best results like lasers, fillers, or deep chemical peels. You will definitely need some treatments in the deeper layers of your skin as well superficial treatments and this is where combination approaches help in getting the best results. We have an approach that uses five to seven steps that treats all the layers of your skin and that is done in about 2 hours. This can help you and we have done it before for people just like you. We have helped people with all different skin tones, and ages and different scars. This procedure is called the Acne Scar Vitalizer Treatment.
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
Large pores and scars from acne that are similar can be described as an ice pick scar. Ice pick scars respond differently than other acne scars like box car or undulating scars. Ice pick scars require that the skin be raised up to the rest of the level of the skin. What is required is controlled trauma from chemical peels or lasering to do this. The skin anatomy can explain some of the reasoning behind this. There are multiple layers in the skin. There’s the Superficial dermis and then there’s reticular dermis and deeper parts of the skin. Ice pick scars are more in the superficial and upper reticular dermis and are formed of tight scar tissue. They require controlled trauma to get them to raise up. In terms of your Retinoids, you may want to consider cutting down on doing them everyday to maybe once a week. You can find what your skin responds to. Often times people put too much retinoids on at once and too many consecutive days that your skin can get burned out.
Thanks,
Dr Philip Young and our Team at Aesthetic Facial Body Plastic Surgery
We are making a new photo directory of different type of scars that you might have. This will allow you to pick out the scars you are concerned about to learn more about how to approach each scar. We have the following captions | scar types | techniques for you to pick from. We will try to grow the list a little more without overwhelming you:
Acne Scar Vitalizer Treatment
Acne Skin Care Before and After Pictures
Box Car Acne Scar Treatment
Depressed White Acne Scar Mark Treatment
Elevated White Hypopigmented Acne Scars
Pock Mark Acne Scar Treatment
TCA CROSS treatment with Subcision
Linear Depressed Straight Scar Geometric Line Closure
