Acne Scar Treatment - Improving Skin Rather than Removing it HD

A young lady asked for an opinion on fractional CO2 laser versus a Baker-Gordon peel to treat acne scars. New York-based Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon Dr. Amiya Prasad offers a different perspective on this based on improving skin quality, rather than peeling or resurfacing skin layers. Acne-scarred skin has lost skin volume, resulting in small depressions. These are not just depressions, but also scar tissue underneath. One acne scar procedure is called subcision where a special type of blade is placed under the acne scar, and release it because it’s not inflammation that causes scarring. It is the depression or loss of volume in the dermis, with a band of scar tissue underneath. The purpose of lasers or peels is to make adjacent skin more even with the deeper skin in terms of the relative depth of the acne scar. In other words, it creates less contrast between healthy, normal skin and acne skin. Dr. Prasad has seen patients who had peels and lasers in the past, especially after multiple, aggressive procedures were done, (not fractionated limited procedures) that resulted in skin becoming thinner. They effectively sacrificed good skin to match the depth and continuity of scarred skin. Dr. Prasad explains that perfectly smooth skin is not realistic after this type of acne scarring, but attention can be drawn away from the scarred areas. He uses platelet-rich plasma (PRP) in combination with hyaluronic acid fillers to try to build up the skin under the scar, and to soften that transition, but instead of an ablative method we add volume. This is a new concept of regenerative medicine. Fillers have always been around to help people with acne scars, but he found many patients with this chronic problem bounce from doctor to doctor for lasers, and fillers, but in frustration they keeping looking for one new solution after another. He explains that treatment should be based on a strategic plan for the best long-term results. Dr. Prasad uses PRP or platelet-rich plasma derived from the patient’s own blood to soften the scars, improve the quality of skin, with a combination of a hyaluronic acid filler to plump up the skin. There are clinical studies for wound healing showing the synergistic and long-term improvement based on more permanent fibro-vascular ingrowth, which means new tissue grows in places where the hyaluronic acid filler disappears. While patients are treated on a case-by-case basis, Dr. Prasad advises against aggressive deep peeling at a younger age, and instead focuses on regenerating and rejuvenating the quality of the skin. Acne scars can’t be completely eliminated, but the overall skin quality can be improved over a period of time with the right treatments, without the trauma and long-term loss of very young skin. For more information on platelet-rich plasma (PRP) treatment, please go to: http://prasadcosmeticsurgery.com/dr-amiya-prasad-injectables-nyc-n