There are three main types of post-acne signs: pink spots, brown spots, and "real" acne scars. Post-acne pink spots will usually fade away on their own within about 2-3 months (once active acne is controlled). Dark, post-acne brown spots can be faded with the help of topical dark spot removers. "Real" acne scars are textured, often referred to as "ice-pick," "boxcar," or "rolling" scars. Textured scars are more complicated to treat and typically require in-office non-surgical acne scar treatment.
Can I get rid of acne scars with topical treatments?
It is not possible to eliminate real depressed acne scars with creams. That said, people that are not interested in surgical procedures, radiofrequency or laser treatments can try and use a retinol/niacinamide cream to improve their skin texture and reduce the appearance of scars. Dark spot removers with hydroquinone or arbutin can help with dark acne scars.
How do you improve textured scars without radiofrequency and lasers?
Depressed acne scars are large and shallow, and "ice pick" scars are narrow and deep. Until a few years ago, the only treatment options for textured scars were dermabrasion (wire brush "sanding" of the skin), deep CO2 laser resurfacing, chemical peels, and microsurgery. Unfortunately, these treatments are frequently associated with prolonged downtime, discomfort, and pain. There is now a new treatment technology available that combines fractional treatment and radiofrequency, two individual skin rejuvenation methods. This combination therapy is known as fractionated radiofrequency (RF).
There are two types of fractionated radiofrequency. Fractional RF skin resurfacing treats both the epidermis and dermis and fractional micro-needling RF treats deeper layers of the epidermis. Both types of fractionated RF have been proven superior to fractional ablative lasers, with comparable efficacy with minimal pain and downtime.
What is fractional RF skin resurfacing (FSR)?
The concept of fractional RF skin resurfacing by laser devices was developed to contend with full-face resurfacing shortcomings. 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. Radiofrequency technology has been used safely for decades 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 stimulates new collagen production. An advantage to RF over laser is that it should 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 of 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 a topical anesthetic cream to your skin to numb the area. After 30 minutes, the treatment will be performed. The pain during the treatment 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 will form on the skin, lasting up to 5 days. Multiple studies using this system found 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 fills and decreases acne scars' width and depth.
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 treating 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 significantly treat 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 needles' tip, 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 except 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.
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