Acne Scars

Overview

Most people experience some degree of acne: approximately 80% of people in their teens and twenties and up to 5% of older adults will suffer from this skin condition. Acne is caused by hormonal stimuli to the acne or sebaceous glands in the skin. This can lead to an increase in the volume of oil which may be accompanied by a blockage to the opening of the duct which will manifest itself as either a blackhead or whitehead.

Acne typically affects the face but can also be present in other areas of the body such as the front and back of the chest, lower back, buttocks and thighs. While many people recover from acne without any permanent effects, some people are left with disfiguring acne scars.

Treatment Options

We strongly recommend that you seek the advice of a Consultant Plastic Surgeon or Dermatologist with regard to skincare conditions and treatments. There are some topical skin care products and medications that may help this condition, but most acne scars are treated with a combination of surgical procedures and skin resurfacing using laser systems. One laser treatment option is the Fraxel® Laser system. Aesthetic Surgery Ireland uses Fraxel® laser technology.

How does the Fraxel laser work?

Fraxel

Unlike other laser treatments Fraxel® lasers are able to precisely treat thousands of microscopic areas of skin, using pinpoint laser beams that penetrate beneath the skin’s surface to reduce old, damaged skin cells. Fraxel® treatment stimulates the body’s own natural healing process which helps to replace damaged skin with fresh, glowing healthy skin.

Clinical studies suggest that for most people, maximum results are realized in just 3 – 5 sessions, which are usually spaced 2 – 6 weeks apart.

The following description outlines the general procedure a patient undergoes for Fraxel® laser skin rejuvenation treatment. The procedure you may undergo for your specific condition may differ and can be fully explained by a Consultant Plastic Surgeon or Nurse.

What happens before your Fraxel® skin rejuvenation treatment?

It is important that your skin is properly prepared for the procedure. Typically an anaesthetic gel is applied to your skin approximately 45 – 60 minutes prior to your treatment.

Skin preparation may also include the application of lighting cream and sunscreen for dark skinned or tanned patients: this is a precaution to ensure that the laser is not absorbed by the tan. This will be decided during your assessment and commenced 2 – 4 weeks before the Fraxel® treatment.

Similarly the Surgeon may decide to apply a water jet to cleanse your skin of any impurities. The use of the JetPeel® water treatment will help to prepare your skin for the laser treatment. The water jet cleanses your skin in preparation for the laser treatment.

If necessary the Consultant Plastic Surgeon or Nurse can apply a topical anaesthetic cream to relieve any discomfort.

What happens during your Fraxel® skin rejuvenation treatment?

Patients are generally required to wear protective goggles. During the application of the laser the patient may feel a snapping or skin-pricking sensation.

Depending on the area being treated the procedure usually can last from 30 minutes (hand) to up to 60 minutes (face).

What to expect after your Fraxel® Laser treatment.

The Consultant Plastic Surgeon or Nurse will cool or sooth your skin immediately after the laser treatment. Depending on your particular condition and the specifics of the laser treatment there may be some darkening of the treated area and redness. In rarely cases there may be crusting or weeping. Generally any such effect is very temporary and will disappear after 3-4 days. Patients can return to work immediately although some patients may decide to apply some form of make-up to hide any temporary discolouration. Usually there is a downtime of 2 -5 days for social activities.

What are the possible side effects?

Fraxel® laser treatment can produce side-effects. The intensity and duration of your side effects depends on the treatment aggressiveness and your body’s healing characteristics. Generally patients who are treated more aggressively experience more intense side effects that may last longer. However, some patients have greater than “expected” reactions to less aggressive treatments and others have fewer side-effects to aggressive treatments than would ordinarily be expected. Notify your Nurse if the severity of your side effects becomes a problem for you.

Swelling: You will notice most of the swelling on the first morning after treatment, particularly under the eyes. Swelling usually lasts 2 – 5 days. To minimise swelling follow the following advice:
a. Apply cold compresses to the treatment area for 10 minutes of every hour on the
day of treatment until you go to bed
b. Sleep elevated the first night and use as many pillows as you can tolerate.

Redness: Most redness resolves during the first week after treatment, but a rosy “glow” can remain for several weeks. If you wish, you can apply makeup immediately after treatment to minimize the redness.

Dry Skin: Your skin may feel dry and may peel or flake. You may notice a “sandpaper” texture a few days after treatment. This is the treated tissue working its way out of your body as new, fresh skin is regenerated.

Bronzing, Crusting and Small Dark Dots: Fraxel® laser treatment causes destruction to microscopic cylinders of skin which then exfoliates during the healing process. In individuals with heavily pigmented skin, or in areas where sun damage has produced pigmented lesions, these microscopic wounds, known as MENDs, contain large amounts of melanin. Because there are so many MENDs, they can make the skin look bronzed, or small areas appear crusted (do not try to scratch them off). When high energies are used to produce deep and wide lesions, the MENDs can sometimes be seen as individual dark dots. On the face, the MENDs will shed within 7 – 10 days: on other areas of the body it may take as long as 3 weeks for the MENDs to shed.

Raw Skin: If you develop areas of raw skin post treatment, keep them moist. You do not need to apply band-aids, but keep the areas moist and do not pick at them. They will heal very rapidly on their own and without problems.

The Consultant Plastic Surgeon may recommend anti-biotic creams to be used for up to a week after your treatment.

What are some of the Potential Complications?

Protective goggles must be worn during laser treatment

Laser, or light, treatments have the potential to burn or blister your skin. While this is rare, it may lead to mild scarring and changes in skin colour or pigment.

Some types of laser rejuvenation treatments are not advised for darker skin tones. If you have a dark complexion, your Consultant Plastic Surgeon can recommend the optimum treatment for you.When you have laser treatment around your eyes, you will experience temporary eyelid swelling.

Fraxel® Laser treatments are not for everyone. Your Consultant Plastic Surgeon may advise you against laser treatment if you are prone to scarring or have a history of light sensitivity that causes a rash or other reaction. Laser therapy is not recommended if you have cold sores or other skin infections at the site of the planned treatment.

Frequently Asked Questions

What is Laser Skin Rejuvenation?
Laser Skin Rejuvenation therapy helps stimulate your skin’s collagen production by deconstructing underlying blood vessels using lasers, helping to ‘plump up’ the skin and minimise the appearance of fine lines. Skin rejuvenation therapy is considered a non-ablative treatment, which means that the surface of your skin shouldn’t be damaged by the process.

What skin conditions do Fraxel® lasers treat? 
In general, Fraxel® lasers used in skin rejuvenation therapy for wrinkles around the eye, age and sun spots, brown spots, acne scars and skin resurfacing.

How often would I require treatment? 
Initial treatment may require four or five sessions spaced a few weeks apart to achieve the level of improvement you desire. Afterwards, you can get treated every six months for maintenance, as required.

Are there any reactions to treatments?
Laser, or light, rejuvenation treatment can leave skin blisters or burns. While this is rare, it may lead to mild scarring and changes in skin colour or pigment. If you have laser treatment around your eyes, you may experience temporary eyelid swelling.Some types of laser rejuvenation therapy aren’t advised for darker skin tones. If you have a dark complexion, your Consultant Plastic Surgeon can recommend the best laser treatment for you.

Are laser treatments painful?
Depending on the type of laser device used and the brand, you may experience mild stinging or burning during the procedure. The area treated may also feel hot for about 15 minutes or so after treatment. In a sense, the laser procedure helps to create a fresh surface which facilitates the growth of new skin. Laser rejuvenation treatments assist the stimulation of your skin’s collagen production, helping to ‘plump up’ your skin and minimise the appearance of fine lines.

After laser treatment, can you go out into the sun again?
You can still go out in the sun, but you should protect yourself by using a high-factor sunscreen (minimum 30+ SPF), regardless of what season it is. Wearing an appropriate sunscreen is always recommended for everyone for summer months when you spend the most time outdoors.

Will I have noticeable facial redness for months after laser treatment?
In most cases your skin will be very slightly pink for up to 10 days.

Does this procedure carry a high risk of skin infection?
Laser therapy does not carry a high risk of infection as the skin surface is not broken during the treatments.