Acne can be incredibly frustrating, but rest assured you are not alone. Acne is one of the most common skin conditions that affects more than 60 million Americans. It is a hormonal and inflammatory skin condition that is caused by a number of factors, including: overactive sebaceous oil glands, poor exfoliation of dead skin cells, and a buildup of bacteria. For many patients, acne can persist into adulthood and appear as deep, below-the-surface or cystic pimples. While acne is often treated with a combination of topical and oral medications, there are many patients with stubborn, chronic acne that become extremely disappointed with their lack of results. If you feel like you have tried the “run of the mill treatments” and nothing has worked, then light and energy treatments may be exactly what you are looking for.
Active breakouts are frustrating enough on their own, but they can often leave scars behind that are downright infuriating. Acne scars are formed when a breakout penetrates the skin deeply enough to damage the tissue underneath. The good news for your complexion is that these scars can frequently be treated with a variety of methods, many of which are tried-and-true treatment methods for all types of scars.
Different acne scars respond to treatments uniquely, so it's critical to schedule a consultation with a board certified dermatologist, to find out which type of acne scars you have, and which treatment plan is the best option for you.
To request a consultation, text message us, or contact Dr. Hooman Khorasani’s Manhattan office by phone at 212-230-3378.
Aerolase NeoClear uses advanced, 650-microsecond technology to destroy acne bacteria and reduce inflammation; thus treating current blemishes and preventing future ones from appearing. Its heat energy also initiates new collagen production which will reduce and improve the appearance of your acne scars. In addition to treating acne, Aerolase NeoClear targets hemoglobin to reduce redness, rosacea, and the appearance of veins. This device also targets melanin, which can help reduce PIH (post-inflammatory hyperpigmentation) which is the darkening of the skin that often occurs after an acne outbreak. Aerolase NeoClear can also treat sun damage, dark spots, and age spots. With just one treatment, you will receive multiple benefits. Aerolase NeoClear will leave your skin blemish-free, clear, and radiant. It will improve your skin’s texture, laxity, and overall appearance within as little as 30 minutes. Given its long wavelength at 1064nm, this device is also safe in darker skin types.
For stubborn acne, photodynamic light therapy (PDT) may be the key. It involves applying a topical medication to the skin, which is then activated by a special light that targets the acne-causing bacteria on your skin. This bacteria (Propionibacterium acnes, or P. acnes) is particularly sensitive to certain types of light. PDT also shrinks the oil glands in the skin, which results in less available “food” for the bacteria and hence less pore-clogging of the skin. PDT uses certain wavelengths of blue or red light, which kills P. acnes without causing damage to the skin. Candidates for PDT are patients with mild to moderate acne. This treatment method requires a series of treatments for optimal results. It is important to stay out of direct sunlight before and after this treatment.
Morpheus8 is a new subdermal adipose remodeling device (SARD) that fractionally remodels and contours the face and body. Penetrating deep into the skin and fat, this morphs the aging face or body into a more desired smooth and sleek appearance, for all skin tones. Morpheus8 has the ability to penetrate deeper into the skin than any other micro-needling device, going as deep as 4mm. Patient comfort is a major advantage of this device because of the sharper needles and tiny punctures it causes in the skin without tugging or pulling. M8 can be used for, but is not limited to treating wrinkles, acne scars, stretch marks, surgical scars and more.
Oral prescription medication is usually the first line of defense against acne (after over-the-counter solutions). Acne medication works in two ways: it reduces oil production and swelling, and it treats the bacterial infection. The treatment regimen depends on each person, so Dr. Khorasani will help determine the right course of treatment for you. For example, you may need to combine oral medication with topical medication. Oral prescriptions can take up to eight weeks to show results. In some cases, it can take months or even years for acne to completely clear up with this more traditional approach
Topical creams are often used in conjunction with oral prescriptions. The most common topical prescriptions include:
Both the Fraxel 1550 and DeepFX emit laser energy deep into the skin to stimulate controlled production of normal, healthy collagen. DeepFX is ablative, whearas Fraxel 1550 is considered non-ablative. Consequently, DeepFX removes more of the damaged skin with each laser blast,and therefore, the results of DeepFX are more significant than Fraxel 1550. However, the more powerful DeepFX treatment requires a longer downtime and may only be used in fair skinned individuals. Overall, resurfacing lasers are most appropriate for patients looking to dramatically improve scar texture and can tolerate some downtime. These lasers need to be used with caution in patients with a darker skin complexion.
Radio-Frequency (RF) microneedling is a safe, non-surgical aesthetic procedure that tightens the skin. This cutting-edge device combines two therapies into one treatment. The first, microneedling, involves the passage of tiny needles into the skin to cause controlled micro-injuries. The body is then stimulated to produce new collagen to heal these small wounds and consequently, improve the skin’s elasticity. The second component involves radiofrequency energy which is emitted by the small needles as they are inserted into the skin. This energy also stimulates the production of new collagen while simultaneously improving the blood supply to the area to fuel and sustain the production of new skin structures. This two-in-one device is best suited for patients who desire improvement in skin laxity or wrinkles, but it can also target acne scars.
Microneedling is a great option for acne scars in skin of color. It involves the insertion of tiny needles into the skin to break up scar tissue in a controlled manner. The body is then stimulated to replace this lost tissue with healthy, normal collagen. There is minimal risk of post-therapy hyperpigmentation (discoloration) that may be seen with other options, such as laser resurfacing.
Typically used for wrinkles and creases in the face, dermal fillers can also be used to treat acne scars. Dermal fillers come in a variety of different formulas and compositions, each of which is designed to correct a certain concern. Fillers act as "synthetic fat" that fill out areas affected by volume loss, or enhance areas that are deficient. This is a non-invasive way to contour and reshape areas of your face that have been affected by acne scars.
Bellafill is a long-lasting collagen filler that is FDA-approved for the treatment of acne scars. The injection of collagen filler results in instantaneous results with minimal downtime. Additionally, the microspheres in this filler stimulate your body's own collagen production to improve the scar's appearance long-term. Given the bovine collagen content of this product, all patients need an allergy skin test four weeks prior to the scheduled treatment.
Punch excision is a minor procedure that involves cutting the individual acne scars and repairing the wound with a single stitch. It is one of the most effective treatments for certain acne scars. That said, it does not help with surrounding skin discoloration. Punch excision may need to be combined with a resurfacing or microneedling treatment.
The Vbeam laser uses a specific wavelength of light to target the tiny blood vessels responsible for the red color that is seen in scars. This precise energy allows the laser to selectively reduce redness without damaging the surrounding skin. It's a highly effective method for treating scars with redness. It does not, however, improve scar texture or irregularity.
Aerolase NeoClear uses advanced, 650-microsecond technology to destroy acne bacteria and reduce inflammation; thus treating current blemishes and preventing future ones from appearing. Its heat energy also initiates new collagen production which will reduce and improve the appearance of your acne scars. In addition to treating acne, Aerolase NeoClear targets hemoglobin to reduce redness, rosacea, and the appearance of veins. This device also targets melanin, which can help reduce PIH (post-inflammatory hyperpigmentation) which is the darkening of the skin that often occurs after an acne outbreak. Aerolase NeoClear can also treat sun damage, dark spots, and age spots. With just one treatment, you will receive multiple benefits. Aerolase NeoClear will leave your skin blemish-free, clear, and radiant. It will improve your skin’s texture, laxity, and overall appearance within as little as 30 minutes. Given its long wavelength at 1064nm, this device is also safe in darker skin types.
If you have active acne breakouts and are looking for a drug-free alternative, or find that no other therapies are working for you, then NeoClear may be right for you. NeoClear is safe to use on all ages, skin types, and skin colors. The treatment can be performed on your face or on the body to target stubborn acne on the back or chest.
When dead skin cells and excess sebum (oil produced by your glands) gets blocked in your pores, P. acnes bacteria can begin to build up and cause inflammation. This leads to active acne blemishes. NeoClear delivers light energy that destroys the bacteria and reduces inflammation. In addition, the laser delivers heat energy to the sebaceous glands to reduce their size and suppress the amount of sebum or oil they produce. The heat energy also coagulates blood capillaries to reduce inflammation and redness. Lastly, a water-based laser energy targets deeper layers of the skin to heat up that layer and initiate collagen production to improve skin texture, reduce appearance of acne scars, and improve skin tightness.
The procedure is painless and does not require any anesthetic. The procedure can last anywhere from 10-30 minutes, depending on the severity of the acne and the area or areas being treated.
There is no downtime associated with NeoClear. You may notice some redness after the procedure, but that should subside within an hour. You should always make sure to wear sunscreen when outside, rain or shine, to reduce the possibility of sun damage.
The onset of wrinkle reduction varies according to the medication used. Jeuveau and Dysport boast the earliest visible changes, appearing within two to three days of treatment. Xeomin requires more time to assert its effects and may not be visible for five to six days. BOTOX, the original neuromodulator therapy, needs seven to ten days before the results may be appreciated.
Depending on the severity of the acne, you may require anywhere from 3-6 treatments. It is also recommended to continue the therapy 1-2 times a year to keep and maintain the results. In addition, additional treatments will continue to address signs of aging and sun damage, reducing redness, dark spots, and improving skin laxity.
If you have stubborn acne, PDT could be a great treatment for you. It is safe for all skin types and colors. However, if you are pregnant you are not eligible for PDT. In addition, you may not have taken Accutane six months before your procedure.
Expect to be in the office for an hour to 90 minutes. First, your face will be cleansed and a photosensitizing solution (Levulan Kerastick®) or cream (Metvixia® or Allumera™) will be applied to the skin. This medication will be left on for about an hour to be absorbed by the skin cells. Then, the blue light will be applied over the face for about 10-20 minutes. Protective eyewear will be supplied. After the procedure, sunscreen will be applied. You can expect your skin to be sensitive and for there to be a slight burning sensation.
There is downtime associated with PDT. Following the procedure, it is imperative that you stay out of the sun for the 48 hours, since further sunlight can impact the treatment reaction. You may experience some stinging or burning for the first few hours following the procedure, but that is expected. Your skin may be sensitive and pink for a few days to a week following the procedure. There is more downtime associated with PDT than NeoClear.
You should notice a reduction in existing blemishes and a reduction in future breakouts. You should also notice improvement in skin texture, pore size, redness, or dark spots. Results build on themselves as you get more treatments. You should notice significant results after three treatments, spaced three weeks apart.
Depending on the severity of your acne, you may need anywhere from 3-5 treatments, spaced three weeks apart. It is recommended that you continue this treatment every few years, especially if you see any new breakouts appearing to maintain and keep a blemish-free appearance.
Morpheus8 is a fractional skin treatment that stimulates collagen production of the underlying layers of the dermis. By targeting the deeper layers of the skin, the building blocks will reorganize themselves in a natural anti-aging process.
Morpheus8 can be used on any areas that can benefit from sub-dermal renewal. The most commonly treated areas include the lower face and neck. Areas of the face and body that exhibit wrinkles, discoloration or acne scarring are suitable for treatment.
Depending on your Morpheus8 treatment regime you can expect to have between 1-3 sessions.
Visible results can be seen within a few days, but typically after three weeks the most noticeable results appear. Improvements continue up to three months after treatment.
Fractionated RF energy is a scientifically proven method to reduce wrinkles and rebuild collagen and fat. It is minimally invasive, using a matrix of micro pins to renew deeper layers of the skin with almost no patient downtime.
Fractionated RF energy is a scientifically proven method to reduce wrinkles and rebuild collagen and fat. It is minimally invasive, using a matrix of micro pins to renew deeper layers of the skin with almost no patient downtime.The benefit of Morpheus8’s color blind technology is that it can be used on all skin types. The unique properties allow even darker tones to be treated.
RF energy heats the deep layers of the skin in a controlled way to revitalize the collagen. The treatment will improve skin complexion and texture for a more radiant and youthful appearance.
Yes, Morpheus8 can be used in the same treatment session, or a few days after other treatments.
Since patient downtime is minimal, makeup can be applied 1 to 2 days after the treatment. Patients should expect to see micro lesions a few days after treatment and slight redness for up to 1 week depending on treatment parameters.
Patients should moisturize the treatment area and avoid direct sun exposure. It is also recommended that patients use a good, broad spectrum sunscreen every day. In addition to reducing their future risk of skin cancer, sunscreens also reduce wrinkles and slow the aging process.
The previous dogma was to allow six months for recovery before treating a scar. New research has demonstrated that earlier intervention of treating a scar is much more beneficial than waiting for an unknown outcome. We now know that infant scars are significantly more amenable to change than older scars. Therefore, in cosmetically sensitive areas, we recommend that if possible, you start your scar treatment as early as six weeks after the initial event that caused the defect.
This depends on the type and severity of your scar, your skin color and the timing of intervention. A few examples are given below as a general guide:
The procedure experience varies according to each scar revision therapy. Patients undergoing laser resurfacing or microneedling treatments will be numbed prior to the procedure with a topical anesthetic cream. Laser resurfacing procedures may be associated with a warm or stinging sensation during treatment. Vbeam treatments have been compared to feeling as though someone is lightly snapping a rubber band against your skin. During a microneedling treatment, you may feel pressure-like sensations as the tiny needles target the scar tissue.
Dermabrasion and surgical revisions require the injection of a local numbing medication to anesthetize the area prior to treatment. During these procedures, you will not feel any pain; however, you may experience some pressure.
Both semi-permanent filler injections (Bellafill) and triamcinolone and 5-FU injections do not require any numbing beforehand, as you will only feel a tiny prick as the needle is inserted. Please note that prior to receiving treatment with semi-permanent filler injections (Bellafill) you will receive a special skin test to ensure you are not allergic to any of the filler’s contents. We then evaluate the skin test site at your next appointment to ensure there is no reaction to the medication. This measure to ensure your safety means that, unfortunately, we are unable to both test and treat you on the same day.
Other than safety, your comfort is our number one priority. If at any time during your procedure you are experiencing discomfort, please inform Dr. Khorasani and he will provide you with additional measures to ensure your comfort. These include our in-office Pro-Nox system which employs nitrous oxide (“laughing gas”) to reduce anxiety and the experience of pain. Pro-Nox can be self administered by you as needed to address any discomfort.
After completing a year long research fellowship in scar management, Dr. Khorasani has spent the majority of his career cultivating expertise in improving the appearance of all scar types. Scar revision therapy is a staple of his practice and he is proud to have helped thousands of patients overcome their scars and, consequently, reinfuse their lives with self-confidence. His knowledge of scars extends beyond the revision stage, as his position as a dermatologic and cosmetic surgeon requires advanced technical proficiency to minimize scar formation following a procedure. Eager to mentor other health professionals so that they too can help patients, Dr. Khorasani has also published multiple studies evaluating scar composition, prevention, and management. This comprehensive and detailed understanding of the scar lifecycle allows Dr. Khorasani to provide you with cutting-edge, personalized therapy that maximizes scar correction.
You are unique and so is your scar. As such, we will work with your particular scar, skin type, health profile, and lifestyle constraints to find a treatment plan that is optimized to help you achieve your personal aesthetic goals. From the moment you contact our office, you are a priority. Dr. Khorasani and his staff are there for you at all times to ensure all your questions are answered and needs are met. We look forward to working with you as a team to transform your goals into reality.
Scars often leave physical and emotional marks on a person, which may significantly impact their self-esteem. Helping patients eliminate this physical reminder of personal trauma is, therefore, one of Dr. Khorasani’s passions, as the benefits of this procedure extend far beyond the improved cosmetic appearance. No matter the size, location, or type of scar you suffer from, Dr. Khorasani will be able to suggest a treatment plan that is tailored to your specific needs. Rest assured that this recommendation capitalizes on Dr. Khroasani’s decade-long experience revising scars and has been hand-picked for you to provide the best possible outcome.
The best candidates for scar revision treatments are those with completely healed scars who are not currently sunburned or tan. Although smoking does not preclude you from receiving treatment, we strongly advise against smoking in the period surrounding your treatment in order to ensure the optimal healing and outcome. Patients with active acne or other on-going active skin problems in the scar area are not candidates for scar revision therapy. Patients on oral tretinoins such as Accutane should wait six months after discontinuation of these medications before starting scar treatments.
Dr. Hooman Khorasani is quadruple board-certified in Dermatology, Cosmetic Surgery, Facial Cosmetic Surgery and Mohs Micrographic Surgery. He is the former Chief of Dermatologic and Cosmetic Surgery at Mount Sinai and for over a decade has helped many patients achieve clear skin with these therapies.
He has access to the most advanced information and tools on the market. You can trust that he is consistently implementing the most effective and research-proven techniques in his practice. He often works with you to create a tailored treatment plan, not only to combat your acne concerns but to ensure that afterwards you will continue to have healthy and clear, vibrant skin.
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 212-230-3378. For more information about how to get in touch:
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