Acne Scar Treatments On Accutane / Oratane

Scar Revision On Accutane At A Glance

  • Best Results2-6 treatments
  • Treatment Recovery0-3 days
  • Procedure Time10 min
  • Skin SpecialistDermal therapist, Nurse
  • Duration of ResultsLong lasting
  • AnaestheticNil required
  • Back to WorkImmediately to 2 days
  • Cost$-$$

Acne Scar Treatments On Accutane / Oratane

The recent global revision of Oratane / Accutane guidelines in 2016 in peer reviewed medical journals has given the green light for most forms of scar revision whilst on Accutane. Early & effective management of acne mitigates acne scar formation. Effective treatment of early scars can reduce the requirement for more invasive surgical procedures.

FactsFacts on treating acne scarring whilst on Accutane / Oratane

  • Treating acne & acne scarring simultaneously can reduce both conditions
  • Patients on low dose isotretinoin can undertake most revision procedures
  • Procedures allowed include focal peels, fractional & vascular lasers, microneedling & RFM in addition to Tixel resurfacing
  • Early scar remodelling can reduce the requirement for surgical scar revision procedures

Why revise scars early?

Early scar remodelling can reduce the severity of acne scars. Early scars can be defined as scars less than 4 months old. Using less invasive techniques such as TIxel, vascular & fractional lasers, dermatologists can remodel & repair scars effectively.

How would I know what is the best treatment for my type of acne scars?

Your specialist will guide you if you are a suitable candidate for revision. I employ methods including the use of TCA (chemical peel) in addition to lasers & energy devices. The optional treatment depends on your scar pattern.

Red scars do best with vascular lasers. Deep ice pick scars do best with focal peels, whilst shallow atrophic scars can be treated with fractional lasers or Tixel.

Simple post on understanding acne
.
👉The primary cause is abnormal cell shedding of the oil gland leading to blockage of the sebaceous glands, everything from this stage onwards worsens the condition
.
👍🏻💯Why retinoids? Retinoids address -
1️⃣Abnormal cell shedding
2️⃣Inflammation of the oil gland 3️⃣Reduces proliferation of c. acnes, the bacteria associated with acne
4️⃣Reduces sebum or oil production
.
🔎Sure, OTC products can work for most cases. If you are struggling with acne,
See one of my colleagues @cutis_dermatology
.
😎Davin Lim
Dermatologist
Brisbane, 🇦🇺
#acne #acnetips #clearskin #acneremedies #acneroutine #acnesolutions #acnediet #dermatologistbrisbane #dermatology #skincare
...

What treatments are not indicated for patients on Isotretinoin - Accutane - Oratane?

The JAMA guidelines state the fully ablative laser resurfacing & segmental or global deep peels do not have enough safety data in the context of concurrent use with oral isotretinoin. On this basis I do not perform these procedures whilst on isotretinoin. In most cases I give patients a 3 month ‘wash out’ period before deep resurfacing.

Note: Fully ablative laser resurfacing is vastly different from fractional laser resurfacing. The former treats all of the skin’s surface, whist in the context of scar revision, fractional laser treats 3-20% of surface area. The same applies to deep focal peels, compared to segmental peels.

Davin’s Viewpoint on early management of acne scars

The current method of acne management is less than ideal for many patients, especially those who exhibit scarring & active acne. Mainstream management is to treat acne, then revise scars or ignore them. Suboptimal for patients!

With the event of isotretinoin revisions based upon recent (2015-16) papers, the majority of scar revision procedures are allowed. These procedures have been deemed as ‘safe’ in patients on Accutane-Oratane.

Laser revision with vascular devices are quick, painless & not associated with any significant downtime. Ideal for red acne scars, & early scarring.

For contour changes, the use of fractional devices, microneedling, microneedling RF, TCA focal application & surgical revision are deemed safe. The two procedures I do not conduct without a wash out from isotretinoin include fully ablative deep resurfacing & segmental – global medium to deep chemical peels.

The most important factor in scar revision is to control your acne, this often means total remission, especially if you have the propensity to scar. Seek a medical opinion as to the correct procedures for you.

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