Why are skin treatments not improving my acne scars?
Unfortunately it’s very common for people with acne scars to be frustrated with their acne scar treatments
I see patients who’ve been treated with multiple devices ranging from different lasers as well as
radio frequency and micro needling devices
patients also report having undergone chemical peels or platelet-rich plasma or PRP injections
and just not seeing the results that they were expecting I’ll share some of my experience helping
my patients who have acne scars I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon
and Fellowship-trained oculofacial plastic and reconstructive surgeon been practicing in New York
City and Long Island for over 25 years I routinely help people with acne scars using specific
lasers and radiofrequency devices I perform acne scar surgery such as subcision for tethered scars
I also have a lot of experience with PRP to improve skin quality texture and hyperpigmentation
these treatments mentioned can improve the appearance of acne scars because
they improve skin quality the skin texture and can even tighten and resurface the skin however
there is a major aspect of acne scars that these treatments cannot address especially the deeper
acne scars where there is deeper tissue loss acne scars are primarily the result of inflammation
inflammation can leave the skin architecture to be fragmented disorganized and leading to tissue
loss at the skin level and deeper the treatment of deeper acne scars may involve some form of
restructuring and restoration for example i perform a procedure to release the tethering
of the skin with the underlying tissue and the procedure is called subcision during subcision
different instruments are placed under the skin to release scar tissue that’s responsible for
pulling the skin inward subcision also stimulates collagen production as part of the body’s natural
healing response after the procedure subcision is generally performed for rolling type scars
after subcision for a rolling scar a hyaluronic acid filler can be placed
underneath the skin to support the skin for a smoother appearance
boxcar scars are more limited to the skin level and have defined edges they are also generally not
as wide as rolling scars I often use combination treatments to help people with boxcar scars
and for example I’ll perform a non-ablative laser for dermal tissue remodeling and use
hyaluronic acid with PRP to optimize volume and collagen production within the skin speaking
of hyaluronic acid an area that is frequently overlooked is volume deficiency below the skin
this volume deficiency can be due to bone projection fat volume or a combination of the two
I’ve had a lot of patients who for all intents and purposes came in to see me after they underwent as
much skin focused treatments as could ever be performed I recognized that for many of
these patients volume support below the skin can create projection and smoothening of this
acne scars fairly effectively so as opposed to placing the filler just below the acne scars
I often place the filler at the bone level with a specific technique called structural volumizing
now this technique allows more stable support of the skin from the bone level many of these
patients have been delighted by the results which they can appreciate immediately afterwards
aggressive marketing of devices in my opinion is why many people are frustrated after not seeing
benefit after one treatment this frustration causes many people to go from one practitioner to
another all of whom who claim to have the latest and greatest device unfortunately these patients
often end up damaging their skin even further recognizing that there are different types of
acne scars skin color and skin types so that there is no one best treatment that applies to everyone
with several modalities and techniques available to use for treating acne scars I generally take
a fairly conservative approach what I frequently do is to treat observe the results and customize
future treatments accordingly in my opinion rather than being manipulated by aggressive marketing
focused on financial transaction it’s better for you to identify a physician who can provide you
with the treatment plan and realistic expectation of results I hope this information from my
experience helped you
If you are interested in recommendations for your individual situation
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