Acne scar treatment energy devices

Fractional laser resurfacing treats ‘fractions’ of skin enabling quicker recovery and shorter downtime for patients. Most patients will benefit from a series of fractional laser treatments.

Facts on fractional laser for scar treatment:

● Fractional CO2 and Erbium lasers are effective for acne scar treatments

● Fractional resurfacing treats a portion of your skin

● Using a scanner the doctor can control the percentage of skin treated

● Fractional lasers have shorter recovery time and lower risk of complications compared to fully ablative laser resurfacing

● Up to 70% improvement of superficial and textural scars can be seen after four treatments

● Side effects are generally rare and laser procedures are very well tolerated

● Recovery time may be tailored according to your preferences, typically 3-5 days

● Erbium fractional laser has shorter downtime compared to CO2

● Erbium fractional lasers are safer in darker skin compared to CO2

● CO2 fractional lasers have longer downtime, however they deliver slightly better outcomes

● Pulsed dye lasers are brilliant for treating fresh / red scars and typically two treatments are needed spaced 3-4 weeks

● Everyone will have an individual pattern of acne scarring, and a bespoke treatment program will give superior results

● RF microneedling (Genius) is not a laser but it is also fractional in the way that it penetrates fractions of skin and delivers radiofrequency (heat) to the dermis

Ablation means skin removal.

Ablative lasers (CO2 / Erbium) remove a percentage of the skin surface.

Ablative lasers are the most potent lasers for treatment of acne scars.

In general, skin texture with minor depressed / atrophic scars respond well to fractional ablative laser treatment.

In some cases, rolling scars are tethered (anchored) and must be treated with subcision for optimal results.

In order to lift scars to the same level, deeper icepeaks and boxcars should be treated with TCA cross before any latter laser treatment.

The number of laser treatments for acne scars depend on your starting point and factors such as the treatment method, the device used, the skill sets of the practitioner, the depth and type of your scars, your healing response, your tolerance to downtime, your skin colour etc. In most cases, 3 to 4 sessions of fractional CO2 / Erbium laser may lead to 60 – 70% improvement.

Treatments are spaced with 2-3 month intervals. More treatments may be performed for even better outcomes.

Some patients aim for the best possible outcomes and go far beyond this number of laser treatments.

Fractional laser produces thousands of tiny ‘ablation’ holes in the skin. Each hole is the diameter of a shaft of hair, however these columns extend up to 2 mm into the skin where the scars lie.

The laser targets the scarred areas and stiff collagen, but also leaves areas of healthy tissue to regenerate.

This fractional treatment allows your skin to heal much quicker than if the entire surface was treated at once.

Erbium and CO2 laser resurfacing is used for the treatment of superficial acne scars that lie in the same level of the skin.

We use numbing cream and nerve block (Lidocain injection) for anesthesia – and mild sedation, if needed (extra charge).

Most often, we use Erbium resurfacing to remove the upper layer of the skin, usually 200-400 microns depth.

As we reach the papillary dermis, some pinpoint bleeding will be seen. This is followed by fractional Erbium or fractional CO2 laser treatment for added effect. Fractional laser creates deep columns of ablation (tissue

removal and coagulation) in the deeper dermis.

The main difference is that laser uses light whereas Genius uses radiofrequency.

Genius has a tip with sterile, insulated needles that penetrate the skin and scar tissue to deliver energy at the optimal depth.

Downtime after Genius is app. four days with aggressive settings, whereas the downtime after fractional CO2 laser with aggressive settings are minimum 1 week. Discomfort during treatment with Genius is higher than with fractional CO2 laser, but the aftercourse is more tolerable after Genius.

Risk of side-effect like pigmentation changes and infection is lower with Genius, which is safe on all skin types all year round.

Patients with superficial skin imperfections (pigment, sunspots, enlarged pores) respond well to CO2 laser, and deeper skin challenges respond better to Genius RF micro-needling.

After fractional CO2 or Erbium laser treatment, your skin will be red, swollen, oozing, and may pin-point bleed for 1-3 days and then gradually decreases.

Discomfort will gradually decrease after 1-2 hours.

Aftercare for CO2 and Erbium laser resurfacing and RF microneedling

For the first week after each treatment:

● Gently wash your skin at least two times daily using a mild facial cleanser

● Rinse or shower your face, wash your hair with shampoo and conditioner as needed

● Apply generous amounts of Cicalfate cream (Avéne) or Cicaplast cream (La Roche-Posay) more times daily. These creams are developed for post-laser skin care.

● Makeup can be used when the skin has healed.

● Keep your skin cool – but not cold. Avoid hot showers and sauna.

● Keep your skin clean. Avoid dust, dirt, and contaminated skin contact

● No picking, let crusts peel off by themselves.

To reduce the risk of skin infection, we may deliver antibiotic tablets (Azithromycin 500 mg) for you. You should take one tablet daily for three days.

If you have a history of recurrent cold sore (herpes labialis), we will deliver you antiviral tablets (Valaciclovir 500 mg). You should take one tablet twice daily for 5 days.

We strive to achieve optimal results with paramount safety and follow-up. However, there is a risk with any procedure involving energy devices.

When laser treatments are performed by an experienced specialist, complications are very rare.

Potential complications include:

● Infection. Less than 2% of cases.

● Scarring is rare and may follow secondary infection.

● Grids or marks from the laser in the skin is seen in less than 10% of cases, however this is reversible with laser resurfacing.

● Post-inflammatory skin pigmentation changes are uncommon in fair skin, but may be seen in 10% or more of cases in ethnic skin. Bleaching creams (Hydroquinone 5%) used one month before and after laser treatment reduces the risk of skin colour changes in dark patients. Hydroquinone is sold over the counter in some countries. We cannot prescribe HQ abroad, but you could speak to a local dermatologist about a prescription or seek at Amazon.

● Erythema (redness) and swelling is commonly seen after Genius, Erbium and CO2 laser treatments. Redness and swelling gradually fades over 3-4 days following Genius treatment and it takes a few weeks after fractional laser treatment, but some redness may persist for 2-3 months after laser resurfacing.

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Dr. Henningsen is available for appointments Wednesday, Thursday and Friday in Cutis Clinic Odense (close to Odense Central Station) and Monday in Copenhagen.

If in doubt, please call the clinic at +45 7020 7066 (press 9 for English) on weekdays between 8:30-11:00 am or 2:00 – 4:00 pm.

or send us an e-mail at: info@cutisclinic.dk