Acne scarring

I am one of a handful of doctors in the UK offering multiple surgical managements options for acne scarring. Available techniques include:

- Subcision (with or without a Taylor Liberator)

- Punch or surgical excision (1mm upwards for punch biopsy)

- Combination with Polynucleotides using a diffuse injection technique (DIT)

- Combination with microfat subdermal infiltration (MSI)

- PRX-T33 the latest TCA treatment giving a skin peel without exfoliation or downtime

- Fully Ablative CO2 Laser (surgery and resurfacing) 

These treatments help to regenerate and remodel the scarred skin thereby giving it a more normal structure and contour. They can also be combined with polynucleotides for even better results.

Depending on whether there are Boxcar, Icepick, Rolling or Superficial acne scars will dictate the directed management. It is possible to utilise a punch biopsy, for example, to remove the central portion of a boxcar and then finely suture the edges to elevate the central component to blend the depression and reduce the contour deficit.

Other techniques which are considered much lower risk can sometimes be ineffective - micro needling, chemical peel, radio frequency micro needling - and the above techniques can be invaluable.

Even more vital is considering not only the physical manifestations of acne scarring but the important and interlinked aspect of the psychological aspect. It is said that acne scarring is more than skin deep as it is a very complex dermal process impacting self esteem and well being, too. 

Complementing the finesse of subcision and punch biopsy treatment is the regenerative potential of polynucleotide injections. Derived from nucleic acid molecules, these injections harness natural healing processes to increase tissue repair and regeneration. 

The unique composition of polynucleotides stimulates collagen synthesis, enhances skin elasticity, and accelerates wound healing processes. There is good data from clinical trials validating their utilisation in acne scarring.

As a result, polynucleotide injections serve as an invaluable adjunct to acne treatment, amplifying its effects and prolonging its benefits - enhancing collagen synthesis to improve skin elasticity and accelerate the wound healing processes.

Worried about healing post treatment? Consider PRX-T33 which provides a novel TCA treatment without injections that gives improved skin quality without the downtime of laser

CO2 lasers demonstrate fractional photothermolysis to create microinjuries within the dermal layer of the skin that stimulates collagen production and promotes tissue remodeling

Moles

Small benign moles can be safely removed with a surgical curettage to remove the mole and a very thin area of underlying skin. 

This is carried out after local anaesthetic injections to fully anaesthetise the area to make it numb. By removing such a thin area the skin can regenerate and heal from the outside edges and the base without stitches. 

The area initially scabs over, a little like a graze, and after a few weeks the graze falls away revealing fresh healthy skin. At first this is red, and over a few months fades to pink and then matches the surrounding skin. It frequently leaves an almost imperceptible area.

Not all moles are suitable for this, some may require surgical excision and stitches, but this way typically leaves a fine scar. This is more suited if there are medical problems that interfere with wound healing, or medications that thin the blood that cannot be stopped.