Acne scar laser treatment
Acne scar laser treatment : For effective and lasting acne treatment, it’s essential to understand the causes, types of acne, and targeted treatment approaches. This is because each skin type and type of blockage requires different key ingredients and care.
The Pathogenesis of Acne
Acne is not caused solely by dirt, but by four main factors working together:
Hyperkeratinization: Abnormal skin cell shedding in the hair follicles, leading to the accumulation and blockage of dead skin cells.
Excess Sebum Production: The sebaceous glands produce excessive oil (often stimulated by androgen hormones).
C. acnes Colonization: The growth of Cutibacterium acnes bacteria, which feed on oil.
Inflammation: The body sends white blood cells to fight the bacteria, causing inflammation, swelling, redness, and pus formation.
Classification of Acne for Treatment
We can divide acne into two main groups to choose the correct treatment method:
• Non-Inflammatory Acne (Comedones)
Closed Comedones: Whiteheads (closed comedones) where the skin covers the affected area, appearing as a white bump.
Open Comedones: Blackheads (open comedones) where oil and skin cells react with oxygen in the air (oxidation), turning them black.
• Inflammatory Acne
Papule (Red bump): A small, slightly painful red bump without pus.
Pustule (Pus-filled bump): A red bump with a white/yellow pus head in the center.
Nodule (Deep inflamed acne lump): A large, painful red lump under the skin without a head.
Cyst (Large cyst under the skin): A large cyst containing pus and blood, with the highest risk of causing acne scarring.
What are the medical treatment options for acne?
• Topical Treatments
Suitable for mild to moderate acne.
• Oral medication (Systemic Treatments)
Suitable for moderate to severe acne or chronic acne.
Clinical Procedures to Supplement Treatment:
• Acne Extraction: Suitable for open comedones (blackheads) to accelerate healing (must be done correctly to prevent further inflammation).
• Intralesional Corticosteroid Injection: Injecting low-concentration steroids into large, inflamed acne nodules/cysts to quickly reduce inflammation and minimize scarring.
• Chemical Peeling: Exfoliating the skin with medical-grade acids (e.g., GA, Salicylic Acid) to reduce blockages and acne marks.
• Laser & Light Therapies:
Blue Light: Helps kill C. acnes bacteria.
V-Beam / Pulsed Dye Laser: Reduces redness from acne and dilated capillaries.
Fractional Laser / Picosecond Laser: Used to treat acne scars and pitted scars after acne has healed.
Light and laser technologies for treating acne, acne scars, and acne pits.
A detailed look at the three technology groups is as follows:
1. Blue Light Therapy
This uses light with a specific wavelength range of 405–420 nanometers (nm), which is not a laser and does not contain UV radiation, therefore it does not harm the skin.
Mechanism of Action: The bacteria C. acnes, which causes acne, naturally produces a substance called porphyrins. When blue light shines on these porphyrins, a chemical reaction occurs that produces singlet oxygen (free radicals). These free radicals directly destroy the cells of the C. acnes bacteria, causing them to die. This results in faster reduction of inflamed acne and reduces the occurrence of new acne.
Suitable for: Early to moderate inflamed acne (papules and pustules), skin resistant to topical antibiotics, or those who wish to avoid oral antibiotics.
Sensation during treatment: Painless, with only a warm sensation on the face similar to a mild sunbath.
Frequency: Typically done 1-2 times per week for 4-8 weeks for noticeable results.
2. V-Beam / Pulsed Dye Laser (PDL)
V-Beam is the trade name of a pulsed dye laser (PDL) that uses a wavelength of 595 nanometers (nm), which is a wavelength that is most specific to oxyhemoglobin in blood vessels.
Mechanism of action: The laser emits energy beneath the skin. The light energy is absorbed by red blood cells in the dilated capillaries (caused by acne inflammation). The light energy is rapidly converted into heat, causing those capillaries to constrict and reducing redness (Selective Photothermolysis). In addition, the heat generated stimulates the production of new collagen around the affected area and helps reduce the number of acne bacteria to some extent.
Suitable for:
Post-Inflammatory Erythema (PIE) that is slow to heal with topical medications.
Severe inflammatory acne (helps reduce redness; the heat waves help inflamed acne subside more quickly).
Key technology: Features a DCD (Dynamic Cooling Device) system that emits cool air a fraction of a second before the laser beam. To protect the upper layer of skin (epidermis) from burning and to reduce pain.
Sensation and results after treatment: You will feel a warm, stinging sensation, like a light rubber band snapping. After treatment, the skin may be slightly red for about 1-4 hours, then it will disappear. In some cases, if high energy is used to clear very dark capillaries, bruising (purpura) may occur, which will fade on its own in 7-10 days.
3. Fractional Laser & Picosecond Laser (Treatment for Scars and Acne Pits)
When acne clears, it often leaves behind “acne pits” (Atrophic Scars), which are caused by fibrosis under the skin pulling the skin down into indentations. Topical medications are ineffective against these scars. Therefore, lasers in this group are needed to reorganize and regenerate the skin.
A. Fractional Laser
The most popular technologies are Fractional CO2 (10,600 nm) and Erbium:YAG (2,940 nm).
Mechanism of action: The laser doesn’t peel away the entire skin layer, but divides the beam into thousands of tiny micron-sized points, penetrating deep into the dermis. This creates microscopic thermal zones (MTZs) that intentionally destroy old fibrosis and stimulate the skin to produce new collagen to fill in the pits. Healthy skin remains around the treated area, resulting in very rapid healing (shorter downtime).
Post-treatment results (Downtime): The skin will develop small, square scabs. The area will be brown all over, and the face will be red and rough for about 5-7 days. Do not pick at the scabs; let them fall off naturally.
Pre-Treatment Care Before Laser Treatment
• The goal is to “calm and strengthen the skin” to prevent photosensitivity and reduce the risk of burns.
• 1-2 weeks before treatment:
Avoid strong sunlight (Sun Avoidation): Avoid outdoor activities such as going to the beach, golfing, or swimming, as sunburned skin has a high level of melanin activity, making it more susceptible to laser burns.
• Avoid exfoliating skincare products and acne medications:
Acids: AHA, BHA, PHA, Glycolic Acid, Salicylic Acid
Vitamin A derivatives: Retinol, Tretinoin, Adapalene (Differin)
Reason: These substances thin the upper layer of the skin and temporarily make it more sensitive to light.
• Avoid scrubbing or exfoliating: Do not use clay masks, peel-off masks, or harsh facial cleansing devices. LANNA
How to Care for Your Skin After Laser Treatment
❌ 3 Things to Avoid (During the First Week)
1. Do not pick at scabs: Let the scabs or broken capillaries fall off naturally (picking at them risks darkening of the skin and scarring).
2. Do not use whitening skincare products/acne medication: Avoid Retinol, Vitamin C, AHA, BHA, and all acne creams until the redness subsides.
3. Avoid extreme heat: Avoid saunas, strenuous exercise, and sitting in front of a grill/hot pot for 3-5 days.
4 Things you must do (Follow these for faster healing):
1. Hydrate frequently: Apply a gentle moisturizer (emphasizing Ceramide, Hyaluronic Acid, and Cica) to accelerate skin healing.
2. Apply sunscreen daily: Use SPF 50+ with a thickness of two fingertips and avoid strong sunlight for at least 1-2 weeks.
3. Gently pat your face dry: When washing or wiping your face, use a “patting” motion; do not rub or wipe vigorously.
4. Drink plenty of water: Drinking lots of clean water helps skin cells regenerate and produce collagen more effectively.
