Acne scar treatment

Introducing our ultimate acne scar treatment, customized to suit your specific scar type. You have the flexibility to choose from a combination of PRP, TCA CROSS, Subcision, PRP resurfacing with fractional laser or microneedling, or even opt for a comprehensive approach combining all these methods simultaneously. This budget-friendly package addresses various scar types without any additional charges.

When it comes to acne scars, diversity is the norm

When dealing with acne scars, individuals often have a mix of scar types on their skin. That's why we provide a range of treatments to address all types of acne scars you may have. Our diverse treatment options are tailored to offer solutions for various acne scar variations in the same person.

Atrophic acne scar: A result of collagen destruction Acne scars are caused by abnormal production and degradation of collagen in the course of the healing process, and result in several types of acne scars. In 80 to 90 percent of cases, there is a net destruction of collagen in the skin that results in an atrophic kind of injury but less frequently, there is a net increase of collagen that results in a raised scar or keloid scars. Type of atrophic acne scar Atrophic scars or indented scars are classified according to the size and depth of collagen destruction; anyway, a different kind of scars is typically seen on the same person, making differentiation difficult.

Icepick Scars (Approx. 65%):
- Narrow, V-shaped indentations
- Less than 2mm in size
- Deep and challenging to treat with standard resurfacing
Boxcar Scars (Approx. 20%):
- Oval-to-round depressions
- 1.5–4.0mm in size
- Shallow scars are manageable with skin resurfacing, while deeper ones pose challenges
Rolling Scars (Approx. 15%):
- The widest scars, up to 5mm in diameter
- Create an undulating appearance due to fibrous adhesion
- Superficial shadowing and challenges in treatment

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Skin resurfacing treatment

Acne scar resurfacing by fractional laser

Laser resurfacing, which eliminates the outer layer of the skin to enhance skin regeneration, has been in use since the mid-1990s. Laser resurfacing also has the effect of heat to improve skin regeneration along with elasticity.

Perfectra laser is the latest generation of carbon dioxide fractional lasers, with the combined effects of CO2 laser and fractional technology. A micro-ablative dot of the laser penetrates deep into the skin. Thus severe skin damage is avoided, while lateral thermal damage is decreased, thus reducing downtime and the chances of side effects.

Perfectra lasers have a double effect – they encourage renewable processes of the wound and new collagen production as the hyaluronic acid.

The results of fractional laser treatment in acne scars are fast and practical. Depending on the scar condition and skin type, it significantly improves the look. About 35% of customers there is a complete removal of scarring and, in another 40%, a significant improvement of scars with nearly all showing a decrease of the lesions. Dotted ice prick and indented scars showed the best response to treatment with fractional laser. Fractional photo thermolysis using fractional perfecta laser is a safe and effective method for treating acne scars.

For individuals with darker skin tones or those seeking an alternative to laser treatment, we offer the option to switch to micro needling as a resurfacing method at no additional cost.

TCA CROSS

TCA cross is short for “Trichloroacetic acid chemical reconstruction of skin scars” is a technique using high concentrations of acid (TCA) focally on indented acne scars to induce inflammation followed by new collagen production. This can lead to a decrease in the dept of scars and improve cosmetic appearance.

The CROSS technique was the first report by Lee and colleagues. In this technique, a high concentration of trichloroacetic acid is registered focally, by pressing a toothpick-like applicator on the entire indented area of the ice pick scar. Producing a frosted appearance on each scar. Healing is more rapid and related with a low chance of complication rate as the adjacent skin structures are spared.

100% TCA is made to order. We start with a facial cleansing using water and soap to remove oil from the skin. All the ice pick acne scars were marked. Apply the bottom of the injury with 100%. The skin was observed until a ‘frosted’ appearance was seen. The frosting is a result of the protein denature, which is the start of inflammation triggering the new collagen production process. The pain and uncomfortable from this procedure are so minute so no numbness cream or any local anesthesia needed. You may experience mild burning, which was well-tolerated. This was accompanied by frosting, redness and edema, which reduce in 4-6 hours. Crust formation was shown on the next day, which gradually falls off within 3-4 days in most patients depending on their skin type.

A sunscreen should strictly use until all crust falls off to prevent post-inflammatory hyper-pigmentation. Makeup can be applied as usual.

Individuals with exceptionally oily skin or those who use an abundance of moisturizer may experience a different healing process, potentially skipping the scab and crust phase.

During the scab phase, in some cases, you may feel that the scar looks deeper than normal. This occurs because the scar tissue is shrinking and preparing to peel off, creating the temporary appearance of a deeper scar bottom. However, this is a transient effect, and the scar will gradually refill through new collagen production after the scab phase, which typically lasts about 10 days, depending on the skin type.

TCA cross result at revival clinic Bangkok.

Eighty percent of our customers show excellent improvement after four sessions and there have never been any severe side effects shown. At the three-month follow-up, the ice prick scar continued to show improvement.

Subcision

At Revival Clinic, we specialize in classic subcision, a minimally invasive procedure that is gaining popularity for its effectiveness in treating atrophic acne scars, especially rolling scars.

During the procedure, a small needle is used to break up fibrous bands of scar tissue beneath the skin. These bands tether the skin, causing depressions. By releasing these adhesions, subcision helps the skin regain a smoother appearance. We prioritize the delicate balance between the risks and benefits of the treatment.

At Revival Clinic, our approach to subcision is cautious. We avoid aggressive subcision techniques that may carry a higher risk of complications, such as scarring. Our focus is on achieving optimal results with minimal risk, ensuring a safe and effective treatment for our clients.

The process involves local anesthesia for comfort, and the needle is strategically moved to disrupt the fibrous bands causing depressions. This controlled trauma prompts the body to produce new collagen, aiding in the elevation of depressed scars.

Recovery is brief, allowing individuals to resume normal activities quickly. Results are gradual, with ongoing collagen production. Multiple sessions may be needed for optimal outcomes.

Subcision is particularly suitable for atrophic scars, such as rolling scars, and may be less effective for raised or hypertrophic scars. Dermatologists often recommend combining subcision with other therapies, like laser treatments, for enhanced results.

Individuals considering subcision should consult with a dermatologist at Revival Clinic to determine the most suitable treatment plan based on their unique skin characteristics and scar severity, ensuring a personalized approach that prioritizes both safety and effectiveness.

PRP

Self-extracted growth factor treatment for acne scar

The self-extracted growth factor contains the plasma portion of high platelet concentration. Platelets release growth factors and also platelet-derived growth factor plus transforming growth factor-β, facilitating and accelerating soft tissue regeneration. With its regenerative properties, the self-extracted growth factor enhances the response of acne scars to resurfacing treatment and decrease the post-procedure side effects.

Multiple mechanisms can explain the synergistic effects of self-extract growth factors on overall clinical improvement.

Activated platelets that contain secretory proteins (e.g., platelet-derived growth factor and transforming growth factor) which facilitate chemotaxis and mitogenesis of stem cells, blood vessel formation, and collagen production.
Enhance the production of hyaluronic acid which can absorb water, increasing skin volume and elasticity, enhance cell regeneration, extracellular matrix, and collagen production.

After care

After-care treatment is a crucial factor for the success of the procedure. Following the treatments, the reliance is now on your body to naturally produce new cells and collagen. To ensure the optimal performance of the treatment, it is essential to provide them with proper after-care.

Avoid exposure to strong sunlight during the first two weeks, as UV light can disrupt new collagen production.

Apply a generous amount of sensitive skin moisturizer, as your own stem cells and fibroblast skin cells will collaborate with the treatment, and they perform best on moist rather than dry skin.

Pay attention to your nutrition by avoiding high-sugar foods. Ensure an adequate intake of protein and vitamin C, as they are essential building blocks for new collagen production.

Refrain from smoking and limit exposure to passive smoking for the next 6 months, as this period is crucial for intense new collagen production.

Do not go swimming for at least 5 days after treatment.

No exercise and avoid for 24 hours of treatment.

Regular make up can apply normally the day after treatment.

Avoid alcohol-based toners and whitening for the first week

Q & A

My scars are quite severe, but I saw you offered many techniques for correction. I want to get an idea of what would be the recommended procedures?

Generally, we use multi-modality in each session (TCA cross, PRP, subcision, fractional laser, micro-needling).

This plan works best because the different treatments will take care of all types of scarring; of course, the details of your treatment will depend upon your skin examination.

We can discuss the details more during a face to face consultation. Keep in mind there is no obligation or consultation fee.

I have resistant acne scarring, what would be the best plan for treatment.

The best way in my opinion is

First session

TCA cross - to correct pitted scar
PRP subcision - self-extracted growth factor help stimulate new collagen production
Revival Peel - improve shallow acne scar
Miracle mask - a decrease inflammation and downtime from the treatment

Second session

Micro-needling - resurface the whole area make the skin even and smooth
fractional laser - for deep pitted scar
PRP subcision - self-extracted growth factor help stimulate new collagen production
Miracle mask - a decrease inflammation and downtime from the treatment

These procedures would be alternated once a month until the desired results are achieved.