Hi, everyone! I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My passion lies in helping patients overcome challenges with acne, scars, and pigmentation issues. Over the years, I’ve developed a keen focus on collagen stimulation techniques, which have proven to be incredibly effective for many of my patients. Today, I want to share an incredible case that showcases the power of combining multiple treatments to achieve remarkable results. I will be talking about acne scar treatments, hyperpigmentation, subcision, TCA Cross, volume replacement and much more.
Recently, a patient came into my office, and his transformation has been nothing short of amazing. His skin looks incredible, and it’s a testament to the progress we can make when we approach skin restoration with a comprehensive plan. Let me walk you through this journey, step by step, highlighting the methods and treatments that made such a significant difference.
Understanding the Patient's Background
This particular patient is Fitzpatrick Type V, meaning he already deals with hyperpigmentation issues. Many professionals might shy away from treating such cases due to the complexity involved. However, I believe that with the right approach, we can achieve fantastic outcomes even for those who have tried and failed with other treatments. In this case, previous treatments like lasers and microneedling had not yielded the desired results. The key was to break up scar tissue effectively and restore lost volume.
The Treatment Plan
To tackle the deep scars, we employed subcision , a technique that involves breaking up scar tissue beneath the skin. This method is crucial because simply using energy devices or microneedling won’t suffice for these types of scars. Additionally, we incorporated collagen-stimulating products such as Sculptra and Bellafill to add volume and support the skin structure. For boxcar scars, we used TCA cross , a highly effective treatment for targeted scar correction.
Seeing the Results
The results speak for themselves. After just a few months, the patient’s skin quality and texture improved dramatically. It’s important to note that these improvements continue over time, especially when patients follow post-treatment care instructions diligently. This includes avoiding sun exposure and maintaining a consistent skincare routine.
Post-Treatment Care and Maintenance
Post-treatment care is as vital as the procedures themselves. Patients must adhere to specific guidelines to ensure optimal healing and long-lasting results. One of the most critical aspects is sun protection . UV exposure can severely damage newly treated skin, leading to hyperpigmentation and undermining the effectiveness of the treatments. I recommend using a high-SPF sunscreen daily and wearing protective clothing.
In addition to sun protection, maintaining a consistent skincare regimen is essential. This typically includes gentle cleansers, moisturizers, and products containing active ingredients like retinoids or azelaic acid. These help manage oil production, reduce inflammation, and improve overall skin texture.
Addressing Hyperpigmentation and Acne Concerns
Hyperpigmentation and persistent acne are common concerns among my patients. For hyperpigmentation, especially in darker skin tones, treatments like TCA peels and azelaic acid creams can be beneficial. They work by gently exfoliating the skin and reducing melanin production without causing excessive irritation.
For acne, particularly cystic acne, a combination approach often yields the best results. Topical treatments like adapalene or clindamycin can be effective, but severe cases may require oral medications such as Accutane or advanced laser therapies like the Cure Laser . Managing oil production is also crucial, and this can be achieved through both topical and oral solutions.
Innovative Techniques and Future Directions
Innovations in skincare are continually emerging, and staying updated is part of my commitment to providing the best care. Recently, I’ve been exploring the benefits of beef tallow for pre-treatment purposes. While still in the experimental phase, initial results suggest it might offer similar benefits to retinoids, promoting skin health without excessive dryness or irritation.
Another exciting area is permanent volume replacement using products like Sculptra and Bellafill. These treatments offer long-term solutions for volume loss, significantly improving skin quality and texture over time. The cumulative effect means patients may require fewer touch-ups, making it a cost-effective and efficient option.
Addressing Common Concerns and Questions
Here are some of the questions I received during my live session:
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Question: How many laser treatments does it take to plateau on scars?
Dr. Qazi: There isn't a definitive plateau. With proper spacing and adherence to aftercare, including sun protection, patients can see continuous improvement. Each session builds upon the last, enhancing the overall outcome. -
Question: Are you taking new patients?
Dr. Qazi: Yes, we are currently accepting new patients. However, our priority remains ensuring timely appointments for our existing patients who have ongoing treatment plans. -
Question: How do you feel about fibroblasting?
Dr. Qazi: I don’t recommend fibroblasting for acne or scars. It’s not effective and can potentially cause more harm than good. - Question: What would you recommend for someone who has used adapalene without success for two years?Dr. Qazi: Consider adding an antimicrobial component, such as a topical sulfur-based cream or clindamycin. Sometimes, additional factors contribute to breakouts, requiring a multifaceted approach.
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Question: How long after a procedure should one avoid sun exposure?
Dr. Qazi: You should never aim to get a tan, as UV exposure damages the skin. Post-procedure sensitivity lasts approximately three months, depending on your skin type. Always prioritize sun protection. -
Question: Have you heard of microcurrent muscle stimulation for the face? Is it beneficial?
Dr. Qazi: Some patients report mild tightening effects, but the cost may not justify the benefits for everyone. It generally doesn’t cause harm, though. -
Question: I've relied on Proactiv for 20 years; any advice on transitioning away?
Dr. Qazi: Gradually replace benzoyl peroxide with alternatives like a sulfur-based wash and incorporate exfoliants like glycolic acid. A low-dose retinoid and moisturizer can also help maintain balance. -
Question: How do you decide between Sculptra and Bellafill?
Dr. Qazi: Sculptra is ideal for broader volume replacement, while Bellafill offers more localized support. The choice depends on the specific needs of each patient. -
Question: Is Luminous CO2 the best option?
Dr. Qazi: Not necessarily. The effectiveness of a CO2 laser depends on how it’s used. Ergonomics and precision matter more than the brand itself. -
Question: Do you recommend at-home microneedling devices?
Dr. Qazi: No, I advise against them. They can lead to pigmentation issues and scarring if not used correctly. Professional treatments offer safer, longer-lasting results. -
Question: Is the forehead area easier to treat for rolling ice pick scars?
Dr. Qazi: Surprisingly, yes. Temples and foreheads respond well to treatments like subcision and TCA cross, often requiring fewer sessions for noticeable improvement. -
Question: How long does redness persist after a breakout?
Dr. Qazi: With proper sunblock and moisturizer use, redness typically subsides within a few weeks. -
Question: Are T3A peels beneficial?
Dr. Qazi: Yes, they can be effective for the right skin type and condition. Individual assessment is crucial. -
Question: How do you remove scars similar to those shown?
Dr. Qazi: Combining manual scar tissue breakup, volume replacement, and targeted treatments like TCA cross and laser therapy yields the best results. -
Question: Do you adjust treatment plans for out-of-state patients?
Dr. Qazi: Yes, we tailor visits to maximize efficiency, considering downtime and risk tolerance. -
Question: Can I purchase Sculptra online without a consultation?
Dr. Qazi: Yes, you can buy it online, but a consultation ensures optimal usage and results. -
Question: What do you suggest for hyperpigmentation and closed comedones?
Dr. Qazi: Control oil production with a topical retinoid like Differin and address pigmentation with creams like Eucerin. -
Question: How frequently do you perform TCA cross?
Dr. Qazi: Typically, three to five times daily, depending on patient needs. -
Question: Does phenol peel help with deep boxcar scars in the temple?
Dr. Qazi: It aids in reducing visibility, particularly for wider scars, but deeper scars may require TCA cross or subcision. -
Question: Does PicoSure laser help with deep scars and can it help reduce the visibility?
Dr. Qazi: It aids in reducing visibility, particularly for wider scars, but deeper scars may require TCA cross or subcision. -
Question: What do you recommend for cystic acne with very oily skin?
Dr. Qazi: Oral medications like Accutane or treatments like the Accure Laser, combined with topical antimicrobials, provide comprehensive solutions.
Final Thoughts
As a dedicated skin restoration specialist, my goal is to empower patients with knowledge and effective treatments. Every case is unique, and personalized care ensures the best possible outcomes. Whether you’re dealing with stubborn scars, persistent hyperpigmentation, or challenging acne, remember that professional guidance can make all the difference.
Feel free to reach out with any questions or concerns. Together, we can achieve the skin transformation you deserve! Click here to self-schedule a consultation.
