Acne vulgaris (commonly known as Pimples or zits) is one of the commonest skin disorders in humans, especially affecting the younger age group. Severe and later stages of acne can lead to disastrous scarring causing severe emotional distress and reduced self esteem. Similarly, a close relative of acne, which is called Rosacea, can also lead to scarring or swelling and thickening of different regions of the face, more importantly the nose, leading to what is called a 'Potato nose/Rhinophyma', and deform the face.

However, modern laser science has now made it possible to reverse the damage to a significant extent, and give back life to the skin and confidence to the patient.

Acne Scars occur as a result of fibrosis of the skin tissue as it heals after pimples subside. At first, the skin that is produced by the body at the site of damaged area looks and functions differently from the rest of the body's skin. However, with time, the body tends to replace it with skin that more closely matches the rest of the skin of the body. Fading of scars depends on certain factors that include size, type of scar, depth of the scar and other personal factors as age and genetics etc.

However, modern laser science has now made it possible to reverse the damage to a significant extent, and give back life to the skin and confidence to the patient.

Types of scar include:

1. Hypertrophic scar
2. Atrophic scar
3. Rolling scar
4. Box scars
5. Ice pick scars
6. Keloidal scars

Scars in addition may or may not be hyper or hypo pigmented. They may have associated broken capillaries in them, and may or may not be associated with deformity or disfigurement of the surrounding tissue, etc.

1. Laser treatment options include the use of non ablative or ablative lasers.

The non-ablative laser delivers heat deep into the skin to cause changes in dermal collagen and thus remodel the scar.It is suitable for the milder variety of superficial scars. Ablation laser treatment is the best option for deeper scars and it involves destructing the architecture of the epidermis up to a particular level and causing dermal collagen remodelling, together they cause much better improvement in the scar appearance.

2. Fractional radiofrequency techniques:

Maybe used in combination with the above for added benefit.

3. Dermarollers for shallow scars
4. Cryorollers for shallow scars
5. Chemical peels for shallow scars
6. Microdermabrasion for very minor scars
7. Scar revision surgery – not very much in use due to availabiility of lasers

Laser Skin Resurfacing helps in eliminating layers of skin one by one with accuracy. Heat and light of measured intensity are delivered into the desired deeper layers of the skin to regenerate fresh collagen and refill depressed scars. As it eliminates the dead and damaged layers of the skin, this technique also helps to eliminate pigment and thus lightens scars simultaneously.

There are ablative and non ablative types of fractional lasers. However, in the opinion of most pioneers in Laser Dermatology, Laser skin resurfacing for this indication is best done by the Ablative Fractional Carbon dioxide laser treatment, and is now considered the gold standard world over.

Treatment depends on type of scar.

1. Atrophic scars also known as depressed scars commonly found after acne heals, usually improve significantly with laser skin resurfacing with or without injectable fillers.
2. Ice pick scars, post acne are very deep and may require a procedure called subscision to break the under scar fibrous bands, before they can be lasered away.

At The Esthetic Clinic, Non-surgical laser scar treatments include fractional lasers, most preferred being the ablative fractional carbon dioxide laser, that deliver light in an array of high precision micro beams. These micro beams create narrow, deep columns of tissue coagulation, penetrating well below the epidermis and into the dermis, while sparing the tissue surrounding the columns from damage.The heat stimulates new collagen formation and gradual resurfacing of the scars happens over time.

This is an outpatient procedure and usually only topical anaesthesia is required. There could be some pricking sensation during treatment with the laser. A typical full face session needs about 30-40 minutes.following this ice packs may be given to you for soothing the burning sensation. And you can then apply sunscreen and go home. Instructions for washing face, shaving, etc. will be given to you once the procedure us through.

Depending on the severity, number of treatments may vary from 4-6 sessions with at least a 6 weeks interval in between two sessions.

There could be some pricking sensation during treatment with the laser, though it is done under topical anaesthesia application.

Some burning sensation post laser for a day is usual, there could be mild redness, swelling post laser for a few days followed by darkening and peeling off of the skin in the treated area. Sun protection is mandatory during therapy.

Since the procedure is non-invasive, the patient will be discharged immediately after the pimple treatment and can go back to normal life with no hospitalization required.

However, follow up acne treatments are usually necessary at 2 month intervals along with topical anti scar medications prescribed specially from the clinic.Scars continue to improve over time even after the required number of sessions are over.

Is the treatment permanent?