Washington Square Dermatology is a leader in the treatment of acne and acne scarring. Our providers skillfully utilize a wide range of procedures and treatments to help you improve your acne scarring. Dr. Jaber, Dr. Park and Susanna Franks PA-C have the expertise and experience to tailor a custom treatment plan to improve your acne scarring and help you achieve the beautiful skin of your dreams!
Almost everyone will struggle with acne at some point in their life. Sadly, when acne is not treated promptly, acne scarring may develop. Acne scarring, which can occur in 10% of patients struggling with acne, is an unfortunate complication of acne and for many is a painful reminder of previous acne. Acne scars can be emotionally and psychologically distressing and acne scarring has been linked to poor self esteem, depression, anxiety, altered social interactions and body image issues.
At Washington Square Dermatology, acne scarring treatments are one of the most popular cosmetic treatments that we provide. Different skin types and different types of acne scars may require a combination treatment approach. At Washington Square Dermatology, we are fortunate to offer the full range of available acne scarring treatments to precisely target your type of scarring for your skin tone.
We LOVE seeing the huge impact we make in our patients’ confidence as their acne scars improve!
Acne scars are caused by cystic, inflammatory acne. Unfortunately even mild breakouts can result in scarring.
Shallow acne scars can sometimes improve with time but unfortunately deeper acne scars are unlikely to improve without treatment and OTC products are generally not strong enough to make a substantial difference.
At Washington Square Dermatology we understand that even mild acne scarring can affect confidence, self esteem and make you less likely to go out with family and friends. Studies have shown that severe acne scarring can result in anxiety, depression and even affect your work success. Fortunately there are treatments that can improve your scarring!
Absolutely! Treating acne scars is one of our favorite and most popular treatments!
Of course! We have a lot of experience in treating all types of acne scars in patients of all skin types.
Acne scars occur when there is excessive inflammation in your skin as it tries to heal from acne. This inflammation damages collagen which leads to permanent changes in skin texture and scarring.
Image Credit: Clark, A.K., Saric, S. & Sivamani, R.K. Acne Scars: How Do We Grade Them?. Am J Clin Dermatol 19, 139–144 (2018).
Some people have a higher genetic predisposition to scarring. If you have other family members with acne scarring, you have a higher risk of acne scarring. The depth of inflammation and severity of acne impacts acne scarring.
If you have deeper inflammation with larger cystic breakouts, you are more likely to develop acne scars over someone that develops small blackheads and whiteheads. Lastly, picking your skin and popping pimples can increase your risk of acne scarring.
There are two categories of acne scars: Atrophic and Hypertrophic acne scars.
The most common type of acne scarring is atrophic which is damage of skin tissue or loss of collagen. Atrophic scarring is much more common on the face. There are three main types of atrophic scarring: icepick, boxcar and rolling acne scars.
Hypertrophic scars or keloids are scars where the skin is thicker. In hypertrophic scars the scar is confined within the original skin injury. In a keloid, the scar extends past the original skin injury. This type of scarring is more common on the chest, back, and shoulders. Intralesional steroid injections are commonly performed to improve hypertrophic and keloid scarring.
Ice pick scars are narrow, deep scars that extend deep into the skin and look like a small hole in the skin. Ice pick scars are common on the cheeks.
Image Credit: Connolly, D, Vu, H.L., Mariwalla, K. & Saedi, N. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep; 10(9): 12–23.
Boxcar scars are oval or round depressions with steep almost vertical sides. They are wider than ice pick scars and give the skin an uneven pitted appearance.
Image Credit: Connolly, D, Vu, H.L., Mariwalla, K. & Saedi, N. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep; 10(9): 12–23.
Rolling scars make the skin look bumpy and uneven and look like wave like depressions in the skin. They differ from boxcar scars as they are not as sharply defined.
Image Credit: Connolly, D, Vu, H.L., Mariwalla, K. & Saedi, N. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep; 10(9): 12–23.
Discoloration that occurs after acne resolves is not a true scar; rather, it is post-inflammatory hyperpigmentation or post-inflammatory erythema.
Post-inflammatory hyperpigmentation is dark, brown, flat marks that occur after acne improves. Hyperpigmentation is much more common in patients of color. Unfortunately, post-inflammatory hyperpigmentation can be very long-lasting and difficult to treat.
Treatment options to accelerate improvement include meticulous sun protection combined with prescription skin-lightening creams, chemical peels, and laser treatments.
Post-inflammatory erythema are red, pink, flat spots that occur after acne improves. They are more common in people with lighter skin complexions. Post-inflammatory erythema usually goes away with patience and time, but the Excel V—KTP laser is an effective option if you are looking to accelerate the improvement.
You can learn more about Excel-V Laser Treatments here.
This wonderful patient had one Cosmelan treatment to treat her post-inflammatory hyperpigmentation from a previous acne breakout and she was ecstatic with her improvement.
Post-inflammatory erythema are red, pink flat spots that occur after acne improves. This is more common in those of lighter skin complexions. Post inflammatory erythema usually goes away with patience and time, but the Excel V- KTP laser is an effective option if you are looking to accelerate the improvement.
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Acne scars often require different treatments depending on the type of scarring and the skin type of the patient. Fortunately there
are many procedures and treatments that are effective to treat acne scars.
Microneedling is a minimally invasive procedure in which tiny needles penetrate the skin, stimulating new collagen production. This causes skin resurfacing and rejuvenation to create an overall smoother and more even skin texture. Microneedling is an extremely popular procedure in our office as it can be used for all skin types and, with multiple sessions, can have dramatic results with minimal downtime.
Radiofrequency microneedling amplifies the power of microneedling by adding radiofrequency energy. By adding Radiofrequency you are able to heat the deeper layers of skin, increasing the production of collagen and elastin, resulting in improvement in skin texture and acne scars.
We use the Secret RF system which utilizes medical grade gold plated needles which gently puncture the skin to deliver the optimal energy at varied depths to improve acne scars.
Learn more about RF Microneedling treatments in NYC here.
Fraxel laser is a powerful fractional, non-ablative laser that can significantly improve all types of acne scarring. The fractional technology creates microscopic laser columns in the skin. The laser treats a specific portion of the skin, leaving the surrounding skin intact and accelerating the healing process. Fraxel stimulates the body to heal the treated areas with new collagen and rejuvenate healthy skin.
For more information on Fraxel treatments at our NYC office, click here.
CO2 is the most powerful laser for treating acne scars. In our office, we use the C02RE, a fractional ablative CO2 laser that uses laser energy to penetrate the skin at both superficial and deep levels. This results in micro-injuries in the skin, stimulating skin healing and new collagen production, leading to new, healthy, resurfaced skin. CO2 works similarly to the Fraxel laser but is much more powerful.
Learn more about CO2 laser treatments in NYC.
TCA Cross is the chemical reconstruction of skin scars (CROSS) using trichloroacetic acid (TCA). This involves the precise application of a localized chemical TCA to a deep acne scar to create focused inflammation and increased collagen production. TCA Cross is particularly useful for deep icepick acne scars.
Subcision is a procedure where an instrument is use to subcise, or break apart, the adherent fibrous base of scar tissue pulling the upper layer of the skin downward. This technique releases skin tension formed by thick scars, freeing the upper layer of skin. Subcision can be combined with injection of a hyaluronic acid filler to stimulate additional collagen production.
Image Credit: Dadkhahfar, S, Robati, RM, Gheisari, M, Moravvej, H. Subcision: Indications, adverse reactions, and pearls. J Cosmet Dermatol. 2020; 19: 1029– 1038.
In our practice, subcision is performed with a blunt cannula, minimizing superficial skin trauma and subsequent downtime. Subcision is an essential treatment for acne scarring that we use for most of our acne scarring patients to ensure the best possible results.
Punch excision is a useful technique when treating very deep icepick or boxcar scars. The procedure removes the pitted scar with a punch tool, and then the skin is stitched back together. The goal of punch excision is to trade the deep pitted scar for a small straight line scar which is less noticeable and will fade over time.
Filler injections can be very effective for treating patients with atrophic acne scars, particularly rolling scars. Filler injections work by plumping up areas of scarring. This technique is performed by injecting filler directly underneath individual scars, which lifts and balances the skin.
Learn more about Filler treatments in NYC.
