Skin Restoration

Azelaic Acid, Subcision, TCA Cross, Acne - May 29th 2025

Hi, I’m Dr. Qazi, a skin restoration specialist based in Newport Beach, California. Every day, I dedicate my practice to helping patients transform their skin—whether it's addressing acne scars, pigmentation issues, azelaic acid or signs of aging. Over the years, I’ve had the privilege of working with countless individuals who feel held back by their skin concerns. Today, I want to share insights into what I do, how I approach skin restoration, and answer some common questions that come up during consultations.

Azelaic Acid

Why Skin Restoration Matters

Skin is more than just our largest organ—it’s often tied to confidence, self-esteem, and how we present ourselves to the world. Many people come to me feeling frustrated because they’ve tried multiple treatments without success. Some are dealing with scars from severe cystic acne, others with hyperpigmentation, and many simply want to look younger and healthier. What excites me most about skin restoration is seeing the profound impact it has on someone’s life. When you address these issues effectively, it can open doors socially, professionally, and emotionally.

For instance, one of my recent patients—a man who had been struggling with both acne scars and anti-aging concerns—experienced remarkable results after just a single session. His skin quality improved significantly within six months, giving him renewed confidence. He told me he no longer felt like his scars defined him or made him look older than he was. This kind of transformation is why I wake up every morning excited to help others achieve similar outcomes.


My Approach to Skin Restoration

When treating patients, I focus heavily on collagen stimulation , which plays a vital role in rejuvenating the skin. Collagen not only smooths out fine lines and wrinkles but also helps repair damaged tissue caused by scarring. Depending on the case, I use a combination of advanced techniques such as:

  • TCA Cross : A powerful chemical peel designed to target deep scars.
  • Subcision : Breaking up scar tissue beneath the surface to release tethered areas of the skin.
  • Bellafill : A long-lasting filler used for volume replacement.
  • CO2 Laser Resurfacing : For texture improvement and tightening.

Each patient requires a customized plan based on their unique needs, including factors like skin type, scar depth, and location. It’s important to note that while progress may seem slow initially (results typically take 6-12 months), patience pays off. The body takes time to rebuild collagen naturally, and rushing the process can lead to subpar outcomes.

One misconception I frequently encounter is the idea that certain over-the-counter products alone will solve deeper skin issues. While ingredients like topical retinoids and azelaic acid have merit, they’re often insufficient for more complex cases. That said, let’s dive into some specifics about treatments and products.


Key Insights on Common Treatments and Products

Azelaic Acid for Hyperpigmentation

Azelaic acid is excellent for mild exfoliation and reducing redness, making it ideal for conditions like rosacea or blotchy hyperpigmentation. However, concentrations above 10% might be too strong for sensitive areas, especially on the body. For pregnant patients, this ingredient is particularly safe since it avoids harsh chemicals.

Subcision for Acne Scars

Subcision works wonders when scars are tethered or “stuck” under the skin. By breaking up fibrous bands, we allow the skin to heal smoothly. In fact, I recently performed subcision on a patient whose jawline area showed dramatic improvement. The key takeaway here? Not all scars require aggressive lasers; sometimes manual intervention yields better results.

Post-CO2 Laser Hyperpigmentation

Hyperpigmentation following CO2 laser treatment isn’t uncommon. Often, it stems from post-inflammatory responses or inadequate prep work beforehand. To mitigate this risk, I recommend using hydroquinone or Triluma cream prior to the procedure. Sun protection afterward is equally critical.

Benzoyl Peroxide vs. Retinoids

While benzoyl peroxide reduces oil production, it’s overly drying for some skin types and carries potential carcinogenic risks. Instead, I prefer prescribing topical retinoids or sulfur-based creams like Dapsone for antimicrobial benefits.

bellafill

Questions Answered

Here are answers to some of the questions I received during the live session:

  • Question: Do you think 16% azelaic acid is effective for moderate hyperpigmentation that's blotchy?
    Dr. Qazi: Yes, azelaic acid can work very well for blotchy hyperpigmentation. However, 16% might still be too strong for some individuals, especially on the body. Consider starting with 10%.
  • Question: What’s your opinion on subcision for acne scars?
    Dr. Qazi: Subcision is highly effective, particularly for tethered scars. We break up the scar tissue underneath, allowing the skin to heal properly. Results are often permanent once completed.
  • Question: What about hyperpigmentation after CO2 laser?
    Dr. Qazi: This is usually post-inflammatory hyperpigmentation. Proper pre-treatment preparation with lightening agents and diligent sunblock use afterward can minimize this risk.
  • Question: Where are you located?
    Dr. Qazi: I’m based in Newport Beach, California, just minutes away from the airport.
  • Question: Is it true that 2.5% benzyl peroxide helps with indented scars?
    Dr. Qazi: Benzoyl peroxide may reduce oil production slightly, but it’s not a direct solution for indented scars. Topical retinoids or other treatments are preferable.
  • Question: How much does a consultation cost? Can I book for a consult and get treatment the same day?
    Dr. Qazi: Consultations cost $150, which goes toward the procedure fee. Unfortunately, we don’t perform treatments the same day due to scheduling constraints.
  • Question: What treatment do you recommend for acne scarring on dark skin (Nigerian ethnicity)?
    Dr. Qazi: For darker skin tones, I avoid high-energy devices unless necessary. Subcision, TCA cross, and volume replacement are safer options.
  • Question: Does isotretinoin make pitted acne scars look worse during treatment?
    Dr. Qazi: Isotretinoin itself doesn’t worsen scars unless excessive dryness occurs. Controlling dosage and moisturizing adequately prevent this issue.
  • Question: Is it possible to get a third-degree sunburn, and is it the same as a chemical burn?
    Dr. Qazi: Third-degree sunburns are extremely rare but theoretically possible. They differ from chemical burns in origin, though both cause significant damage.
  • Question: Are subcision results permanent, or do you need touch-ups?
    Dr. Qazi: Subcision results are generally permanent. Touch-ups are rarely needed unless new scarring develops.
  • Question: I had a completely smooth nose, but now there are pitted marks after removing sebum plugs. How do I fix this?
    Dr. Qazi: Try controlling oil production with low-dose Accutane or tretinoin, followed by TCA cross treatments.
  • Question: My GP says the pain on my cheeks may be rosacea. What medication would help?
    Dr. Qazi: Metronidazole or ivermectin topicals are great options for managing rosacea symptoms.
  • Question: Do you offer FaceTime consults?
    Dr. Qazi: Yes, we conduct virtual consultations through our online platform.
  • Question: What’s the best treatment for rolling scars?
    Dr. Qazi: Subcision combined with volume replacement offers excellent results for rolling scars.
  • Question: What’s your opinion on phenol peels?
    Dr. Qazi: Phenol peels are effective for specific scar types but involve significant downtime. They aren’t always necessary depending on the case.
  • Question: Would a mini facelift help lessen scars?
    Dr. Qazi: A mini facelift might provide slight improvements, but breaking up scar tissue first is crucial for optimal results.
  • Question: Can I get your expertise for burn scars?
    Dr. Qazi: Absolutely! I have extensive experience with burn scar revision and aim to restore functionality and aesthetics safely.
  • Question: If people travel for treatments, how long do they need to stay in California?
    Dr. Qazi: Most patients leave the same day without any issues.
  • Question: Do you perform Taylor Liberator procedures?
    Dr. Qazi: Yes, I incorporate Taylor Liberators selectively based on the patient’s needs.
  • Question: Do you think many dermatologists and plastic surgeons offering treatments don’t know how to treat acne scars effectively?
    Dr. Qazi: Unfortunately, yes. Treating acne scars requires specialized skills, patience, and focus—not all practitioners possess these qualities.

Final Thoughts

Skin restoration is an art and science combined. Every patient’s journey is unique, and my goal is to empower them with knowledge and personalized care. Whether you’re battling acne scars, hyperpigmentation, or signs of aging, remember that solutions exist. You deserve to love the skin you’re in.

If you’d like to learn more about skin restoration or click here to schedule a consultation. Together, let’s create a brighter future for your skin!


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