If you’re reading this, you’re probably either dealing with acne scars or just exploring the latest treatment options out there. Trust me, I’ve been in your position—spending hours researching, trying to figure out what actually works and what’s just hype. My name is Dr. Nadir Qazi, and I’m a skin restoration specialist based in Newport Beach, California. Over the years, I’ve dedicated my career to helping people tackle acne scars, pigmentation issues, and even facial balancing. Today, I want to share some of my experiences, insights, and tips to help guide you through this journey.
The Emotional Toll of Acne Scars
Acne scars do more than just affect your appearance; they take a toll on your emotional well-being. Many patients come to me feeling stuck, frustrated, and even depressed. They've tried countless treatments—microneedling, phenol crosses, laser sessions—but nothing seems to help. One patient shared her story of undergoing five subcision procedures on her forehead, only to find out that the scar tissue was still entirely tethered. She felt betrayed, having invested so much time and money into treatments that promised results but delivered little improvement. This emotional roller coaster is all too common, and it's heartbreaking to see people lose hope.
Why Some Treatments Fail
So why do some treatments fail? It often boils down to the practitioner's skill and focus. I've heard stories of doctors who claim expertise but lack the necessary precision. For example, one patient recounted how her doctor couldn't treat the left side of her face because he was right-handed and had his sister perform the procedure instead. Such negligence leads to poor outcomes and further frustration for patients.
Effective Treatments That Work
Through years of practice, I've developed techniques that yield significant improvements. Here are some of the most effective treatments:
- Subcision: This involves breaking up scar tissue beneath the skin. When done meticulously, it can dramatically improve the appearance of tethered scars.
- TCA Cross: A powerful chemical treatment that targets specific scar types, particularly ice pick scars.
- CO2 Laser: Ideal for resurfacing and smoothing the skin, especially around the eyes.
- Erbium Laser: Preferred for its minimal heat, reducing the risk of post-inflammatory hyperpigmentation, especially under the eyes.
Subcision and TCA Cross:
These treatments target different types of scars. Subcision breaks up the fibrous bands that pull the skin down, while TCA Cross uses trichloroacetic acid to create a controlled injury, prompting the skin to heal and regenerate. Both methods require precision and care to avoid complications.
CO2 vs. Erbium Lasers:
While both lasers aim to resurface the skin, CO2 lasers penetrate deeper and are excellent for significant textural changes. However, they carry a higher risk of post-inflammatory hyperpigmentation, making erbium lasers preferable for lighter skin tones and delicate areas like under the eyes.
Fillerse and Volume Replacement:
Volume loss often accompanies acne scars, requiring strategic filler placement. Diluted Radiesse and Bellafill are popular choices, offering long-lasting results when administered correctly.
Combination Therapies:
For optimal outcomes, combining treatments is key. For instance, subcision followed by TCA Cross and laser resurfacing addresses multiple layers of scarring, ensuring comprehensive improvement.
Questions Answered:Â
Let’s address some common questions I received during my live session:
Question: Can you still receive acne scars treatments while using tretinoin?
Dr. Qazi: While we can pause tretinoin temporarily and switch to a cream with a milder retinoid during treatment, it's important to ensure that the skin is in optimal condition for the procedures.
Question: How many of your patients report skin sagging post-subcision and how many have returning scars on average?
Dr. Qazi: Skin sagging isn't an issue in my practice. Returning scars are rare unless accompanied by factors like weight loss or new acne.
Question: If after subcision you have boxcar scars that still appear atrophic when you smile, is that normal or is more subcision required?
Dr. Qazi: It might indicate volume loss rather than tethering. We can address this with fillers or additional subcision if needed.
Question: Is microneedling PRP helpful and can it deal with acne scars?
Dr. Qazi: Microneedling PRP has limited effectiveness for deep scars. Combination therapies often yield better results.
Question: Does the volume fill itself after subcision without fillers or are fillers a must after subcision?
Dr. Qazi: Mild cases may not require fillers, but significant volume loss usually necessitates them.
Question: What about a VI peel?
Dr. Qazi: VI peels are beneficial for mild texture issues and pigmentation but aren’t ideal for severe scarring.
Question: If it is possible to heal those scars, can it also solve stretch marks? CO2 laser what is the best?
Dr. Qazi: Stretch marks respond well to erbium lasers due to their gentle resurfacing capabilities.
Question: Thoughts on subcision with fat transfer?
Dr. Qazi: Fat transfer should be done separately from subcision to ensure proper placement and avoid complications.
Question: Are stretch marks the same as scars?
Dr. Qazi: While both involve collagen disruption, stretch marks tend to respond differently to treatments compared to scars.
Question: After releasing a tethered scar, is there a chance that they retether?
Dr. Qazi: Retethering is unlikely if the initial procedure is thorough and precise.
Question: Does subcision with Sculptra help?
Dr. Qazi: Yes, combining subcision with Sculptra stimulates collagen production effectively.
Question: What is your approach with chickenpox scars?
Dr. Qazi: Chickenpox scars require tailored approaches such as punch excisions, elevations, or CO2 laser treatments.
Question: How long is erbium recovery?
Dr. Qazi: Recovery typically takes 2-7 days depending on the intensity of the treatment.
Question: How long is erbium recovery under the eyes and why do you like it better than CO2 laser for light skin?
Dr. Qazi: Under-eye recovery with erbium lasts about 2-4 days. Its lower heat reduces risks associated with thinner skin areas.
Question: How far up the cheek is it appropriate to use Radiesse?
Dr. Qazi: Radiesse works well along the zygomatic arch and nasolabial folds, especially when diluted.
Question: Does a dermaroller work?
Dr. Qazi: Dermarollers have limited efficacy. Stamping devices offer better control for at-home use.
Contact Us For More Information
Treating acne scars requires a personalized approach and unwavering dedication. As someone who has battled scars myself, I understand the profound impact they can have on self-esteem and quality of life. By staying informed and choosing skilled practitioners, you can achieve remarkable improvements. Remember, healing isn’t just about physical changes, it’s about reclaiming confidence and joy. Feel free to reach out if you have more questions or need guidance on your journey to clearer skin. You can self-schedule a consultation by clicking here or you can call or text my office at 949-336-7293.Â
