Light Based Treatments
Treatments for Post-Acne Scarring
Acne is almost always treatable and early intervention is recommended to avoid the complication of scarring. An array of treatments exists, reflecting the diversity of acne and post-acne scarring conditions.
Acne is aesthetically unpleasant and embarrassing and may cause severe physiological distress. According to several studies, employment prospects can be decreased and interpersonal difficulties are common.
Acne is so common that it is often thought of as a normal stage in human development but with early treatment, subsequent scarring can be averted. Post-acne scarring is particularly devastating and often represents the failure of adequate and timely medical treatment.
The nature of post-acne scarring
Acne scarring is either a problem of excess tissue (hypertrophy) or of loss of tissue (atrophy). In addition, scars may be obvious because of their colour.
Scars with excess tissue are seen in people who are predisposed to this type of scarring. They are difficult to treat, and many different types of treatment may be necessary.
Scars that result in a loss of tissue are much more common. Post-acne scarring often involves the deeper structures, rather than the surface of the skin, leading to the appearance of indentations. These indentations may appear as depressed scars, or as sharp-walled 'ice-pick' scars. There may also be pigmentation changes in the skin. Hyperpigmentation (an increase in colour) is more common in olive-skinned patients, and will fade in 3-18 months if sun protected. New scars may also be red and will mature in time, losing their colour.
Treatments for post-acne scarring
A number of different procedures may be employed in the treatment of indented acne scarring. Laser resurfacing of the area is commonly performed; often in conjunction with other techniques such as fat transplantation, photodynamic therapy, blood transfer, punch grafting and skin rolling. If the scars are particularly indented or are in areas with a loss of tissue, subcision or Fraxel® laser treatment may be favoured.
Photodynamic Therapy (PDT)
This non-surgical, light-based treatment selectively destroys skin cancer and spares your healthy skin. It is also effective in the treatment of sunspots and certain types of acne.
Skin cancer affects half of the population in Australia at some point in their lifetime. This is largely due to our high exposure to sunlight and the harmful ultraviolet rays that it contains. The hot climate, coupled with our greater life expectancy, gives these dangerous rays more time to inflict damage.
PDT is effective for some of the less severe skin cancers and has a lower risk of scarring compared with surgery.
In the treatment of acne, non-UV light treatments like PDT are good alternatives for patients who either can't or won't use Isotretinoin due to its potential side effects. Light treatments are also a viable alternative for those whose acne hasn't responded to Isotretinoin.
They are perfect for those with long-term milder acne that is failing to respond to other remedies such as topical treatments. Light treatment is also ideal for those who demand a 'natural' treatment with a low incidence of adverse side effects.
Who is most at risk of skin cancer?
Skin cancers tend to arise after the age of 40 but are often not seen until people are in their 60s and 70s. Despite being more common among older people, skin cancer may arise at any age.
The procedure
PDT is not a complicated procedure and usually requires just a few treatments over the course of a few weeks.
The treatment consists of applying a special photosensitising cream to the skin cancer and, approximately 3-6 hours later, shining a pure red light (or green, yellow or blue light, depending on the specific treatment) upon the area to be treated. The light interacts with the cream and destroys the cancerous cells.
After treatment, a special dressing is applied to the area and you will be allowed to go home.
The healing process
Photodynamic therapy does not appear to harm normal skin so the cosmetic outcome following this treatment is usually very good. The procedure has been given a health and safety seal of approval by the regulation authorities.
Scabbing. After the dressing has been removed, a crust may form. Healing takes place beneath this crust, so it must be left to fall off on its own accord. After 24-36 hours you may wash, bathe or shower as normal. Do NOT rub the treated area, rather, gently dab it dry. Healing is rapid and the final quality of the healing and the eventual cosmetic result is very good.
Non-Ablative Skin Rejuvenation
A non-surgical alternative suited to those who wish to improve the quality of their skin without having to take time away from their daily activities
The procedure
To reduce any potential for pain, anaesthetic cream is applied to the area 30 minutes prior to the procedure. Two lasers that interact with blood vessels and brown spots are used. First, the area is treated with a fine light beam to specifically target individual spots by interacting with their colour. The area is then treated with a broader beam at the same wavelength, which is used to target future spots or vessels that may not be visible. It is also able to treat more widespread flushing, redness or blotchy pigmentation. Finally, a penetrating beam is used to target deeper blood vessels and hair follicles by transmitting heat to the dermis, which is the second layer of the skin. This induces new collagen formation and therefore improves the general texture of the skin. New collagen formation is not scientifically proven but there have been modest improvements noted with this form of technology in such problems as minor wrinkling and sun damage.
A number of treatments, generally 3-5 are required at four-week intervals to obtain optimal results. The treatment gives a gradual, rather than sudden, improvement in the appearance of the skin.
The healing
Ice is applied after the treatment to limit swelling and further application of this at home is suggested. Sleeping in a more upright position than usual is also helpful to alleviate the swelling.