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What are safe and effective non-ablative treatments for acne scars if I have active acne?

Acne & Scars Skin, Hair & Nails

I have suffered from acne my whole life. I am now on my 2nd course of low dose Accutane (10mg/day). I am still breaking out badly. I have extremely severe acne scars, and now I am thinking of treating my scars. Through researching, I found out that non-ablative treatments while on low dose Accutane is safe. I would like to find out what are possible safe and effective non-ablative treatments for acne scars if I have active acne? Would it be safe to go for INTRAcel with active acne? Thank you very much.

DOCTOR’S ANSWER (2)



I'm sorry to hear about your ordeal with acne; it surely can be a frustrating affair.

1. With regards to the current treatment of your active acne, it might be best to have a thorough history of your acne occurrence, your previous forms of management, and your current regime to find an effective solution for it. Oral isotretinoin, together with continued topical management is key. 

Other solutions include chemical peels for acne control, as well as more definitive solutions such as AGNES micro-needling radio-frequency treatment to permanently destroy existing sebaceous glands that are causing the recurrent breakouts.

2. Ablative treatments have been deemed safe for use even if on oral isotretinoin, and especially so if on low-doses. These treatments include the traditional CO2 and erbium lasers. If you are looking for something with a lower downtime, however, non-ablative lasers like the Picosecond fractional lasers (also offered at our clinic) are a good option. 

A combination of treatments are ultimately key, but that will be decided during consult.

3. I would not recommend attempting acne scar treatment if you are currently facing a severe acne breakout for two main reasons:

i) The stimulation and heat from scar treatment can aggravate active acne
ii) As the active acne subsides, it may leave new scars that were not otherwise treated by the scar therapy, requiring more subsequent sessions to completely manage

Your current issue with acne sounds like a tricky one, and I would advise a a thorough consult to align your understanding and expectations with medical management. Do feel free to contact us should you require further assistance. 

Cheers.
Best Regards,

Dr Shane Abucewicz-Tan


Dr Shane Abucewicz Tan
MBBS, MRCS

Genesis Aesthetic Clinic

68 Orchard Rd, #01-50, Singapore 238839


663 views 2 Nov 2018

It is very frustrating, and I understand it well (had horrid acne in the past). Had solved it with Isotretinoin and now I use selectively good noncomedogenic products to reduce any outbreaks.

Pertaining to your question, low dose Accutane (30mg per week) can allow even fractional lasers based on recent studies. Which treatments would do well will ultimately depend on your acne scars morphology.

Intracel RF with active acne is fine, if the acne isn't pustular or severely cystic as the risk of spread with the needles may result in a wider spread. Isotretinoin also increases the risk of hyperpigmentation from treatments, including CO2 and INTRAcel, from my past experiences. So do it when its a lower dose (currently you are not suitable in my opinion)

Winston


Dr Winston Lee
MBBS, MCEM, MPH

Inle Aesthetics and Anti-Aging Clinic

3 Simei street 6, #02-28

Singapore 528833


638 views 3 Nov 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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