Fractional CO2 Laser Resurfacing For Acne Scars

First, why should a Doctor do the laser procedure and not a technician? Each skin has its own shade of color. The intensity of laser and the depth of the intensity must be calibrated by a trained physician and not a technician. Severe burn and unrecoverable skin damage might ensue if the laser intensity is not calibrated correctly for the right color of skin. For both Acne and Wrinkle Scars removal, Dr. Behnam charges as low as $495 (partial facial) for first session. Partial facial areas are forehead, templates, cheeks and chin.

CO2 laser skin resurfacing treatment is able to reduce the appearance of acne scars by removing damaged skin layer by layer. It turns back the clock on your complexion and reveals the more youthful looking skin that lies underneath.

Benefits include not only the effective correction of moderate to deep lines, acne scars, and wrinkles, but also treatment for uneven pigmentation, photo damage, and a host of other skin imperfections.

 

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Safe, and simple, this procedure offers excellent results in approximately twenty to forty minutes. CO2 laser treatment has many benefits. It can rejuvenate skin that has been damaged by the sun, and create an even skin tone by minimizing discolorations. This brief procedure is done as an outpatient procedure and requires only local anesthesia.

Patients who undergo the procedure are allowed to return home after. The procedure itself involves placing carefully guided pulses of light on the skin to vaporize the top layer to a specific depth, revealing clear, healthy skin beneath. Patients are given a soothing ointment that alleviates the discomfort while sealing out air until the skin is completely healed.

There are many benefits to this treatment. Patients typically appreciate the ease with which the procedure works to even out skin and skin tone on both face and neck skin. Healing after the procedure is very rapid and requires only minimal care, with all redness subsiding within a week. Perhaps one of the biggest benefits for patients, however, is that goals can usually be achieved with only one to two treatments.

Meet The Doctor: Dr. Behnam is a Fractional CO2 Laser Specialist. He specializes in laser resurfacing of the face and has been featured on ABC7 and The Doctors Show performing the procedure. Please look below for pictures, videos and testimonials.

 

Acne Scar: 5 months post 1 session of Fractional CO2 laser resurfacing for acne scar (Dr. Behnam)

Fractional CO2 laser for Acne Scar

FAQ

Does my skin color matter for fractional CO2 laser resurfacing?

Yes. Skin color and skin tone do matter. Patients that have darker skin tone, such as Middle Eastern, Hispanics, and Asians have a higher risk of pigmentation at areas of laser resurfacing compare to white skin individuals. Thus, one must be very careful to use the appropriate setting on them in order to prevent unwanted side effects. Dr. Behnam is board certified dermatologist and about 80% of his patients are of Hispanic and Asian origin. Dr. Behnam specializes in treating acne scar in patients of darker skin tones.

What are Dr. Behnam’s credentials in treating acne scars?

Dr. Ben Behnam is a board certified dermatologist recognized nationally by Newsweek as one of the top 10 Physicians and Surgeons in the US, with appearances on The Doctors Show, FOX Good Day LA and ABC News. Dr. Behnam has appeared on ABC news and The Doctors show performing this exact laser, the CO2 fractional laser. Thus he is recognized as an industry leader and expert in the field in the treatment of Fractional CO2 laser resurfacing.

How much improvement would I see with one session?

Typically 25-50% improvement is seen after one session. In darker skin individuals, the improvements are typically around the 25% whereas in lighter individuals the improvement is more near the 50%. However everyone reacts differently to the laser.

What is a typical day in the day of Laser Resurfacing for acne scars?

1. Patient arrive 1 hour and 15 minutes prior to the procedure
2. You are taken to our laser room with windows overlooking beautiful Santa Monica
3. Face is washed
4. Potent topical numbing is applied for 75 minutes
5. Patient takes a vicon pill or gets a shot of demeral
6. After 1:15 of topical numbing, the numbing cream is removed, face washed with alcohol, then dried and the patient is ready for the laser procedure.
7. The laser procedure takes 20 to 30 minutes
8. During the procedure, a chiller is used to cool down the face and make the procedure even more comfortable.
9. The patient is then cooled down with wet towels
10. Topical Aquaphor moisturizer is applied to face and the patient goes home.
11. Patient is given Dr. Behnam’s personal cell phone number to call if there are any problems.
12. Patient returns to clinic in one week for follow up

CO2 Laser Resurfacing Tips:

1. Wear a lot of sunscreen 2 to 4 weeks prior to the procedure
2. You should not be tanned the day of the procedure.
3. If you are on oral Doxycyclin antibiotics, you must switch to one that is not as photosensitizing
4. Must use Hydroquinone 4% bleaching cream 2 to 4 weeks prior to procedure (Darker skin individuals)
5. Use non-hydroquinone bleaching cream after the procedure (Darker skin individuals)

Types of Acne Scars

Many different forms of acne scars exist. There are both depressed and raised acne scars. Depressed acne scars can be in the shape of rolling scars, icepick scars or boxcar scars. Most patients have more than one form of acne scars on their face. The reason why we differentiate between the various forms is because some treatment methods work better on some scars than others. Unfortunately, some practitioners use laser as the go-to treatment for all forms of acne scars, but this method will not lead to the best results.

Rolling Scars:

Definition of rolling scars: During acne scar formation, fibrous tissue develops under the skin. These fibrous tissues pull down the skin at various levels, thus creating a wavy appearance of the skin, known as rolling scars. Typically the most common area of rolling scars appear on the cheek.

Treatment options for rolling scars: There are two treatment options that work for rolling scars and sometimes these two are combined together. Fractional CO2 laser resurfacing is the gold standard for treatment of rolling scars. Depending upon the severity, multiple sessions may be required. Fractional stimulation stimulates collagen production, thus improving the appearance of acne scars. In addition, subcision is also another very good potential treatment option for rolling acne scars. Subcision is minor in-office surgery procedure that is performed by threading a sharp needle under the skin. The act of threading the needle will cut off the various fibrous tissues pulling down the skin surface, thus helping to raise the skin at that level and help its appearance. Multiple sessions of the subcision may be required. There is also a method known as saline injections. Saline injection, which is technically a form of subcision, is the act of using bacteriostatic saline and injecting it into the acne scar, within the dermis. When injecting into the skin, the pressure will stretch out the fibrous tissue and loosening them up. Several sessions are required, typically 4 to 6, but the results may be impressive for such a simple technique. Saline injection work best for rolling scars.

Boxcar Scars:

Definition of boxcar scars: A boxcar scar is one that has sharp drop-off edges, kind of like a cliff. The diameter of a boxcar scar is bout 3-5mm. They may be shallow or deep. They can happen anywhere on the face but are very common on the temples. Clinically, they deep ones mimic chickenpox scars.

Treatment options for boxcar scars: Just like rolling scars, boxcar scars may be treated with both fractional CO2 laser resurfacing and subcision. The reason why subcision will work in this case is because it will cut the fibrous tissue that is bounding don the base of the boxcar scar. Fractional CO2 works by drilling tiny columns in the skin to stimulate collagen production, thus filling in the scar over time. Again, multiple sessions of both subcision and fractional CO2 laser resurfacing may be required to achieve satisfactory results. Chemical peels, like Jesner’s or TCA peels may also help stimulate collagen production and smooth out the acne scar. For a quick fix, the individual depressed boxcar scars may also be injected with a filler, like restylane or juvederm. The injections are made withing the skin to raise the tissue up to the same level at the surrounding skin. The results are very impressive. Dr. Behnam commonly does this a week or two before the Oscars or Emmy’s and his patients absolutely love the result. For deep boxcar scars, punch excision is used to remove the scar. Basically, the area is numbed, the scar excised out, and then sutured up. The area will heal with a linear scar. The final result typically looks better than the original depressed scar.

Icepick scars:

Definition of icepick scars: Icepick scars are ones that look as if one took an icepick and jammed it into the skin. Clinically, they have a cone-like shape, with a wider opening and a narrow depth portion, typically only 1-2mm wide. They can go deep into the skin. These are one of the toughest acne scars to treat. These type of scars can appear anywhere n the skin.

Treatment options for icepick scars: The gold standard in the treatment of icepick scars is the TCA CROSS Technique. TCA CROSS is a method where high concentrated TCA Chemical peel is applied deep into the scar and the area frosts up. Typically TCA 80%, 90% or 100% is used. The TCA chemical peel will induce collagen stimulation in the icepick scar. The patient returns in 1 month and the procedure is repeated again. About 2 to 3 sessions are required to see good improvemenet. TCA CROSS technique may be used in all skin colors, but darker skin individuas need to use a bleaching cream hydroquionone 4% cream after the procedure. There is always a risk if pigmentation in darker skin individuals. In addition, Fractional CO2 laser resurfacing will aslo help with icepick scars .Typically, typically the two procedure, TCA CROSS and Frational CO@ laser, combined togethere (not on the same day) will yield satisfactory results in patietns with icepick scars. Unfortunately, unlike boxcar scars, fillers like restylane and juvederms dont work very well in icepick scars.

Hypertrophic Scars

Definition of hypertrophic scars: Hypertrophic acne scars are raised, thick, and hard tissue proliferation at the area where acne existed on the face. These type of scars typically occur on two area, along the jawline and on the chest. African Americans are more prone to these types of scars, but they can technically occur in anyone and anywhere on teh face and trunk. Hypertrophic scars can sometimes be painful and red.

Treatment for hypertrophic scars: The standard of therapy for hypertrophic scars is Kenalog injections. Typically 2.5/cc is used, however higher concentration may be required. Kenalog injetions will reduce the scar, however it will take many sessions. If the scar is red, lasers can be used to reduce the redness. In these instances, kenalog injection combined with the V-BEAM laser will be effective.