The best way to achieve maximal improvement in acne scarring
The best way to achieve maximal improvement in acne scarring is to address each individual scar type, whether icepick, boxcar or rolling scars. A multifaceted approach enables the practitioner to address all scar types in a single session, thereby minimizing downtime.
At the Acne Center of Michigan, our comprehensive acne scar session includes the following protocol, in a single session:
- Oral sedation and topical anesthesia starting 2 hours prior to the procedure
- A light chemical peel including Jessner solution and 20% TCA to the entire face to
blend non-scarred areas. - 100% TCA CROSS into icepick scars and/or Fotona SP Dynamis 0.5 mm ablative
laser into narrow icepick scars and pits - Fotona SP Dynamis fine focused laser to smooth out the edges of boxcar scars and
irregular mounds to blend the acne scars into the surrounding skin - Tumescent anesthesia with Taylor Liberator subcision to release scar bands
- Fractional ablative Erbium laser OR Fractional ablative CO2 laser depending upon
the skin type of the patient - Punch excision or elliptical excision of deep scars
Important facts to know:
- 1. The comprehensive nature of this procedure results in prolonged downtime.
- 2. It generally takes 7 to 10 days for scabs to resolve and the skin to re-epithelialize.
- 3. No significant physical exertion is permitted for 2 weeks after the procedure. If you overexert yourself and raise your blood pressure, there is risk for hematoma formation.
- 4. Redness will persist often for several months. This may be camouflaged with make-up or tinted sunscreen.
- 5. Flushing with exercise may also be seen.
- 6. There is risk for hyperpigmentation, and therefore, we require strict avoidance of direct sunlight until ALL redness is resolved. This is usually a 2-to-3-month time frame. Photoprotection includes sunscreen and shoulder to shoulder hats along with UV faceshields (Blackstone).
- 7. There will be micro swelling of the skin and therefore one cannot make any judgments as to how much improvement he/she has made until at least 1 month after the procedure. Collagen production continues for at least 3 months after the procedure.
- 8. Our protocol uses conscious sedation. The patient is drowsy but awake and is monitored during the procedure. Most patients do not remember much afterwards. Overall, the procedure is well-tolerated and comfortable.
- 9. A driver is required. It is NOT permissible to Uber.
There is meticulous aftercare that must be followed to reduce the risk of any complications.
- Our patients are confined to their home or hotel for a minimum of 7 days.
- We do not recommend traveling on an airplane for 1 week after the procedure.
- We ask the patient to return to the clinic the next day to remove the protective mask and review aftercare.
- If you are flying in from out of town, we would prefer that you remain in this area for 1 week afterwards. If you are driving from a distance, please be aware that we may need to bring you back if we have concerns about your recovery.
- The patient will text photographs to Dr. Singer every day for the first week after the procedure to monitor the healing.
It is impossible to predict how much improvement someone will achieve with this comprehensive acne scar process. However, we have adopted Dr. Mark Taylor’s protocol, and in his published studies, most people see a minimum of 25% improvement, and many see 50% improvement or more. The cost of the procedure is individualized based on the extent of the scarring.