Channel: Dr Davin Lim

Category: Film & Animation

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Description: instagram.com/drdavinlim More on acne scars & how to treat Dr Emil Henningsen @emil_henningsen Acne Scars | Dermatologist Podcast Acne scar revision is a complex field, as this treatment is often trivialised by aestheticans as well as physicians. The most important aspect of scar revision is to identify the scar type and then treat accordingly. Acne scarring is classed as a medical treatment and NOT cosmetic. For patients with significant scars we are bring skin structures back to normal, or close to normal as we can. We are not enhancing a baseline, and hence revision is medical and not ‘aesthetic’ in nature. In the majority of cases manual therapy is far more effective than devices such as lasers, microneedling, RF, HIFU etc… Devices should ONLY be used as adjunctive treatment. Of course there are exceptions to the rule. An example is if one has monomorphic shallow to medium box car scars. This pattern responds to ablative lasers as the scars are all in the same plane of ablation. The vast majority of acne scars are atrophic, meaning there is a depression in the skin. Atrophy can be due to loss of fat, collagen, elastin, hyaluronic acid, or a combination of all elements in the dermal-subdermal layer. If you can not generate collagen with your own immune system, fillers may be required. There are 3 more options for atrophic scars, including 1. Fat. Fat transfer is not predictable, there is a higher risk of lumps and bumps with this procedure. 2.Dermal grafts. Involves incision with specks of dermis inserted via a nick in the skin. This requires multiple sessions and will leave a linear scar. 3. Dermal smashing is similar to dermal grafts, downside is possible epidermal inclusion cysts as a result of transfer of keratinocytes from follicular units into the dermis. Most atrophic scars will have attachments in the deeper dermal and fat layers, hence the need for proper subcision. The early studies in 1995 used beveled needles, the latest studies conducted within the past 3 years have shown the efficacy of cannula subcision as the treatment instrument of choice over normal needles and NOKOR needles. Studies have clearly demonstrated that cannula is more effective and safer compared to traditional needles and NOKOR. The field of acne scar revision is complex, I hope this video gives patients an insight as to how specialists in this field approach scar revision. Our opinions are reflected in the most recent publications on this topic. Dr Davin S. Lim @cliniccutis Brisbane. Australia.