There are three main types of post-acne signs. Brown spots, pink spots, and "real" acne scars. Pink spots will usually fade away on their own within about 2-3 months (once the active acne is controlled). The dark, brown spots can be faded away, using dark spot removers. "Real" acne scars, also referred to as "ice-pick," "boxcar," or "rolling" scars, are more complicated to treat, and will require in-office non-surgical acne scar treatment.
How to improve depressed and Icepick acne scars without surgery?
Depressed acne scars are large and shallow and ice pick scars are narrow and deep.
Until a few years ago, the only treatment options were dermabrasion (wire brush "sanding" of the skin, deep CO2 laser resurfacing, chemical peels, and microsurgery. As these treatments are frequently associated with prolonged downtime, discomfort, and pain their use decreases.
A new treatment technology combines two methods previously used individually for skin rejuvenation, fractional treatment, and radiofrequency. This combination therapy, known as fractionated radiofrequency, can be used for all skin types and is very effective for the treatment of acne scars.
There are two types for fractionated radiofrequency. Fractional RF resurfacing that treats both the epidermis and dermis and fractional micro-needling radiofrequency that treats deeper layers of the epidermis. Both types of fractionated RF have been proven to be a superior alternative to fractional ablative lasers, comparable efficacy with minimal pain and downtime.
What is Fractional skin resurfacing (FSR)?
The concept of fractional skin resurfacing by laser devices was developed to contend with the shortcomings of full-face resurfacing. With these systems, small microscopic "dots" of skin are ablated, allowing for rapid healing with minimal pain and downtime.
What is radiofrequency?
Radiofrequency (RF) is the same energy that is used to transmit radio signals. It is used in medicine very safely for many decades. Radiofrequency technology has been used for many years to improve skin laxity and rhytids. This technology works differently than laser, as it uses tissue resistance within various layers of the skin to transform radio wave (RF) energy into thermal energy. This then stimulates new collagen production. An advantage to RF over laser is that it should also be safe for all skin types since no light is emitted into the skin to stimulate melanin directly.
What is Fractional skin resurfacing (FSR) with radiofrequency?
The original, 3DEEP fractional RF Resurfacing handpiece uses a matrix 112 tiny RF micro-electrodes, to create small zones of epidermal coagulation with simultaneous volumetric dermal heating of up to 2.8mm. The unique system developed EndyMed uses six independent sources of RF instead of the one source used in other RF systems on the market (Monopolar, Bipolar, "Multipolar"). The use of multiple sources of RF in the EndyMed PRO allows for both deep dermal non-ablative skin tightening and micro ablative fractional RF skin resurfacing, all on the same system console.
What is expected during the treatment?
After the treatment area is cleansed the doctor will apply to your skin a topical anesthetic cream to numb the area. After 30 minutes the treatment will be performed. The pain during pain is very minimal if any. After the treatment, the treated skin will be red for a few hours. On the second day of treatment, small micro crusts were formed on the skin, which lasted up to 5 days. Multiple studies using this system were no incidences of infection, scarring, hypopigmentation, or any other serious complications in any of the patients.
What is Fractional micro-needling with radiofrequency?
Fractionated RF micro-needling uses very thin, 300-micron needles, to safely deliver fractional radio-frequency (RF) energy to specific locations into the deeper skin layer known as the dermis. This energy promotes the body's natural production of collagen and elastin, which fill and decrease the width and depth of acne scars.
What are the advantages of fractional RF micro-needling over fractional lasers?
There are many advantages to fractionated RF micro-needling over fractional lasers. A limitation in treating acne scarring with fractional lasers has in the treatment of acne scars, is the risk of hyperpigmentation, particularly in darker skin types. Radiofrequency energy is not absorbed by melanin, which decreases the risk of post-inflammatory hyperpigmentation, In addition, in contrast to the uncontrolled tissue interactions with fractional lasers, the energy in fractional RF systems can be accurately controlled and can be delivered by the needles at precise depths.
Both RF and fractional lasers have been shown to stimulate collagen production which will help decrease wrinkling and tighten the skin. Radiofrequency has the added advantage of increasing elastin density which can be significant in the treatment of depressed and icepick acne scars.
Is there a difference between fractional radiofrequency micro-needling devices?
Fractional micro-needling RF devices are very different. Older generation systems like Fractora by Inmode and Syneron profound use manual or mechanical insertion of the needles. These technologies are usually much more damaging to the epidermis, more painful, and with a higher risk for PIH (post-inflammatory hyperpigmentation).
A newer, more sophisticated systems like the Endymed Intensif uses the smooth motorized insertion of the needles. This technology provides a safer and more effective procedure with no to minimal pain.
Another difference is the way the epidermis is protected. The older type of microneedles (Infini Lutronic and Syneron profound) protect the epidermis with plastic sheets. As the RF is emitted through a small portion at the tip of the needles the treatment is more painful and longer. Electronically epidermal protection used by Endymed, allows homogenous heat emission along with the need, reducing pain, reducing treatment time, and increasing safety and efficacy.
How is micro-needling RF performed?
Each treatment takes about 15–20 minutes of active energy delivery, and results gradually appear over the next several months. While each patient's skin condition is unique, Intensif RF Microneedle treatment generally requires a series of treatments spaced approximately four weeks apart to ensure optimal results. The procedure is typically well-tolerated, with little discomfort and minimal downtime. There is no need for any special post-treatment expect for sunscreens. The most common side effects are redness and swelling in the treatment area, which generally resolves within a few days. In contrast to fractional laser treatment, RF devices can be used on all skin tones and the incidence of inflammatory hyperpigmentation is very low.