Many patients suffer from acne over the course of their lifetime. Unfortunately, acne and acne breakouts, if not taken care of promptly, can result in acne scars. Dr. Michele Green is a board certified dermatologist, specializing in acne, skin discoloration and dark spots from acne, skin care, and the best acne scar treatment in NYC. Dr. Green has the most cutting edge laser treatments and technologies for treating acne scars in her boutique, private, New York City office. It is important to understand the fundamentals of acne and acne breakouts to best prevent and treat potential acne scarring.
Dr. Green offers extensive experience in the diagnosis and treatment of acne in order to prevent the evolution of acne scars, hyperpigmentation and dark marks. Dr. Green provides effective acne management, and the best acne scar treatment to reverse the effects of past acne scars and discoloration. With an extensive array of acne scar laser treatments and dermal fillers to produce new collagen, and replace lost volume, all types of acne scars can be treated safely and effectively.
With over 25 years of experience with the best acne scar treatment in NYC, Dr. Green will provide a personal and private consultation with you to determine what are your best treatment options for improving your acne scars. From Fraxel laser, eMatrix, chemical peels, TCA cross, dermal fillers, microneedling, dermabrasion, subcision, and other treatment options, Dr. Green will tailor the best acne scar treatment based on the type of acne scar and your skin type. Dr. Green is listed as one of the best doctors in New York in Castle Connolly, New York Magazine, and the NYTimes, for her expertise in cosmetic dermatology, and particularly acne scar treatment.
Woman treated with acne scar treatment, vbeam and ematrix, 5 treatments
What is the cause of acne?
When the sebaceous glands function properly, they collect and excrete an oily substance called sebum, which helps to keep the skin healthy and prevent it from drying out. However, the very narrow channels through which the sebum leaves the sebaceous glands often become plugged. Acne is caused by this clogging of the pores and inflammation of the sebaceous glands.
Once these channels are blocked, bacteria that normally live within the sebaceous glands multiply rapidly, initiating the chemical reaction we know as inflammation in the skin cells. This in turn leads to the pimples, pustules, and cysts, associated with inflammatory acne.
Depending on the type of acne which each patient is suffering from, the goal is to cure existing breakouts and treat these flareups with either topical medications, oral medications, acne extractions, facials, hydrafacials, chemical peels, Blu-light therapy, or other in-office procedures at Dr. Green’s private NYC office.
What are the different types of acne?
- Blackheads – appear as black dots on the surface of the skin. They are also called open comedones because the head of the pore is open and the rest of the pore is clogged.
- Whiteheads – are also called closed comedones, which occurs when your pores get clogged from oil, bacteria, and excess sebum production.
- Papules – are small red bumps that appear on the skin, which are due to clogged pores, mixed with bacteria, such as P. acnes. Papules are generally free of pus as the bacteria has escaped through the open pore.
- Pustules -are generally inflamed and infected due to bacteria increasing in the blocked pore. The contents of these pustules contain pus, which is infectious in nature.
- Nodules and Cysts -are flesh-colored bumps that are below the surface of the skin and contain deep infections, which are laden with bacteria, and are generally very painful.
Topical acne treatment
There are several approaches in dermatology which can be very helpful for controlling active acne, for preventing acne flare-ups, and improving skin tone and texture. Topical medications represent the first line of acne treatment currently utilized. Commonly used acne-fighting skin-care products and topical medications include the following:
- Topical antibiotics such as erythromycin, clindamycin, and sodium sulfacetamide to reduce surface bacteria.
- Benzoyl peroxide to reduce the bacteria living on the skin’s surface.
- Retinoids such as Retin-A, Retinol, and Tazorac which unplug the pores, gently exfoliate the skin, reduce inflammation, and increase cellular turnover.
- Azelaic acid to soothe inflammation, provide an anti-inflammatory effect, and reduce surface bacteria.
It is very important that patients follow their topical skin care treatment plan carefully, as the ultimate amount of improvement obtained depends at least in part on how well patients take care of their skin at home.
Does acne scar cream work?
For the majority of patients, topical medications are a useful method to treat active acne lesions and to prevent the formation of acne scars. For those with mild scarring that has caused discoloration on the surface of the skin, topical brightening creams can be a very effective treatment to reduce the appearance of acne scars. For those who have moderate to severe acne scars, Dr. Green typically recommends treatments beyond a topical treatment in order to reduce the appearance of scarring on the surface of the skin.
Oral Medications to prevent acne scars
Oral medications are often used in combination with topical medications to treat existing acne and prevent new acne breakouts. Dr. Green may prescribe the following oral medications:
- Antibiotics such as Minocycline, Tetracycline, Doxycycline, and Oracea, to control the growth of bacteria in the skin and in the sebaceous glands.
- Birth control pills or Spironolactone (aldactone) to control the hormonal aspect of acne (in women).
- Accutane, as a last resort, to control acne that has been resistant to improvement through any other oral, topical, mechanical, or laser treatments.
23 year old woman treated for acne with accutane – 3 months
Extractions and Injections
Extraction of acne lesions refers to the drainage of pus, oil, and bacteria from acne lesions. Removal of these substances relieves any pain and pressure that may be present, shortens the healing time, and reduces the risk of acne scarring. Extraction of an acne lesion is often followed by injection of cortisone into the acne lesion to hasten healing.
Acne cysts heal quickly after they are injected with a diluted amount of steroid directly into the cyst. When used in this manner, the steroid rapidly reduces the inflammation and redness in the lesion. Injection of a pimple with a diluted steroid is the ideal treatment when the skin absolutely and positively must look better within 24 hours. This treatment is one of the secrets behind celebrity skin care.
What is an acne scar?
An acne scar is the result of an inflamed acne breakout, when the affected area of the skin becomes engorged with excess oil, sebum, dead skin cells, and bacteria. As the the affected pore swells, the bacteria also increases, and causes damage to the skin tissue. A small area of damage causes a small scar but a deeper infection leads to a deep scar on your skin. Although your skin will try to repair itself, there are many times when the wound is too large, or your skin is too delicate. In these cases, there is not enough new collagen to repair the wound. The result of this lack of collagen is an atrophic, or depressed scar. The three main types of atrophic scars are boxcar scars, icepick scars, and rolling scars.
What is the best acne scar treatment?
There are a myriad of methods to help improve the appearance of these depressed scars and Dr. Green is an international expert in the field of acne scar treatment. While some acne is the result of genetics or hormonal imbalances, careful skin care and treatment can avoid acne from progressing into acne scars. It is best not to delay treatment if you have acne breakouts, and never to squeeze or pick your skin, since this will increase your chances of acne scarring.
What is the best acne scar removal treatment?
The best method of removing acne scars is often a combination of different treatments. The first determination, which is necessary to remove acne scars, is to identify the type of acne scar. Are your acne scars red, white, raised, or indented? If your acne scars are red, you would benefit from the Vbeam laser treatment to reduce the redness in the scar. If you scar is discolored or hyperpigmented, a series of chemical peels, Cosmelan, Vitamin C serum, and Hydroquinones, may be the best choice. It is vital to select the best treatment regime to treat these dark spots, which appear as acne scars, from previous acne breakouts. If you have ice pick scars, or rolling scars, you might need a combination of various treatments such as chemical peels, laser treatments , and dermal fillers such as Restylane and Juvederm, to give you the best acne scar treatment. If you have keloid or raised scars, you may need intralesional cortisone injections and laser treatments to reduce these acne scars. It is very important to consult an expert in all of these different types of acne scars for the best cosmetic results.
Does acne scar removal work?
Acne scar removal not only works, but can be an incredibly successful method to help restore the health and evenness of the skin. When you work with Dr. Green, she’ll be able to look at your current skin condition, as well as your medical history, to determine which options will be the most effective treatment to meet your needs. Dr. Green is an expert in acne treatment and acne scar removal, and the satisfaction and health of her patients is her top priority.
Chemical Peels for acne and acne scars
Chemical peels are an effective way to treat acne and acne scars. Chemical peels for acne work by removing the surface layers of the skin, helping to exfoliate the epidermis, and producing new skin during this healing process. When chemical peels are done for acne, they are generally relatively mild. Appropriate peeling agents for acne include 20-40% glycolic acid, 10-15% trichloroacetic acid (TCA), salicylic acid, lactic acid peels and alpha hydroxy acids peels.
Regardless of the peeling agent used, a chemical peel for acne will help clear acne blemishes, reduce fine lines and wrinkles, lighten brown spots which result from acne (as well as from the sun or melasma), and smooth and brighten the skin. This process is a great way to help remove dead skin cells, and reduce dark marks on the skin. Patients undergoing chemical peels for acne will generally need to repeat their treatment approximately every four to six weeks. Dr. Green combines chemical peels for discoloration, particularly from post-inflammatory hyperpigmentation (PIH), with various strengths or percent hydroquinones. Dr. Green compounds a range of hydroquinone products in her office, from two percent to 10 percent, for her patients. After an acne chemical peel, the skin may be minimally red and irritated, but the recovery from the peel is very rapid and should be complete within a few days. Ultimately, both acne and acne scars will heal as new cell turnover is achieved. Lighter skin types are able to tolerate higher strength chemical peels that those with darker skin tones.
Chemical peels can be used on all types of scars. It can be used on atrophic scars such as ice pick scars, and rolling scars. Ice pick scars are best treated with a chemical peel process called TCA Cross. A strong strength of TCA is used, from 30 to 100 percent, and applied directly with a fine needle into each individual acne scar. This method of chemical peels is best reserved for patients with light skin tones. Patients of dark skin tone could potentially be hyperpigmented or have a loss of pigment, hypopigmented, from such a strong strength of acid. Patients with darker skin tones are best to avoid such high strength chemical peels and use the proper lasers or other modalities to treat their acne scarring. Sunscreen, with an SPF 50 or higher, is essential after chemical peels, to prevent further hyperpigmentation. It is extremely important to protect your skin while your acne scars are being treated so that the scars and surrounding skin do not get damaged and can increase new collagen production.
Facials to treat acne and acne scars
Dr. Green also performs acne facials with great success on patients and recommends her at-home regime from MGSKINLabs, Inc. to complement these facials. The facial begins with a surface cleansing of the skin and a light microdermabrasion or glycolic acid treatment. This dermabrasion technique is followed by treatment with steam and extraction of any pimples. Then, a soothing and purifying mask with vitamin e and nourishing antibiotics is applied to the face. The final step in the facial is the application of oxygen. The acne facial improves acne, lightens any dark spots and blemishes, and leaves the skin glowing. This facial should be repeated at monthly intervals until the skin is clear, and should be thought of as an integral component of the acne at-home skin care program. Acne facials combined with your at-home skin care, will prevent future acne breakouts and acne scarring.
Hydrafacials are a medical grade facial in NYC, which helps treat superficial acne and acne scars. The skin is cleansed with the Active-4 cleanser, which is gentle and effective for all skin types. The cleanser softens sebum and dislodges dead skin cells. The next step in the Hydrafacial is an acid peel, the strength of which will be chosen by Dr. Green. We use salicylic acid and glycolic acid, during acne facial to help clean the residual acne. The next step is extraction using vortex technology to tighten pores and clear congestion. Lastly, your skin is hydrated with essential antioxidants, moisturizers, and vitamins to leave you refreshed and glowing.
eMatrix for acne scars, 1 treatment
How much is laser acne scar treatment?
Since there are a variety of different lasers used for acne scar treatment, the cost differs depending on which laser treatment you are having done. For example, a Vbeam laser treatment or IPL treatment will be less expensive than a resurfacing laser, which may require significant downtime and anesthesia. It is best to research which laser treatments would be best for you. The price of laser treatments for acne scars will also differ depending on the experience of your treating dermatologist, versus a clinic or spa.
Blu-U Photodynamic Therapy for acne and acne scars
For those patients who cannot tolerate oral medications to treat their acne and scars, BLU-U photodynamic therapy is effective for treating your acne and reducing the appearance of acne scars. The BLU-U Light kills the bacteria which cause acne breakouts, and treatments take only 15 minutes once or twice a week. PDT, or photodynamic therapy, works by reducing the oil glands on the skin, which in turn decreases the bacteria, and reduces the amount of acne. Photodynamic therapy can be combined with the Vbeam or IPL lasers, to best treat your acne scars.
Does laser acne scar treatment work?
Laser therapy and laser acne scar removal treatment are incredibly effective treatment options for patients who are dealing with active acne lesions and/or acne scars. However, the key is matching the best laser treatment for your specific type of acne scars, and your skin tone. If you have hypertrophic or keloid scars you will need a different laser modality than if you have atrophic or depressed acne scars. Similarly, some acne scars may need a combination of lasers, or chemical peels, for the best treatment. Each individual’s acne scars are unique and need a specialized approach to their treatment. Dr. Green has a mastery over modern laser treatment technologies and can determine your best laser treatment option based on your skin type and current skin condition.
Female with 2 Sculptra, 2 eMatrix and 1 Restylane injection
Treatment for Hypertrophic scars
Many patients suffer from keloid scars or hypertrophic scars. These types of scars need to be treated differently from atrophic or depressed acne scars. These hypertrophic scars are raised, and the best treatment involves intra-lesional cortisone injections and laser treatments to shrink these scars. In general, surgically excising or attempting to remove keloid scars, causes them to re-grow, and often larger than before. That is why the best treatment for hypertrophic scars is a a conservative one. If these scars are red, as they often are, especially from surgical scars from breast reductions, face lift, or a tummy tuck, the Vbeam laser treatment will work best to remove this color and return the skin back to its original color.
How do Dermal Fillers treat acne scars?
Atrophic, depressed scars, like rolling scars and boxcar scars, can be quite deep. In order to help repair these deep scars, Dr. Green is an expert in replacing the lost collagen in these atrophic scars with an array of dermal fillers. The art of restoring the balance to your face, and improving the appearance of your scars, is selecting the right combination of dermal fillers for cosmetic injection. The most popular dermal fillers for the past ten years are formulated from hyaluronic acid. For deeper scarring, dermal fillers such as Restylane®, Restylane Lyft (Perlane®), Juvederm® or Juvederm Voluma may be injected below the surface of the skin to restore lost facial volume.
Depending on the nature of the acne scarring, Dr. Green may choose to inject Sculptra to help your body produce its own collagen. Through a series of injections with Sculptra, this liquid injection will replace lost collagen and naturally restore the balance of your face. Over time, Sculptra will induce new collagen formation and renew and repair the balance to your face from the acne scarring.
Bellafill was FDA approved in 2015 as an alternative to treat moderate to deep acne scars and nasolabial folds. Bellafill injections can last up to five years in duration and for this reason it is a popular alternative in certain patients with acne scars. Bellafill injectable fillers are composed of a collagen base and polymethyl methacrylate (PMMA) microspheres. Since Bellafill has a bovine collagen base, it is important to skin test all patients to Bellafill, before cosmetic injection; a subset of patients will be allergic to Bellafill. When Bellafill is injected into your acne scars, the body absorbs the collagen, and the PMMA microspheres stay in place in the skin. The PMMA acts to maintain long lasting support, up to five years, after the collagen is absorbed. This long term treatment for acne scars is why Bellafill is appealing to a subset of patients with deep scars.
Does Subcision work for acne scars?
Subcision is a unique treatment which helps improve depressed acne scars such as rolling scars and boxcar scars. Subcision for acne scars involves using a sharp instrument or a needle to “subcise” and help break up scar tissue from the surface of the skin. By breaking apart this scar tissue, which is tethered to the dermis, the epidermis, or top layer of skin is able to heal and produce new collagen. Dr. Green performs subcision at the same time that she is injecting acne scars with a dermal filler. By first using subcision, and then filling the space with a dermal filler, such as Juvederm or Restylane, the hyaluronic acid fills in the area which is depleted of collagen, until your body can produce its own natural collagen. This subcision technique is extremely effective since you have the immediate benefit of restoring volume into these scars via the injectable filler, and the long term effect of producing new collagen and elastin and rejuvenating your skin. Dr. Green’s unique technique of subcison and injection will improve the appearance of scars even after one only treatment.
Does Excision Work for Acne Scars?
For some severe acne scars, such as deep ice pick or boxcar scars, excision can be used to remove the scar, during which the scar is surgically removed and the remaining wound is healed. However, this process of excision has a risk of acne scarring during the healing process. For this reason, Dr. Green only recommends certain acne scars be removed via punch excision over other treatment options. During your consultation, Dr. Green will discuss the most appropriate acne scar treatments based on your type of acne scars, pigmentation, and skin tone.
Which skin care is best to maintain healthy skin?
Patients always ask Dr. Green what is the best way to maintain healthy skin and minimize acne and the potential to have acne scarring. Dr. Green often prescribes Retinols, Retinoids, and alpha hydroxy acids, as these compounds increase skin cell turnover and new collagen formation. Her Essential Antioxidant Infusion is replete with Vitamin-A based Retinol and other essential skin vitamins. Retinoids reduce fine lines and wrinkles, increase new collagen production, and encourage neovascularization of the skin. Dr. Green recommends using a Retinol at night and combining it with a topical Vitamin C serum during the day, like Dr. Green’s most popular Vita-C-Serum in her MGSKINLABS, Inc. line of products. Skinceuticals’s Vitamin C serum with Ferulic acid is also quite popular. When choosing over-the-counter skin care at Sephora or Ulta, it is important to look at the ingredients in the products which you are purchasing, especially if you have acne prone skin.
When choosing products for acne prone skin, a cleanser with a salicylic acid base is generally recommended since salicylic acid is a powerful acne fighting ingredient. Salicylic acid can be incorporated into face washes as in Dr. Green’s Pore Minimizer Cleanser for acne prone skin, or into peel pad treatments, like Dr. Green’s Retexturizing pads. These Salicylic acid based products decrease pore size, exfoliate the skin, unclogs your pores, and with its anti-inflammatory properties, leaves your skin clear and visibly refreshed. When patients have an occasional acne breakout, it is important to have an acne spot treatment on hand to dry out that new pimple overnight. Dr. Green’s Acne Spot Treatment has Benzoyl Peroxide as its active ingredient to dry out that new blemish, making it disappear faster, either overnight or during the day.
Moisturizing acne prone skin is also extremely important since many topical acne treatments can be drying. It is important to choose an oil free moisturizer, which is non-comedogenic, and will not clog your pores. Dr. Green’s Ultimately Sheer Moisturizer is designed with oil-blotting technology, so while it moisturizes the skin, it will also remove the oily areas from your skin and does not leave it shiny like so many moisturizers can. When choosing a moisturizer it is very important to choose one that has been tested not to cause more acne, and states that it is non-comedogenic. Another important ingredient in a moisturizer is one that contains hyaluronic acid, as this ingredient provides excellent hydration, reduces the visible signs of fine lines and wrinkles, and speeds up wound healing. Dr. Green’s Hydra Repair is the number one hyaluronic acid serum used by the patients in her office.
eMatrix 5 months 4 sessions
Acne, acne scars and emotional health
Many patients feel depressed, anxious, and are self-conscious from their acne or resulting acne scars. Acne is an entirely treatable condition and there is no reason to suffer and not consult a specialist to help receive the correct treatment. The longer you suffer with acne, without the correct treatment, the greater the chance of acne scarring, and the more emotional distress it can cause. Dr. Green has cured every type of acne and she likes to say “there is no permanent acne!” We urge you to consult an expert, like Dr. Michele Green, to ascertain the etiology of your acne, provide the best treatment plan, reduce the appearance of your acne scars, and give you back beautiful clear skin.
TCA Cross for acne scars
TCA Cross is an abbreviation for trichloroacetic acid chemical reconstruction of skin scars. This amazing methods of acne scar treatment involves using between a 70 and 100% trichloroacetic acid solution, placed carefully with a fine needle or tooth pick, into atrophic acne scars. TCA Cross is used to stimulate new collagen and elastin formation in areas of depressed acne scars. TCA Cross is performed several times, 6 to 8 weeks apart. Darker skin tones may need TCA which is less strong and require a few more sessions to increase the collagen and rejuvenate the skin.
Is acne scar treatment covered by insurance?
Unfortunately, in most cases, acne scar treatment is not considered medically necessary, meaning that it is definitely as an elective cosmetic treatment and is thus not covered by health insurance. However, acne treatment is often covered by health insurance, and certain treatments can benefit both active acne and acne scars. In any case, it is best to check with your individual insurance carrier to see which treatments are covered.
How much do acne scar treatments cost?
The cost of acne scar treatments depends on the modality of treatment used and whether a board certified plastic surgeon or dermatologist versus an aesthetician is performing your treatments. The cost for a Hydrafacial will be much less than an ablative laser resurfacing procedure. In addition, each hyaluronic acid dermal filler is priced differently and it depends on how much volume and the number of syringes needed, to correct your scars and restore your facial volume. It is very important to google your treating physician and make sure that they have the expertise and experience in treating acne scars to have the best cosmetic results.
Is acne scar treatment permanent?
In many cases, acne scars can be permanently removed through the use of laser treatments, V-Beam laser, eMatrix, Fraxel, CO2 laser, or combination treatments. Chemical peels, subcision, microneedling with PRP, dermal fillers with hyaluronic acids and Hydrafacials are all able to reduce the appearance of acne scars, often permanently removing acne scars.
If you’re frustrated with the appearance of your acne or acne scars, there’s finally a solution that can help. Dr. Michele Green is an internationally renown expert in treating acne scars and will help customize the best treatment protocol for you, to regenerate new collagen, remove discoloration, and return you with beautiful clear skin. To schedule a consultation contact Dr. Green online or call our New York City office at 212-535-3088 to learn more about whether our combination approach toward acne scar treatment may be the best option for you.