Hi, I'm Dr. Qazi, a skin restoration specialist based in Newport Beach, California. My focus is primarily on treating acne and scars, pigmentation issues, and collagen stimulation. Over the years, I've helped numerous patients achieve remarkable improvements in their skin health. Today, I want to walk you through one of my most rewarding cases—transforming severe acne scars into nearly flawless skin.
The Case Study: Transforming Severe Acne Scars
This particular case involves a patient with Fitzpatrick 4 skin type, which presents unique challenges in treatment due to the risk of pigmentation issues. She had previously undergone treatments elsewhere without satisfactory results. When she came to me about three years ago, her goal was clear: she wanted her scars to be as smooth as possible.
We embarked on a comprehensive treatment plan that included multiple steps over two years. Here’s what we did:
- Subcision : This procedure involves breaking up scar tissue underneath the skin manually.
- TCA Cross : An acid placed at the base of scars to destroy scar tissue and promote healing.
- Laser Resurfacing : Both fully ablative CO2 laser and lower energy erbium laser were used to remodel and restructure scars.
- Filler Treatments : Specifically, Bellafill, a collagen-stimulating filler, was administered in several rounds.
- Pico Laser : This addressed hyperpigmented areas and further improved the texture.
The results? Nearly complete resolution of her scars, even under harsh lighting conditions. Her family and friends have noticed the transformation, and she feels more confident than ever.
Why Skin Restoration Takes Time
Achieving such dramatic improvements doesn’t happen overnight. For this patient, it took three years of consistent treatments spaced out to ensure proper healing and minimize risks like pigmentation changes. Patience and persistence are key components of successful skin restoration.
Importance of Customized Treatment Plans
Every patient's skin is different, and thus, a customized approach is crucial. In this case, we had to carefully balance aggressive treatments with the patient’s Fitzpatrick 4 skin type to avoid pigmentation issues. We opted for treatments like TCA Cross and laser resurfacing instead of phenol peels, which could have caused significant pigmentation problems. Customization ensures not only effectiveness but also safety, minimizing downtime and side effects.
Role of Lifestyle and Skincare
Lifestyle choices and skincare routines also play a vital role in the success of skin restoration treatments. Simple yet effective practices, such as using moisturizers and sunblock, can significantly impact healing and overall skin health. During treatments like Accutane, avoiding active ingredients like glycolic acid or retinoids is essential to prevent excessive dryness and irritation. Patients often underestimate the power of basic skincare, but maintaining a consistent routine can make a substantial difference in treatment outcomes.
Questions Answered
Here are some common questions I received during my live session:
- Question: Why can't filler just resolve the issue?Dr. Qazi: Filler alone isn’t enough because these aren’t just fat loss issues. Boxcar scars require more than just volume; they need structural changes that fillers alone can’t provide.
- Question: For similar scars but deeper, would the best plan be a phenol peel?Dr. Qazi: Phenol peels carry significant risks for Fitzpatrick 4 or higher skin types, including pigmentation changes. We opted for less aggressive methods like TCA Cross and laser treatments.
- Question: Is it possible to get scarless skin?Dr. Qazi: While “scarless” might be an ambitious term, achieving near-invisible scars is certainly possible with the right combination of treatments over time.
- Question: Is this laser treatment?Dr. Qazi: Yes, but it’s not just laser. It includes subcision, TCA Cross, fillers, and various types of lasers tailored to individual needs.
- Question: Do you have any before and after photos of dark under-eye circles with hollowness?Dr. Qazi: Absolutely! I have excellent results showcasing improvements in under-eye hollowness using advanced techniques like ultrasound dissolving.
- Question: Hi, I have very deep acne scars and was wondering if one treatment of PRP laser would help my skin.Dr. Qazi: PRP is beneficial for healing but not ideal for deep acne scars. Multiple sessions combining different treatments yield better results.
- Question: Can you get Bellafill if you already have hyaluronic acid filler without it being dissolved?Dr. Qazi: Yes, you can combine Bellafill with existing hyaluronic acid fillers effectively.
- Question: Hey doc, getting my second round of Accutane, I was wondering what would be beneficial to try to subside the purging.Dr. Qazi: Zinc, omega-3s, Claritin, moisturizers, and avoiding active ingredients like glycolic acid can help manage purging symptoms during Accutane.
- Question: Hey Dr. Qazi, given that you did TCA, subcision, and laser, when would a dermatologist do punch excisions instead?Dr. Qazi: Punch excisions are reserved for specific, deeper scars. Misapplication can lead to complications, so careful assessment is crucial.
- Question: Do you think that with advancements in medicine, we might eventually find a 100% cure for scars?Dr. Qazi: With current technology, near invisibility is achievable. Future advancements may bring us closer to perfect solutions.
- Question: Is there more of a risk of sagging with subcision when performed on older skin?Dr. Qazi: Risk depends more on location and technique rather than age alone. Proper execution minimizes risks.
- Question: Hi Dr. Qazi, I've seen some before and afters of dark lips becoming much lighter using the Pico laser—is this true or Photoshop?Dr. Qazi: It’s true! The Pico laser stimulates collagen and lightens dark lips effectively.
- Question: Is there a way to reduce the risk of scarring from existing breakouts just dealing with new spots here as a cure is kicking in?Dr. Qazi: Silicone tape, oral antibiotics, and antihistamines like Claritin can mitigate scarring risks significantly.
- Question: How long did it take to achieve this result?Dr. Qazi: About three years, with treatments spread out to allow proper healing and optimal outcomes.
- Question: I’ve been on dapsone for many months and am worried about antibiotic resistance with it. Is there any way I could avoid this?Dr. Qazi: Combining dapsone with benzoyl peroxide or clindamycin reduces resistance risks. Regular monitoring ensures safety.
- Question: Anything to help reduce redness while on Accutane?Dr. Qazi: Vanicream is highly effective for hydration and reducing redness during Accutane treatment.
- Question: What's your opinion on dermabrasion?Dr. Qazi: Dermabrasion works well for certain types of scars but should be done cautiously to avoid hypo-pigmentation and infection risks.
- Question: Can silicone tape reverse new acne scars that are a few weeks to months old?Dr. Qazi: While reversing isn’t guaranteed, silicone tape helps stimulate collagen production, potentially improving newer scars.
- Question: Any worry about immune response from Bellafill filler?Dr. Qazi: Rarely, but skin tests can identify potential reactions. Most patients tolerate Bellafill well, even those with autoimmune conditions.
- Question: Do you think many people of all different severities can achieve the more polished look with the right approaches and time?Dr. Qazi: Yes, with dedication and appropriate treatments, most individuals can see substantial improvements regardless of initial severity.
- Question: Can fractional CO2 laser cause fat loss in the face?Dr. Qazi: Aggressive settings can lead to fat loss, but controlled use minimizes this risk.
- Question: Hi Dr. Qazi, I did a cool laser, and my skin seems worse. How can I heal my skin?Dr. Qazi: Post-laser irritation can occur. Use intensive moisturizers like Vanicream consistently for several months to aid recovery.
- Question: Can rosacea cause acne?Dr. Qazi: Absolutely. Treating underlying rosacea often leads to better control of acne symptoms.
Conclusion
Skin restoration is both an art and a science. Each patient requires a personalized approach tailored to their unique skin type and condition. By combining various treatments—from subcision and TCA Cross to advanced laser therapies and fillers—we can achieve transformative results. Remember, patience and consistency are vital. With the right care and guidance, achieving smoother, clearer skin is within reach.
If you’re interested in learning more about skin restoration or scheduling a consultation, feel free to reach out. Together, we can work towards your skincare goals and help you regain confidence in your appearance.
