As inflammation from an acne breakout resolves, it may leave behind residual redness (post-inflammatory erythema, PIE), brown pigmentation (post-inflammatory pigmentation, PIH), or true scars (pitted or raised). Often times, a patient may have any combination of PIE, PIH and true scars. Developing new scars often have redness within them as well.
Although PIE and PIH tend to resolve over time (as opposed to permanent true scars), these blemishes are understandably frustrating and treatment is commonly requested. From past experience, early laser treatment of post-acne redness not only helps to clear up these blemishes faster, but it also helps to prevent or reduce the formation of new permanent pitted scars with early intervention of red developing scars.
Besides laser, one of the things any patient can do to reduce scar formation and acne recurrence is to continue using your prescribed topical acne medications, such as Epiduo gel and retinoid creams, on the PIE, PIH, and acne-prone areas even after their active breakout is better, as instructed by their doctor. Sun protection and avoidance is also recommended.
Different types of laser treatments
For laser treatment, a combination of different lasers might be required to target a combination of different post-acne discolourations and scar.
For post-acne pigmentation (PIH), pigment-targeting lasers are needed to remove the hyperpigmentation. Nano- and Pico-second Nd:Yag lasers are the most commonly used and often with success.
For post-acne redness (PIE), vascular lasers are used to reduce the tiny dilated blood vessels within the blemish and trigger a healing response in red scars. Pulse dye lasers like VBeam, is a classic example that I’ve seen results with. Micro-second Nd:Yag lasers can also be beneficial for post-inflammatory redness patients who are still experiencing breakouts.
The options available doesn’t end there. Fractional resurfacing lasers, like Fraxel Restore (erbium glass laser), have also proved to be helpful for patients suffering from combinations of new or mature scars, stubborn PIH and PIE. Acne should be well-controlled before resurfacing. Those with sensitive or dry skin might take longer to recover after these lasers.
We have had good experiences with newer non-laser modalities such as Sylfirm (a micro-needle repeated pulse radiofrequency treatment) in more sensitive-skinned patients with persistent post-acne redness, deep PIH, early scars and signs of ageing as well.
Perhaps there is no one single best laser that’s ideal for everyone. But there will be a customised solution out there that will work for you. Get your trusted doctor to take a look and have a discussion. Best wishes!
