Resurfacing the acne-scarred face.

BACKGROUND : Dermabrasion has been a useful method for the improvement of acne scars since 1953. However, the improvement is often limited. Adjuvant procedures are often necessary to improve results. OBJECTIVE : To improve the results of resurfacing the acne scarred face. By combining the techniques of subcutaneous filling, laser shrinkage of collagen, dermabrasion, and excision, we hope to achieve better results. METHODS A Jessner/TCA peel is performed on the neck and décolleté area after the skin has been preconditioned with vitamin A conditioning lotions. The acne scars are subcised with a semi-blunt needle, and the developed pockets are filled with adipose tissue. Following this, the surface skin is vaporized with three passes of the CO2 laser, and the deeper acne scars in the mid-face region are sanded with a diamond fraise. Residual scars are excised and sutured. A semi-occlusive dressing is used for 5 days, then replaced with an ointment-based moisturizer. After 10 days, a moisturizer-sunscreen is used, followed with a bleaching cream at 15 days. Make-up may be applied after 14 days. CONCLUSION : By combining these multiple modalities it is possible to produce a dramatic improvement of the acne-scarred complexion.