ACNE Blackheads, whiteheads, pimples, scars | Korean Aesthetic Clinic

In the previous article of this ACNE series, we discussed about basic home remedies and simple acne treatment formulae.Now over to more intensive forms of treatment:Different types of acne scars on the face can undergo different types of laser treatments for optimal results.

Types of acne scars:

Ice-pick scars	these are deep, narrow, pitted scars
Rolling scars	broad depressions with sloping edge
Boxcar scars	broad depressions with with sharply defined edges
Atrophic scars	flat, thin scars or depressed scars

Atrophic scars: Combination of fractional lasers, subcision +/- microneedling
Hypertrophic and keloidal scars: Combination of fractional lasers +/-microneedling, with silicone gel and steroid injections
Post inflammatory hyperpigmentation (PIH) (red, brown) in scars: Non ablative lasers like Dual Yellow Laser, QS NDYag, long pulse ND Yag, Pulse dye lasers and Alex lasers work well

Acne marks ( post inflammatory hyperpigmentation)

ACNE PIH

PIH (brown) PIH (red)

ACNE SCAR. ICE-PICK SCAR

ACNE SCAR, BOX SCAR

ACNE SCAR, ATROPHIC SCARS

ACNE SCARS, ROLLING SCARS

HYPERTROPHIC, KELOIDAL SCARS

(pictures courtesy of dermnetnz)

hypertrophic, keloidal scars

Unfortunately, true acne scars never completely disappear. Treatments can improve their appearance. They can be disguised with make-up. So moral of the story is, do not lack acne scarring happen.Scars can be treated elegantly with 2 main modalities, RF Microneedles and C02 lasers for texture, and Lasers and peels for Colour.

RF microneedling is a sophisticated technique which uses insulate microneedles at varying depths, powered by RF energy. There are various brands in the market. I do not think the brand of machine is as important as the Physician who carries out the procedure. He has to balance the depth of needling with the level of energy and the number of shots to give you the patient, the best results. From my experience, in skilled hands, this treatment gives more effective results with less downtime than even the fractional C02 machine.

The Fractional CO2 Laser technology is a skin resurfacing treatment that tightens open pores, reduces wrinkles and fine lines, controls sebum production and improves the appearance of acne scars. It involves a laser beam that resurfaces the skin, destroying tissue a millimeter deep in microscopic spots. The “injury” triggers the self-healing mechanism of the skin, stimulating collagen and smoothing wrinkles.

It is effective for skin rejuvenation as it treats various skin problems such as skin laxity, fine lines, wrinkles, age spots, blotches and pigmentation, to unveil beautiful skin safely with minimal discomfort and micro-downtime.

Chemical Peels:

As mentioned, AHA and BHA work well for acne. They act to kill the P acne bacteria, exfoliate dead skin and control oil.

So my recommendation for chemical peels are the following:

Glycolic acid
Salicylic acid
Jessner -> TCA

Moving on, here is an example of the Black Gold Peel Laser, which works on the principle of targeting angry active acne…

carbon laser peel

This laser peel

Reduces oil gland activity, reduces bacterial inflammation, and promotes exfoliation, hence unclogging your pores to control your acne
It also serves to tighten and improve the appearance of your pores
And improves your skin texture, giving you a soft natural glow.

Common side effects include redness, mild bumps on the skin which are tolerable.

Another option is the Copper Bromide Laser. This targets both red and brown spots.

The non-ablative Brightening Laser uses an exclusive and versatile modified aesthetic device that gently corrects a range of skin problems. This unique Brightening Laser emits two shades of light: Yellow and Green, both of which have different functions. The combination of the two colours can penetrate more deeply and can be used together or separately, to help achieve a complexion that looks clearer, brighter, firmer and younger. In addition, the laser promotes re-growth of dull skin and reduces pigmentation and freckles for complete skin rejuvenation. This laser can also fade dark eye circles for a further brightened complexion.

It is effective in stimulating collagen production, the essential protein for giving your skin elasticity, that produces fast results in improving vascular lesions, pigmented lesions, melasma and acne, all in a painless treatment with no downtime.

adult acne

(here is an example of adult onset acne)

As a general rule of thumb I find that this laser, which serves to kill the P acne bacteria, shrink pores, and reduce oil production, is a good treatment to undergo. In addition, I would recommend the following coupled with a good skincare regime to get on top of your acne.Now acne can be classified into mild, moderate and severe. Below is a summary and their corresponding treatment.

Mild (comedonal acne or mild inflammatory acne): topicals retinoids +/- AHA, BHAs
Moderate: oral and topical antibiotics for inflamed acne, + benzoyl peroxide, +/- OCPs
Severe (nodular): please speak to your dermatologist

Many have asked me,

Why do some people get breakouts after a chemical peel or laser?

There are 3 main reasons.

Skin is too dry. Hence not suitable for treatment.
Skin is unstable, and having active breakouts. This can be due to a multitude of reasons. So any treatment during this period acts to purge pimples.
Skin is reacting to the skincare that was used after the treatment. Remember, it takes time to get used to a new product.

DR DANIEL CHANG