The Treatment of Acne Scars, a 30-Year Journey.

Over the past 30 years, the treatment of acne scars has undergone changes that have been significantly influenced by the concurrent development of new devices. The advent of fractional resurfacing lasers was a watershed moment for acne scarring therapy. The author recounts a career history of considerations of acne scarring treatments as well as the literature supporting the experiences causing changes in practice. Fractional ablative and nonablative lasers, sublative radiofrequency, picosecond lasers, microneedling with and without radiofrequency and fillers are the bulk of the treatments covered, along with a discussion of combination therapy. A practical algorithm for acne scarring for selection of treatment modalities is presented.

Evaluation of a nonsurgical, muscle-stimulating system to elevate soft tissues of the face and neck.

Non-invasive procedures for tissue tightening and elevation are new frontiers in dermasurgery. Current methods for achieving a "nonsurgical face-lift" include radiofrequency and infrared light devices which disrupt non-covalent collagen bonds and stimulate collagen production. This study evaluated a novel treatment protocol designed to achieve a nonsurgical face-lift with electrical stimulation of muscle. Thirty-five women were treated with the Pan G Lift (Pan Germinal Systems, Clearwater, Florida) to enhance skin and induce soft-tissue lifting via hypertrophy of the facial musculature. The protocol consists of biweekly treatments for 10 weeks followed by monthly maintenance treatments. Results were evaluated by both the investigating physician and patients for up to 12 months. Estimates of percentage improvement were based on a scale of 1 to 4 (1 = 0%-25% [mild]; 2 = 26%-50% [moderate]; 3 = 51%-75% [good]; and 4 = 76%-100% [marked]). After 10 weeks (20 treatments), the median lifting improvement scores as assessed by patients and physician were the following: cheeks-2.0 and 2.0, jowls-2.0 and 2.0, and texture-2.0 and 2.0, respectively. Physician-evaluated eye lift and neck lift showed similar improvement. At 12 months (32 treatments), lifting and skin texture changes (assessed by patients and physician) reached 3.0 to 4.0, respectively, while physician-evaluated eye lift and neck lift achieved at least a 3.0 at 20 and 26 treatments. At one year (32 treatments), neck lift reached a 4.0. There was no downtime and no complications occurred. The non-invasive, muscle-stimulating Pan G Lift is a novel procedure that yields significant 3-dimensional improvements of the face and neck (nonsurgical face-lift), which demonstrates progressive improvement with continued monthly treatments over time.

Treatment of rosacea with intense pulsed light.

Rosacea is a chronic disease that affects millions of men and women. Topical and oral antibiotics are effective, yet often leave individuals with treatment plateau associated erythema and persistent flushing. We investigated the use of intense pulsed light for treatment of the redness, flushing, and breakouts associated with rosacea. Thirty-two consecutive patients of Fitzpatrick skin types I-III underwent 1 to 7 treatments with intense pulsed light. Patients were assessed clinically and photographically. In addition, patients completed a detailed questionnaire regarding their response to treatment. Following treatment, eighty-three percent of patients had reduced redness, 75% noted reduced flushing and improved skin texture, and 64% noted fewer acneiform breakouts. Complications were minimal and transitory. It appears that intense pulsed light is an effective treatment for the signs and symptoms of rosacea and represents a new category of therapeutic options for the rosacea patient.