Cheshire Lasers often receives enquiries asking how we can help treat scarring and acne scars.

Dr Teri Johnson discusses the various treatments available for scars and how they work.

What are Scars?

Scars develop after trauma to the skin; this can be due to an injury, post-surgery, or skin conditions such as acne. They are a natural part of the body’s healing process and occur when the skin’s deeper layers are damaged. This results in the formation of fibrous tissue to repair the injury. Scars may vary in appearance, texture, and size, depending on factors such as the type and severity of the injury, individual healing characteristics, and the scar’s location on the body.

When it comes to acne scarring, any type of acne spot can lead to scarring, but it’s more common when the most serious types of spots (nodules and cysts) burst and damage nearby skin. Scarring can also occur if you pick your skin or squeeze a spot, so it’s important not to do this.

While scars are permanent, they often fade and become less noticeable over time but may still remain visible.

Which Treatments Help Scars?

At Cheshire Lasers, we provide the following treatments for acne scarring:

• Polynucleotides
• Microneedling
• RadioFrequency Microneedling
• Rioblush Carboxytherapy
• Microdermabrasion

Other treatments you can consider include:

• TCA CROSS treatment
• Surgical Excision of scars
• Laser Treatments: can be ablative and non-ablative.
• Punch techniques

Sometimes, for best results, a combination of treatments is required.

Polynucleotides

Polynucleotide therapy is a new way to treat scars. It involves injecting special substances made of DNA and RNA into the scar tissue. Here’s how it works:

1. Makes Skin Stronger: These substances help the skin make more collagen, which is like a building block that makes skin stronger and helps scars heal better.
2. Helps Skin Repair: PN therapy helps damaged skin repair itself faster, making scars look better over time.
3. Reduces Redness and Itching: Scars can be red and itchy because of inflammation. PN therapy can help calm down this inflammation, making scars less red and itchy.
4. Makes Skin More Flexible: Scars often feel tight and stiff. PN therapy can make the skin more flexible by adding more collagen so scars feel softer and move better.
5. Improves Scar Colour: Sometimes, scars are darker than the surrounding skin. PN therapy can help lighten the colour of scars, making them blend in better with the rest of the skin.

Polynucleotide injectable treatments are safe with very little downtime. They work well in combination with other treatments to enhance the results.

Overall, they strengthen the skin, helping it repair faster and reducing redness and itching. It’s a simple treatment that can make a big difference for people with scars.

Microneedling

Microneedling, also known as skin needling, involves using small needles to cause tiny punctures in the skin. These small contact points encourage the body to create a wound-healing response. The needling also can break down old scar tissue and stimulate the production of new skin cells. New collagen and elastin grow as the skin repairs to give a smoother, plumper skin surface.

This treatment also improves skin texture leading to smoother skin and reduces pores size and fine lines. Microneedling can also reduce pigmentation, which is sometimes seen with some scarring.

Before and after three microneedling treatments for acne scars at Cheshire Lasers.

RadioFrequency Microneeding

This treatment combines microneedling with radiofrequency energy.  The combination treatment is much more effective than microneedling on its own. The radiofrequency energy heats the tissue in the region of 55 – 65°C and, depending on the depth, it stimulates cell renewal, new collagen, increased hydration and also skin resurfacing. The heat is more effective at stimulating fibroblast action, which is responsible for healing and repair.

Radiofrequency Microneeding is a more aggressive treatment than normal microneedling; however, surprisingly, the downtime is often much less. Here at Cheshire Lasers, we have found that fewer treatments are usually needed to deliver the same results.

Rioblush Carboxytherapy

Carboxytherapy is also a good treatment for treating acne scars. A tiny needle is used to inject Carbon dioxide into the scar. The same needle can also be used to gently subcise deeper scars, which allows blood to pool under the affected area. The blood clot helps form connective tissue, which pushes up the rolling scar so it’s level with the rest of the skin’s surface. Carboxytherapy also increases blood flow to the scar promoting healing, reducing redness and stimulating collagen and elastin production. The result is smoother, fresher, more healthy-looking skin.

Carboxytherapy can cause bruising but otherwise has very little downtime.

The following research paper compares carboxytherapy with microneedling.

Carboxytherapy Versus Skin Microneedling in Treatment of Atrophic Postacne Scars: A Comparative Clinical, Histopathological, and Histometrical Study

At Cheshire Lasers, we sometimes combine microneedling with Carboxytherapy to achieve the best results.

Before and after three carboxytherapy treatments at Cheshire Lasers for acne scarring.

Microdermabrasion

Microdermabrasion involves deep exfoliation of the top layer of skin.  Your skin will look red after treatment but will soon settle down.

Although this treatment claims to treat scars, it only helps with minor superficial scars, such as mild surface acne scarring.

You will need a course of treatments for the best results.

Other Treatments for Acne Scarring

The following treatments are also options for treating scars. These treatments are not available at Cheshire Lasers. However, we can recommend local clinics that provide them.

TCA CROSS treatment

TCA CROSS treatment involves the application of trichloracetic acid at high concentrations to the base of a scar. This causes trauma to the scar tissue, which triggers an inflammatory response that stimulates the production of new collagen. After each treatment, the scar gradually fills in from the bottom up and reduces in appearance.

This treatment is very useful for various Acne scars, including ice pick, box and rolling scars. It can also help with chickenpox scars and enlarged pores

View more information about TCA CROSS treatment from Dr Maeve Kenningham, who provides this treatment at her Wrexham Clinic.

Laser treatments

You can also consider Laser treatment to treat mild to moderate acne scarring. There are 2 types of laser treatment:

• Ablative laser treatment – where lasers cause skin trauma and remove some scar tissue, to produce a new, smooth-looking area of skin. This treatment can have significant downtime.
• Non-ablative laser treatment – where lasers are used to stimulate the growth of new collagen (a type of protein found in skin), which helps to repair some of the damage caused by scarring and improves the appearance

Punch techniques

Punch techniques are surgical methods that can treat ice-pick scars and boxcar scars. There are three types of punch technique:

• Punch excision – used to treat mild ice pick scars. The scar is surgically removed, and the wound is sealed, leaving smoother and more even skin.
• Punch elevation – used to treat boxcar scars. The base of the scar is surgically removed, leaving the sides of the scar in place. The base is then reattached to the sides but lifted up so it’s level with the surface of the skin. This makes the scar much less noticeable
• Punch grafting – is used to treat deep ice-pick scars. As with punch excision, the scar is removed, but the wound is “plugged” with a sample of skin taken from elsewhere on the body.

Surgical Subcision

Subcision is a surgical treatment which can treat deep rolling scars. The upper layer of the skin is removed from the underlying scar tissue, allowing blood to pool under the affected area. The blood clot helps form connective tissue, which pushes up the rolling scar so it’s level with the rest of the skin’s surface.

Once subscision has been completed, additional treatments are usually needed to improve the appearance of the scar further.

Why have I got large pores?

The size of your pores is determined by your skin type. Large pores are more common if you have oily or thick skin. Pores become larger and more noticeable if they become congested with sebum the oil we produce to protect the skin. A combination of old dead skin cells and sebum can block the pores and then oxidise into a black plug known as a blackhead.

As we age pores get larger!  This is due to the loss of collagen that occurs with the ageing process, which provides support to the skin and its structures. The more support is lost, the more pores dilate and appear bigger.

Which Treatments Remove Large Pores?

Unfortunatley there is no treatment available which will remove large pores for good.

You can only improve / reduce them and you will need to continue with treatments to maintain the results.

How Can I Improve My Large Pores?

Good Home Skin Care Treatments

Good skincare can make a big difference there is a lot that you can do.

Products that reduce oiliness, unclog pores, stimulate cell renewal and stimulate collagen can all help reduce the size of pores. Also, you must avoid products that clog pores and make them bigger.

Here are our top tips for reducing large pores at home:

Do:

• Use an exfoliating cleanser for at least a minute twice a day, ideally one containing salicylic acid, which is great for unclogging pores, glycolic and lactic acid are also good.    We love ZO Exfoliating Cleanser
• Use a scrub daily, if your skin can tolerate it to exfoliate dead skin cells and stop them from clogging pores. We love ZO Skin Health Exfoliating Polish and ZO Skin Health Dual Action Scrub
• Apply a daily toning solution containing salicylic, glycolic and or lactic acid, which speeds up cell renewal and unclogs pores. Our favourites are ZO Skin Health Complexion Renewal Pads and Medik8 Press & Clear
• Use a Pore Refiner use products that target pores specificaly. Use daily on the areas more prone to large pores.  We love ZO Instant Pore Refiner apply to pore prone skin daily to help shrink the appearance of pores and prevents congestion.
• Apply a hydrator with a gentle retinol or retinoid to reduce oil production and speed up cell turnover . We love ZO Daily Power Defence it suits all skin types of all ages and won’t irritate sensitive skin or clog oily skin.  
• Use a Sulfur, Charcoal or Clay mask once or twice a week to draw out the oils and impurities from your skin. Our favourites are  ZO Skin Health Sulfur Masque and Medik8 Clay Mask

Do not:

• Overuse moisturisers, they slow down cell turnover and compact dead cells in the pores, which then enlarge.
• Don’t try to cover up the problem with foundation or powders because again it can compact dead cells.
• Avoid using fake tan. The tan stains the sebum and dead cells in the pores making them appear more visible.

Which Treatments Reduce Large Pores?

Microdermabrasion

Microdermabrasion is a facial treatment that blasts your skin with tiny crystals sanding off and removing dead skin cells. This treatment removes just the top surface of the skin and unclogs pores and blackheads. It also helps reduce fine lines and stimulates collagen which gives the pores more support.

Microneedling

Microneedling is another way to reduce pore size. This treatment uses a needling device to create thousands of tiny holes in your skin.  The healing process stimulates the release of growth factors and stimulates the production of collagen and elastin, giving firmer skin, which supports the pores so they appear smaller.  This treatment also helps resurface and smooth the skin’s surface, which also helps reduce pores.

Skin peels

A skin peel can smooth the surface of the skin making pores appear less noticeable. Cheshire Lasers offers a wide variety of skin peels. Choose from a milder peel which gives little or no downtime but are less effective and the results are short-lasting. Or a more aggressive peel which gives more peeling and more downtime and the results can last a few months.  Many people opt for a course of mild peels and step up in strength until they achieve good results and then have a maintenance treatment every month or two.

Our favourite peels for reducing large pores are:

• BioRePeel
• Obagi Blue Peel Radiance
• ZO Stimulator Peels

Hydrafacial

The Hydrafacial is famous for its properties for unblocking pores. The treatment jet washes the skin with products which exfoliates the skin and removes dead skin cells. It then applies a product containing glycolic and salicylic acid to soften blockages in the pores, and then a vacuum removes the softened gunk. Finally, the Hydafacial applies a combination of vitamins, peptides, and moisturising hyaluronic acid to hydrate and plump the skin and reduce wrinkles if you have any!

Radiofrequency

Radiofrequency (also known as RF),  involves heating up the skin layers to stimulate collagen production. A course of 6 to 8 treatments can tighten and brighten the skin providing support for the pores, which can reduce their appearance.

Botox

Botox is known for its use to freeze facial muscles and reduce sweating. However, it is now also being used to reduce the production of oil in the skin. Injections of tiny doses of Botox are placed into the surface of the skin, and this causes a temporary reduction in sebum production which can reduce pore size in some people.