Acne Scar Treatments Brisbane
Cutis Dermatology has the reputation as one of the world’s leading centres for scar revision. Our dermatologists are nationally and internationally recognized as experts in the field of scar revision, having treated over 8,000 patients over the past 15 years.
Understanding how dermatologists approach acne scars will give you a clear pathway to successfully removing scars. We tailor procedures based upon scar type, your skin colour and your recovery time. Read more to understand why our approach to acne scar treatment gives the best results.
With scar directed treatments, the team at Cutis Dermatology can remove 85% - 95% of your acne scars. Permanently.
Understanding Scar Types - The Most Important Step
An important concept to understand is how we match treatments according to your scar patterns. Each scar type has an optimal treatment algorithm and each patient has a unique scar signature.
Boxcar scars are well defined scars with sharp walls. Ice-pick scars are deep scars with the height exceeding the width. Rolling scars are undulating with a normal surface texture. Hypertrophic scars are raised.
Different scars have different treatments. In most cases even the most expensive and advanced lasers are not as good as manual methods including painting and punching. Finding the correct treatment for your set of scars will give you consistent results.
Targeted Acne Scar Treatments: Why one solution doesn't always work
Step 1. How to find out your scar type?
Book a FREE* consultation with the nurses at our Brisbane clinics to determine your best treatment options. They will identify your scar types and will provide a cost effective and effective solution.
Boxcar scars are best treated with TCA Paint, laser resurfacing and RF microneedling
Learn more (link to TCA CROSS under acne scars)
Ice pick scars are best treated with TCA Paint and CROSS
Learn more (link to TCA CROSS under acne scars)
Rolling scars can be treated with CO2 laser resurfacing.
Learn more (link to CO2 lasers under acne scars)
Red acne scars can be treated with vascular lasers.
Learn more (link to red acne scars under acne scars)
Why Cutis Dermatology?
Cutis Dermatology is home to Brisbane’s leading dermatologists and nurses who are experts in managing and treating all types of acne and acne scars. Our dermatologists are nationally and internationally recognized as experts in the field of scar revision, having treated over 8,000 patients over the past 15 years. We understand that your acne journey can be sensitive and personal, which is why we pride ourselves on working compassionately with all our patients.
Our publications are not in Vogue magazine, but in leading dermatology and plastic surgery journals. Skill sets, combined with the very latest in laser technology ensures that patients are receiving the best results possible.
How do experts approach scar revision, and how is this different from other clinics?
Dermatologists approach scar revision based upon the depth and type of scars. We carefully examine your skin under direct and angled lighting. We palpate the skin to understand issues like laxity and turgor. In some cases, we will ask you to animate to look for tethers and attachments.
Once examined, we formulate a treatment plan based upon examination. No two treatments are alike as each patient has a unique map.
What treatments are there for acne scars?
Our dermatologists and nurses perform revision based upon matching treatments to the scar type. These include:
Deep focal peels: TCA or Phenolic acid. This is known as CROSS or paint.
Laser resurfacing (full ablation): Erbium or CO2 lasers
Fractional lasers: MixTo, eCO2, CORE 2, Ultrapulse Deep Fx, Scar Fx, Fraxel
Subcision: Nokor, blunt cannula, hypodermic, Taylor, dove-tails
RF microneedling using the Genius RF or Lutronic Infini
Microneedling with Dermapen, SkinPen and dermarollers
Nano RF treatments; older eMatrix series
Surgical: Punch elevation, excision, grafting, dermal grafting, fat transfer, micropigment transfer
Micrografting for hypopigmented or white scars.
Pico lasers for dark scars or PIH
Vascular lasers for red scars or marks.
Surgical excision for linear and deep ice pick scars.
Steroid injections for raised scars.
What are the common scar types?
Knowing your scar types is the very first step to effective scar treatments. More on that below. Acne scars can be divided according to the depths.
Shallow scars include boxcar scars, pick, shallow pits, polymorphic and linear scars.
Deep scars include deep ice picks, rolling and larger volume atrophic.
The level of scarring will determine the next step, which is matching the scar type to the optimal treatment/s.
Scar typing can be complex, so if you need some help, book an appointment with our nurses or dermatologists.
How to match scar types to treatments?
This is where the magic happens. Providing you are accurate with scar typing, matching the most appropriate treatments will give you a predictable result (providing execution of the procedure is correct).
Ice pick scars can be treated with: Surgery, sharp subcision, TCA / Phenol or small spot lasers to the side walls.
Boxcar scars are treated with: TCA or phenol paint, lasers, RF microneedling or microneedling (not as good).
Polymorphic scars are treated with: TCA partial paint, fractional lasers, RF microneedling.
Saucer scars are treated with: subcision and or dermal fillers.
Deep rolling scars are treated with: surgical subcision or deep RF microneedling/ deep fractional ablative lasers.
Shallow picks and pits can be treated with lasers, RFM, microneedling and peels.
* If you are uncertain about scar types, book a no obligation consultation with our clinical nurses. Alternatively book a consultation with our dermatologists. A consultation fee applies if seen by a specialist.
What is RF microneedling and how is it different from microneedling?
RF stands for radiofrequency. This device emits pulse energy at the tip. Energy is transferred as heating, and heating stimulates proteins called HSP or heat shock protein. HSP accounts for the marked scar remodelling seen with RF treatments. Heat is not generated with normal microneedling.
Our dermatologists have experience with Infini, Intensif, Intracel, Secret, and Morpheus 8, however we are currently using the Genius RF as this has better power, insulation and tissue resistance monitoring capabilities compared to other systems.
RF microneedling is a good adjunctive treatment for rolling scars, though it can improve boxcar scars and shallow ice picks.
Learn more about acne scar treatments
Do we microneedle acne scars?
Yes, microneedling is useful for mild hypertrophic scars, especially when combined with anti-inflammatory medications. Microneedling can be a non-specific treatment for mild rolling and boxcar acne scars.
What is the best laser for acne scars?
CO2 lasers are best, that is why we have 4 types of CO2 lasers.
Ultrapulse Deep Fx and Active Fx: for lighter skin types
eCO2 : for darker skin
CO2RE: for fine work
Mixto: for mixed scars in medium skin tones
In some cases, we use erbium lasers, both in fully ablative and fractional settings. In severe scarring we use hybrid lasers, most often erbium with CO2 fractional.
When do we use dermal fillers for acne scars?
When you cannot generate enough collagen using your own immune system to do so. If you have large holes or atrophy, your body may not be able to generate enough collagen to repair atrophic scars. This can be related to genetics, age, health (smokers) or diet. In most cases it is idiopathic or unknown.
If you still have atrophic areas that will not improve despite the best attempts, consider dermal fillers. We use both HA fillers and collagen stimulating dermal fillers (preferable). We also use fat transfer and adipose stem cells, however fat is not as malleable or as stable as fillers.
How much does acne scar revision cost?
We have tiered costs to ensure that everyone can afford scar revision. In some cases, Medicare and private health insurance will cover some, or the majority of costs.
For non-surgical management of scars, our team of nurses can provide cost effective solutions including deep focal peels, lasers, dermal fillers, RF microneedling and more.
Our nursing team provides a FREE consultation service (redeemable with procedures). Alternatively, book a consultation with our dermatologist. For Medicare claims, referrals are mandatory.
When do we use dermal fillers for acne scars?
We can predict the outcomes in 85-90% of cases. Our team will give you realistic timelines, costs, and outcomes based upon your scar pattern. 3 caveats apply:
Inflammation matters. If you have background acne, you are compromising your revision process. Scar revision is about building collagen. If you have inflammation (even a small amount), your potential for regeneration is limited. You will be warned throughout the revision process if your acne is active. We have a medical team that deals with acne treatments.
Immune response is variable between individuals. Some patients are more efficient at building collagen, others lie to the left of the bell curve.
Age matters. The older you are, the less efficient you are at building collagen. Additionally support for the overlying scars are diminished.
How do dermatologists approach scars in darker skin types?
Scar revision in darker skin types is much more complex because of two reasons:
PIH or skin darkening can occur with peels and lasers (loss of pigment is rare).
Hypertrophic and keloid scars are more common in darker skins.
On this basis our dermatologists use special lasers, energy devices and peel concentrations. In many cases we prescribe pigment correctors post treatment. As a rule, darker skin patients require 2-3 more sessions compared to lighter skin counterparts.
What are the potential risks of scar revision?
What is the end point of scar revision?
Our clinic works via objective endpoints. This means we strive to achieve the following goal- to get you to understand and realise that ‘the end point is achieved when others do not see your scars.’
The goals are achieved when in normal lighting, others do not get distracted by facial scarring. Subjective improvements are secondary gains. BDD(body dysmorphic patients) patients visualize scars that normal individuals (family/friends) cannot see. These patients are best seen by a psychologist or a psychiatrist. Providing you are under the care of these specialists we may elect to treat you with appropriate modalities.
Scar revision carries a small risk of adverse events. These should be differentiated from expected outcomes and heal times. These include:
Infection; rare. About 1-3 % of cases. Easily managed.
Prolonged pigmentation changes, more common in darker skin ethnicities.
Idiosyncratic scars: very rare, less than 2% of cases, treatable.
Bleeding, haematomas: 2-5% depending on the instruments and procedures.
Your treating specialist will discuss specific risks, based upon the procedure.
What should you consider before undertaking acne scar revision?
Undergoing scar revision is an investment of time, effort, and money for patients. Here are some helpful points that may help you along your journey.
Always control your acne. You will go infinitely faster and better with any scar revision treatment. This means absolute (or almost absolute control), it does not mean ‘much better than before.’ If you have inflammation, your collagen remodelling is compromised. If in doubt, seek professional advice from our dermatologists and nurses.
Time. Collagen remodelling does not occur in weeks, but months. You must be committed to the timeline and treatment plan.
Sun protection is paramount. It does not mean you can’t go out in the sun, it means sun protection is important. SPF 50+ twice a day regardless of exposure. If a 50 ml bottle lasts longer than 3 weeks, you are not using enough sunscreen.
Darker skin type; you may require more sessions compared to lighter skin. In some cases, we will expectedly darken your skin, but will come up with solutions to lighten it back to normal.
Costs. If cost is an issue, our nurse led scar clinic can provide you with cost effective treatment options. This way you can budget your spend and maximise your gains.
Settings of laser / devices matter. Lasers are just tools to get the job done. Parameters are crucial for best outcomes. Additionally, using the best brands are super important.