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Forward in 2017

Acne Scars Are Greatly Reduced

The impact of acne scars goes well beyond the visible skin irregularities seen on a person’s face. There are severe tolls on one’s self-esteem and confidence which affect social interactions, relationships, and overall mental health. Feelings of ugliness, isolation, and anger are described by a majority of these sufferers. Unfortunately, even with the best makeup, acne scars are hard to conceal. Treatments for acne scars have not been very effective, but recent advancements have led to significantly improved outcomes.

The mainstay of treatment has been ablative laser resurfacing. The results were mild improvements, and there was a price to pay. There was downtime, up to a week, with dressing changes and wound care required. Individuals with darker skin were at risk for hyperpigmentation (darkening of the skin), which could be hard to treat. The results plateaued after several treatments as well.

Infini was introduced to the United States in August 2013. It is not a laser but uses radiofrequency energy, a technology that has its roots in medicine for over fifty years. Infini uses an array of insulated microneedles to introduce energy (heat) to the dermis (skin). The insulation allows for the energy to bypass the skin surface, thus decreasing the downtime and pigmentation risks that are associated with lasers. The heat causes collagen remodeling (breaking up of the scar tissue) and leads to new collagen and elastin formation in a more organized fashion (akin to normal skin). One benefit of Infini is that it can be used on all skin types, regardless of how much color there is to the skin. Another is that there is no need for wound care, and downtime in most cases is about a couple days due to swelling and redness. A series of at least three treatments is recommended. At a recent dermatology conference, there was a consensus that Infini was the best energy device for treating acne scars.

Acne patient before and after treatment with Infini, Excel V, and Spectra laser Aesthetic Clinique
Treatment with Infini, Excel V, and Spectra Laser, used along with topical Retin-A

While Infini is becoming the gold standard of devices for acne scar treatment, there will be some scars that need more than just Infini. If the scars are deep and have significant volume loss, they will need a filler. That’s where Bellafill has its role. Bellafill was FDA approved for treating acne scars in 2015. It is best used for the rolling-type acne scars that are distensible (flatten when stretched). Bellafill is composed of 20 percent PMMA (polymethylmethacrylate) microspheres and 80 percent bovine collagen. Over a period of two to three months, the added collagen is degraded, and the body forms collagen in response to the PMMA. The procedure involves injecting the Bellafill underneath the scar to elevate it. Most people require more than one treatment. Results will be long lasting as Bellafill was shown to last at least five years in a recent FDA study. A small portion of the population is allergic to the collagen; therefore, a skin test is required three weeks before the administration of Bellafill.

Both Infini and Bellafill are used for mature scars that have been present for years. The newer red scars require another type of treatment. These scars are treated with the Excel V or VBeam laser. These lasers are vascular lasers and are attracted to the red (hemoglobin) in the scars. They cause these scars to heat up and promote collagen remodeling. These treatments have mild swelling for up to twenty-four hours; a series of three or more treatments is required. Another laser, the Spectra Gold Toning laser, can be used in combination for even better results.

As alluded to earlier, there are different types of acne scars: rolling, boxcar, and ice pick. The Infini can improve all three types of scars. Bellafill is best used for the rolling scars. The hardest scars to treat are the ice pick scars—deep channels which appear as holes in the skin. The technique used to treat these scars is called TCA Cross. TCA is used for deep chemical peels. The concentration of the TCA is much higher in this procedure, and it is placed just within the depth of the scar. This causes a small injury to the scar and leads to the scar contracting from the depths of the scar up to the skin surface. As with all the other procedures, it requires multiple treatments to get optimal results.

There is new hope for the acne scar sufferer. Significant advances have been made to get better results with even lower risks than prior treatment options. Improving these scars can heal years of emotional “scarring,” leading to a whole new perspective on the future for these patients.


Dr. Steven F. Weiner, MD Aesthetic Clinique
Steven F. Weiner, MD

About Dr. Weiner Dr. Steven Weiner is the largest provider of Infini in the country, with over a thousand procedures performed over the past three and a half years. He is an international lecturer, trainer, and researcher for Infini. Dr. Weiner also lectures and trains for Bellafill. Dr. Weiner is a board-certified facial plastic surgeon who “laid down his scalpel” in 2005, opened the Aesthetic Clinique, and has concentrated on nonsurgical cosmetic procedures ever since.

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