Dr. Tania Cohen, DMSc, PA-C, typically starts acne scar treatments by pre-processing the skin with a peel to minimize the risk of hyperpigmentation from subsequent laser procedures. For severe scarring, she often employs punch excision or subcision techniques. In cases where tissue loss has occurred, Bellafill injections are used to restore volume. This is usually followed by laser treatments, and the regimen is completed with microneedling combined with platelet-rich plasma (PRP) and growth factors to boost collagen production and enhance healing.
To address facial redness associated with acne and its scarring, Tania Cohen DMSc, PA-C utilizes a combination of Intense Pulsed Light (IPL) therapy and vascular laser treatments.
KELOID SCARS
Also referred to as “Hypertrophic Scars,” keloids are typically thick, raised, and dark red or purple in appearance. Treatment options commonly include topical therapies and scar gels, vascular lasers, Intense Pulsed Light (IPL), LED light therapy, steroid injections, fractional lasers, fractional radiofrequency treatments, and microneedling with platelet-rich plasma (PRP).
ATROPHIC SCARS
Characterized by sharp-edged “Boxcar Scars” or rounded “Rolling Scars,” these sunken, pitted depressions are more conspicuous under side or overhead lighting, creating shadows in the divots of the skin. Dr. Tania Cohen, DMSc, PA-C, employs a customized approach that includes microneedling, ablative or non-ablative laser resurfacing, microneedling with PRP, microneedling RF, subcision, dermal fillers, collagen stimulators, and chemical peels.
ICE PICK SCARS
Often called “Pox Scars,” these deep, narrow pits in the skin do not respond well to laser treatments or chemical peels alone. To effectively treat stubborn Ice Pick scars, Dr. Tania Cohen, DMSc, PA-C, utilizes TCA CROSS or punch excision, complemented by microneedling RF, radiofrequency skin remodeling, peels, and injectable fillers.
LASER TREATMENTS FOR ACNE SCARS
Before performing fractional skin resurfacing or ablative laser treatments, Dr. Tania Cohen, DMSc, PA-C, prepares the skin by using a peel. This pre-treatment step helps to ready the skin cells for deeper laser penetration. Additionally, when peels are used both before and after laser procedures, they can help reduce the risk of post-inflammatory hyperpigmentation, particularly for patients with darker skin tones.
ABLATIVE AND NON-ABLATIVE LASERS
Fractional ablative lasers, such as CO2 and Erbium, are powerful treatments that vaporize the skin’s surface to remodel it. These lasers are effective in improving scarring, discoloration, sun damage, and fine lines and wrinkles in just one session. They utilize short-pulsed light energy to remove thin layers of skin, promoting cellular turnover and collagen production in the treated area. This process replaces the ablated skin with new, healthier skin cells.
Fractional non-ablative lasers,
Fractional non-ablative lasers, such as HALO, offer lighter skin resurfacing aimed at treating textural issues and superficial scarring. When used at a low density, these lasers pose a minimal risk of hyperpigmentation, making them suitable for patients with darker skin tones.
Vascular Lasers, including the 1064 YAG, are designed to target unwanted or abnormal blood vessels, making them a preferred choice for Dr. Tania Cohen, DMSc, PA-C, in treating facial redness and hypertrophic acne scars (or keloids). These lasers deliver high-pulsed energy deep into the scar tissue, helping to shrink thickened collagen and reduce discoloration. Beyond acne treatment, vascular lasers can also improve discoloration and pigmentation issues, rosacea, visible veins, and stretch marks.
MICRONEEDLING FOR ACNE SCARS
Microneedling has garnered significant attention in Hollywood, where achieving perfect skin is paramount. This treatment involves using a microneedling device to create tiny punctures in the designated area, inducing pinpoint bleeding and stimulating new collagen production. It is highly effective for treating acne scars and can be performed frequently with minimal pain and downtime. Dr. Tania Cohen, DMSc, PA-C, incorporates microneedling as a fundamental part of her patients’ monthly skin care protocols. She also recommends weekly at-home dermaroller treatments to sustain collagen production and promote cellular turnover between laser sessions.
MICRONEEDLING RF
Microneedling RF employs the same technique as traditional microneedling but enhances it with radiofrequency energy. The addition of RF energy boosts collagen production and accelerates healing, with adjustable energy levels tailored to the severity of the scars. Dr. Cohen uses microneedling RF devices to customize treatments for specific scarring, including non-invasive fractional skin remodeling. The RF energy penetrates deep into the subdermal layers, stimulating collagen production and thickening the tissue. This results in tightened skin, an improved complexion, and reduced pore size.
Microneedling RF is also safe and effective for individuals with darker and more sensitive skin, as no heat is applied to the skin’s surface.
TCA CROSS FOR ICE PICK SCARS
TCA CROSS, or the Chemical Reconstruction of Skin Scars using Trichloroacetic Acid (TCA), is a specialized procedure designed to treat ice pick scars.
TCA CROSS- A UNIQUE PROCEDURE
This distinctive technique is particularly effective for ice pick scars and is performed by only a select group of skilled professionals due to the precision required. Dr. Tania Cohen, DMSc, PA-C, expertly administers a concentrated TCA solution directly to the base of the ice pick scar. Upon application, the treated area turns white as the skin reacts to the TCA, initiating new collagen production. In the following days, the treated area will scab and gradually resurface, with significant improvement often visible after 3-6 treatments.
TCA CROSS can also be combined with other treatments such as lasers, peels, and microneedling to achieve more rapid and enhanced results.
DERMAL FILLERS FOR ACNE SCARS
Dermal fillers such as Bellafill, Juvederm Ultra, Juvederm Ultra Plus, Restylane, Restylane Silk, Restylane Lyft, Voluma, and Sculptra can be utilized to elevate acne scars, providing a smoother skin appearance. Other options include Volbella. Typically, this treatment is combined with lasers, microneedling, and sometimes TCA CROSS for optimal results. During the consultation phase, Dr. Tania Cohen, DMSc, PA-C, will make specific product recommendations based on your unique needs and skin type.
DERMAL FILLERS
Acne scarring manifests in various forms, such as rolling, tethered, and boxcar scars. The imaging techniques mentioned earlier allow Dr. Tania Cohen, DMSc, PA-C, to customize treatment plans for these different types of scarring. Subcision combined with dermal fillers helps to break the bonds that tether the skin down, while the fillers stimulate collagen production. This combination is particularly effective for treating tethered and atrophic scars.
FIGHT ACNE SCARS WITH LONG-TERM INJECTABLES
Stem cells and growth factors, such as PRP (platelet-rich plasma), can be utilized to boost volume and collagen production beneath acne scars. This approach not only lifts the scar immediately but also provides long-term structural improvements that enhance the scar’s appearance. Here’s how it works:
Dr. Tania Cohen, DMSc, PA-C, may also opt for fillers like Sculptra or Bellafill, depending on your specific type of scarring, skin type, and other unique factors.
– Finally, stem cells and PRP are injected into the living tissue to aid in building and remodeling damaged areas, leading to natural improvements over time.
SUBCISION FOR ACNE SCARS
Acne scars form when the top layer of skin is pulled down, creating a divot and shadow. Through subcision, Dr. Tania Cohen, DMSc, PA-C, inserts a blunt cannula beneath the scar’s surface to release the top layer of skin. This process breaks up the scar tissue, enabling subsequent treatments like lasers, microneedling, and fillers to further reduce the depth of the divot.
PUNCH EXCISION FOR ACNE SCARS
Punch excision involves surgically “punching” out the acne scar using a blade that fits precisely around the scar. The resulting wound is immediately sealed to initiate healing. This technique is particularly effective for deep boxcar and ice pick scars with well-defined edges. In a variation known as punch elevation, the core of the scar is elevated to the level of the surrounding tissue and then reattached, making the scar less noticeable.
