Acne and Acne Scar Treatments

A Premiere Medica Spa - Acne Treatment and Acne Scar Removal Procedures.

What is Acne?

Acne is a general term that refers to lesions commonly known as pimples, blackheads, whiteheads, and cysts. These lesions commonly occur on the face and neck, but may sometimes appear on the chest, back, shoulders and the upper arms of many young people. Often associated with puberty, acne may develop in adulthood, and occasionally persists for many years, especially in women. Acne occurs in both sexes, although teenage boys are more likely to have the most severe outbreaks.

THERMSCAN ACNE LASER TREATMENT

What Causes Acne?

There are many myths about what causes acne. Acne isn't caused by poor hygiene, uncontrolled sex drive, chocolates or greasy foods. Scrubbing your face 5 times a day won't change your predisposition to this embarrassing and unsightly skin problem. Stress doesn't cause acne, but stress can make it worse. Poor diet doesn't cause acne, but can make it worse. Steroids taken by some athletes and bodybuilders can also cause severe acne outbreaks. Hot, humid weather causes skin cells to swell and thus can make your acne worse. Oral contraceptives may trigger acne in some women but suppress it in others. This depends both on the pill and the woman taking the pill.

The exact reason as to why some teenagers develop acne, while others going through the same hormonal changes don't, is mostly unknown. Heredity, high levels of testosterone, the male sex hormone, during or after puberty; a person's skin response to an increase in testosterone production are behind most forms of acne.

Some people are more sensitive than others to increased levels of sebum or testosterone. Sebum, the oil responsible for keeping the skin and hair moisturized, is produced by oil glands (sebaceous glands) found in the skin. Testosterone signals the oil glands to make sebum. When the skin cannot cope with an increased level of sebum, the sebum clogs the openings to hair follicles, and pimples, blackheads, and whiteheads form. Sometimes the follicle walls break under the pressure of sebum buildup and the sebum leaks into nearby tissues giving rise to cysts. Cysts are firm swellings below the skin's surface that become inflamed and sometimes infected. When ruptured, cysts can leave temporary or permanent scars. Moreover, bacteria (P. acnes), naturally found in hair follicles, attract white blood cells to the follicle. These white blood cells produce an enzyme that breaks down the sebum and damages the wall of the follicle, causing inflammation and the formation of papules (bumps that are up to .5 cm in diameter), pustules (dome-shaped lesions that contains pus and sometimes water), or nodules (elevated solid lesions that are greater than .5 cm in diameter).

What are Acne Scars?

While many people recover from acne without any permanent scars, others, especially those with severe acne, end up with disfiguring acne scarring. Color changes are more common with acne than scarring. When acne clears, pink, red, purple, or dark spots sometimes appear on the skin where the acne once was. Post-inflammatory color changes of the skin is very common in those with darker skin tones or in those who tan easily. The good news is that these are not scars and will eventually fade. To be classified as scar, the skin defect has to persist a year or two after an acne lesion has healed.

Acne scars are formed when collagen within the skin is damaged from inflammation. Picking, pressing or rubbing your pimples or whiteheads increases the possibility of scar formation. Acne scars take several shapes: ice pick (deep pitted scars with steep edges), atrophic scars (pitted but have smooth borders and are not as deep), boxcar (depressed, crater-like scars are larger than ice pick scars.), rolling scars (curved indentations on the skin) and hypertrophic scar (thick lumpy scars that sit above the surface of the skin), more common on the back and chest. If you are concerned about your acne scars, speak to your doctor about choosing an appropriate treatment.

LASER RESURFACING AND DERMAL FILLERS FOR ACNE SCARS

What are the Best Medications for Acne and Acne Scars Treatment?

Mild acne cases usually respond well to over the counter topical treatments. Preparations containing salicylic acid, benzoyl peroxide, and tea tree oil (a natural remedy) are just a few examples that have proven to be effective. For acne that resists topical treatment, or for more severe acne, your doctor may prescribe topical medications containing Retin A or an antibiotic, or a course of oral antibiotic treatment. For women, oral contraceptives or other hormonal therapies are sometimes effective in controlling acne. Accutane (Isotretinoin), a powerful "last resort" medication for severe acne, often gives very good results; however, this drug has many serious side effects (see below) and some people believe that it can lead to suicidal symptoms.

As for Acne scars, a skin lightening cream may help lighten the color of dark spots. Topical applications that contain glycolic acid, retinol, or vitamin C can make shallow scars less noticeable by helping the body produce new collagen and plump up the skin.

Most successful acne and acne scar treatments may take months or even years before a person can visibly see the results. The management of severe cases; on the other hand, often requires the intervention of a cosmetic surgeon or a dermatologist.

Accutane - Warnings and Side Effects

Accutane (Isotretinoin), an effective drug for acne therapy, has been linked to several serious physical and mental health problems. Adverse reactions following Accutane treatment are too many to list. The suffering and pain caused by the side effects of this drug have led many patients to file lawsuits to seek compensation. Reported common Accutane side effects include: dry or fragile skin, dry or cracked lips, dry mouth, dry nose, itching, joint pains, and nosebleed. Less common Accutane side effects may include chest pain, vision problems, depression, fatigue, headache, problems regulating blood sugar level, bleeding from the rectum, severe diarrhea, higher than normal rate of suicide attempts, aggressive and/or violent behaviors, negative interaction with many medications, nausea, stomach and intestinal discomfort, sunburn-sensitive skin, thinning hair, and urinary discomfort.

Currently, new FDA regulations require that before taking Accutane, women enroll in a federally regulated distribution program called iPLEDGE, and complete an informed consent form before the drug is prescribed by a physician. The goal of iPLEDGE is to prevent any pregnancies in women taking Accutane. A woman must not become pregnant while taking Accutane. The drug can cause severe birth defects; mental retardation and physical malformations are some examples.

Treatment Options for Acne Offered at Nu Vela

For patients with resistant forms of acne not responsive to over-the-counter and physician prescribed medications, there are limited number of treatment options. At Nu Vela, a premiere Los Angeles Medical Spa, we offer a combination of minimally invasive treatments including state-of-the-art lasers, microdermabrasion and blue light treatments. Unlike Accutane, these effective alternative therapies do not affect the entire body, do not require any downtime, involve minimal to mild discomfort, have minimal side effects and an excellent safety record.

Acne treatment is one of the areas of specialty and expertise of Nu Vela Esthetica. Dr. Dishakjian of the Center has successfully treated many acne patients who have failed conventional treatment with medications but who do not wish to be on Accutane. After an initial consultation and examining your skin, Dr. Dishakjian will formulate a specific effective treatment plan designed to suppress and control your acne and to improve scarring that has already occurred as a result. Visible reductions in acne breakouts are typically observed over several weeks after initiation of treatment sessions. Most patients receive about 4 treatment sessions per month for optimal results.

Microdermabrasion: At Nuvela Esthetica we use the DiamondTome™ system (crystal free) to gently but effectively exfoliate the top dead layers of the skin. This treatment not only leaves the skin smooth, supple and healthier looking, it also helps unplug the skin pores and prevents the accumulation of excess skin oil in sebaceous glands. In terms of exfoliation, this treatment is a wonderful alternative or compliment to chemical peels, takes less than 30 minutes, is non-invasive, pain-free and requires no down time. The number of treatment sessions required vary depending on skin type and condition. Results are gradual but highly effective. Most people experience softer, smoother skin immediately after their first treatment.

ThermaScan™ (Nd:YAG) laser treatment: The ThermaScan™ procedure is a FDA approved "no downtime" acne laser treatment. ThermaScan™ delivers infrared energy at a wavelength of 1319 nm, a wavelength ideal for acne treatment. The ThermaScan™ laser works on acne by gently heating up the sebaceous glands found in the upper layers of your skin. The heat produced in the glands causes a reduction of oil production and thus the number of active acne lesions. In addition to treating over-active sebaceous glands, this non-ablative procedure will also lead to collagen remodeling of the treated areas, proliferation of active fibroblasts, and improvement in acne scarring. The computer guided scanner of the ThermaScan™ laser allows for very uniform treatment at high speeds, while its integrated contact cooling allows for accurate and reliable cooling of the skin's surface to prevent heat injury. This combination results in maximum patient comfort in addition to treatment consistency and reproducibility, unachievable by hand placed laser treatments. The procedure, which takes between 30 and 45 minutes, is effective on all skin colors and types with minimal side effects and no downtime.

BBL™ (Sciton technology): The final step in your acne treatment session involves BBL™'s pulsed light treatment. The BBL™'s blue-light at 420 nm wavelength allows controlled heating of sub-epidermal layers of the skin. This acne laser treatment takes advantage of the fact that the bacteria which is the root cause of acne (P Acnes), produces a compound known as Porphyrin. When exposed to blue light, the porphyrin molecule produces free radicals that in turn kill the bacteria producing the porphyrin. Reduction of this bacteria subsequently results in the reduction of acne.

ACNE TREATED AT THE CENTER - BEFORE LASER RESURFACING

Treatment Options for Acne Scar Removal Offered at Nu Vela

The best way to prevent any acne scars from forming is to prevent more acne in the first place. If active acne is not treated, there will be an increase in the amount and severity of acne scarring. Even mild cases of adolescent acne can leave permanent scars. In addition to the physical damage, acne scars can also have adverse psychological effects. Fortunately, acne scars can be successfully treated with a range of procedures. During your free consultation session, Dr. Dishakjian will evaluate the severity of your acne scars and may suggest one or more treatments best-suited for your skin condition. The basic steps of acne scar treatment may include a combination of the following procedures:

Dermal injectable fillers: These are substance that can be injected into depressed scars to plump them up to the level of the surrounding skin. Collagen, Restylane™, Juvyderm™, Radiesse™, and Sculptra® Aesthetic are good fillers for shallow to deep acne scars. The benefit from dermal fillers usually lasts 3 to 18 months, depending on the material used. Your own fat, taken from another part of the body, can last 1 to 3 years. While you can usually return to your everyday activities immediately after the injections, some minor bruising may be visible. These can be covered with a concealer. To maintain the result, the scars must be re-injected at regular intervals. Read more . . .

Chemical peels: Involve the use a chemical solution to burn away the outer layers of skin. The solutions, which are available in several strengths, are used according to the degree of peeling desired. A series of 4 to 6 superficial peels are effective for improving discoloration from acne, while medium depth peels or a deep peel can improve the appearance of atrophic acne scars (see above). Healing, during which a smoother layer of skin is being formed, can take from three days to three weeks depending on the depth of peeling. Protecting your skin from the sun during the healing period and following instructions given by your physician helps prevent unwanted side effects such as infection and scarring. Read more . . .

Dermabrasion: During this procedure, the skin is cleansed, numbed, and then "sanded down" with a wire brush or diamond burr. The treatment is often recommended for severe acne scars and works well on both raised and grooved areas of the skin. Seven to ten days later, the skin forms a new, smoother layer. Patients can expect full recovery in about six weeks.

Microdermabrasion: Often referred to as "skin polishing", refers to exfoliation of the top dead layers of the skin to remove damaged skin cells. These gentle treatments can provide noticeable improvement to acne scars. The treatments are progressive and applied through a course of weekly sessions. Read more . . .

Intense Pulsed Light (IPL) treatment with BBL™: This light-based therapy delivers pulses of light to the deeper layers of skin without harming the skin's surface. It rejuvenates both the superficial and deeper skin layers by stimulating the most superficial collagen layer and addressing an array of superficial pigment changes and fine vascularity, which can make scars stand out. The procedure is associated with mild discomfort, is done with numbing skin cream and required minimal downtime. Most patients receive a series of about several treatments. Depending upon the type of acne scar, results can be dramatic. The improvement is gradual and continues improving even after treatment has stopped.

Laser resurfacing with the Erbium:YAG laser: Acne laser scar removal with the Erbium:YAG laser is fast gaining popularity Los Angeles because it is safer and less painful than the alternative CO₂ laser resurfacing system. Cosmetic laser surgery with this laser gives excellent results when used for the removal of shallow boxcar scars, as well as for smoothing and tightening scars that have been treated with other surgical modalities. Ice pick scars need prior surgical removal or dermal fillers. The Erbium:YAG laser is similar to the CO₂ laser in that it targets water in the skin. Because this laser targets water and water is everywhere in the skin, this laser will virtually vaporize and remove the skin layer by layer. Moreover, the special scanning device of Sciton's Contour TRL™ system used at the medical spa, moves the laser beam across the skin in a predetermined pattern and gives your physician precise control to gently remove a uniform depth of damaged skin with each pulse or pass. The special properties of the Erbium:YAG laser are due to its wavelength in the infrared region, at 2940 nm. At this wavelength, water absorbs over ten times as much energy as it does at 10,600 nm, the wavelength of the CO₂ laser. Consequently, virtually all of the laser energy is consumed by water, heating it and vaporizing tissue. Very little energy is left to scatter into the skin and produce nonspecific heating. This offers several advantages, including less pain, less risk for undesired color changes of the skin, 30-50% faster healing, and less redness of the skin after healing compared to CO₂ laser resurfacing.

Laser scar removal can be performed with topical numbing cream for more superficial treatments, while deeper and full face resurfacing is usually performed with nerve blocks and pain pills. Added safety and comfort are achieved by the highly effective super cold air, continuously provided by the Zimmer cooling machine. In some cases, only a single treatment is required. Redness following treatment usually lasts 2-3 weeks and improvement in the appearance of scars continues to occur for the next 8-12 months. When the procedure is performed by a skilled physician, side effects are relatively infrequent. Laser resurfacing with Erbium:YAG laser drastically improves the appearance of facial skin and the results are maintained for years to come. If you opt to undergo a laser resurfacing, it is critical to find a reputable Laser Cosmetic Surgeon. Call us for a free consultation..

ACNE SCARS TREATED WITH SCITON'S CONTOUR TRL™

Questions About Cost or a Treatment?

You may reach our Los Angeles medical spa and clinic by clicking the "Contact us" button at the top of the page, or by calling 818-832-4500. Our receptionist will be delighted to assist you with any enquiries regarding cost, additional information, or scheduling a free consultation session with Dr. Dishakjian, a cosmetic surgeon and phlebologist.