I have acne scar patients whom I treat every 1-2 months and patients whom I treat every 3 months. For those with a have a higher chance of a quick recovery, I have them come in more often. But unfortunately, some people missed that "golden time." For those with deep, tethered, and defined scars...

[Acne Scar Treatment Cases] Hello! I am Dermatologist Dr. Kwon Inhyuk. Today's topic is: how much can my acne scars heal? I've prepared for this topic.

Since scar treatment results vary vastly by individual, people who have started treating their scars or have considered getting their scars treated wonder if their scars will actually get better or to what extent they will get better and I believe many people will be curious about this

so I've prepared this video. As we filmed the last Skin Rescue video, some people said they would like to see pictures while I explained, so I prepared this. It actually took a while for me to prepare, about 2 months Of our recent visitors who came these past 2 months,

I selected a variety of acne scar cases, received permission to use 10 people's images, and had to prepare, so it took some time. There are two conditions that are difficult to tackle: melasma and acne scars. Melasma was treated mainly by laser toning

but many great treatments have since emerged. In terms of acne scar treatment, there have been innovative changes within the past 2 years. The first one I introduced in the past that cuts tethered scar fibers for an accurate subcision effect in the papillary dermis

and injects regenerative drugs is the CureJet. The second one is the emergence of JuveLook and JuveLook Volume The third one is several lasers that minimize damage to the skin's surface.

These three factors are the biggest changes in the past 2 years By using these tools, I will explain how I treated patients And how much they improved. First I gathered the images of the people I am treating

so while we see their initial condition I want you predict how much their scars will improve. Actually, there's a limit to how much you can see with pictures. This is because scars have pitting and need to be seen in 3D as many people's scars are more severe under certain lighting.

Many people's scars look mild in 2D but look severe on the side or under certain lighting so there are limits, but I hope you keep that in mind as you observe. First one. As you can see, there are many red scars

and there are some old scars but there are many new scars in this first case. I'll show you the results later so let's check these pictures first. This second case is mostly deeply pitted icepick scars.

In the third case, there are round, uneven rolling scars with old, tethered scars and old, white scars and keloid scars by the jawline so a mix of various scars. The fourth is sensitive skin.

There are many icepick scars that look like pores and there are boxcar scars mixed in but overall, the skin is red and sensitive so we must approach with caution. Even though these are also icepick scars, it is mixed in with sensitive skin.

The fifth one looks more severe in person but mild in the photo. In person, the scars are widely pitted so his skin is lumpy and uneven. The fifth [sic] one is the same. They're wide and lumpy all around.

Wide scars instead of sharply-defined ones. The sixth case. This person doesn't have sensitive skin but there are a lot of icepick scars and among the icepick scars they are more red and newer icepick scars.

They are mixed in with pores. Next there are severe scars. There are many tethered scars, there are icepick and boxcar and diverse scars, the borders are very defined and the skin is quite thick.

Next there are many icepick scars that are almost indiscernible from pores, with some boxcar scars mixed in and scars with defined borders. This last case also has severe tethering

with wide pitting and sharp and deep scars. These are all patients currently undergoing treatment. The results of scar treatment vary by individual but I've chosen four main factors. The first is scar shape.

Whether it's an icepick scar, a boxcar scar, or a rounded rolling scar, this is very important. Next is scar depth. There are wide scars that are shallow

and narrow scars that are deep. How we can determine the depth based on photos is among dark scars that look poked and have a shadow are mostly all deep because if they are deep, they cast a shadow and appear dark. On the other hand,

with the same scar, if it doesn't look dark and has a skin-colored base are typically shallow scars. So scar depth is very important. Third is the degree of tethering. What I mean by tethering

is even if there are similar scars that are pitted, there are scars that are soft and rounded, and even if they are the same depth, there are scars that aren't soft that have dense scar fibers making the bottom hard. Similarly, by looking at the surface or looking at a photo

how I predict the level of tethering is the sharper the borders, the more likely it is tethered. Next, the older the scar, the more likely it is tethered. Also those with thicker skin are likely to have tethering And older people are more likely to have tethering. The fourth important factor is age.

Early 20s, 25-35, late 30s, then 40s and 50s. The effect varies greatly by age group. I'll explain later but even if the scar shape is the same, The difficulty between early 20s and 25-35

and 40s and 50s is completely different. In the past, many 20 to 30 year olds came in for scar treatment, but nowadays, I also treat many people in their 40s and 50s. The treatment difficulty is much greater for 40 and 50 year olds. These four factors are the most important in predicting the outcome of treatment.

Based on that, if you see how well these people's treatments are going First. This patient is in her 20s. If you look at her scars, they're red. They're red, and as I said

Newer red are likely to be soft and not tethered. These scars heal comparatively well. They heal well, and she is currently being treated. Especially for people in their early 20s, some can heal up to 90 or 100%. So for patients in their early 20s,

I make it my goal to revert their skin to normal. So although there are also older scars, the newer scars heal very quickly. The second case is the same. They're icepick scars. Icepick scars are one of the more difficult scars to treat.

But there are some exceptions: newly-formed icepick scars and icepick scars on people in their 20s respond relatively better to treatment. And even among icepick scars, there are deeply-set, dark icepick scars

and there are scars where you can see the bottom fairly well. The scars where you can see the base better will smooth out relatively faster. Deep scars will take more time but eventually smooth out. Next is the same. This person mostly has icepick scars

and I think he was in his 30s. He's in his 30s and didn't have any boxcar or rolling scars. They were mostly sharply indented, small scars. This patient is also undergoing treatment His red marks are fading and his scars are getting better.

I'm treating him every 3 months. Fourth case. He has a mix of acute scars and old scars. His scars look relatively severe but aren't that deep. So he is getting relatively better.

I had to approach this case carefully. This patient also had icepick scars as well as boxcar and red scars. But not only were the scars red, his base skin was also flushed. These kind of people

got CO2 fraxel lasers to damage their skin multiple times at other clinics. These people with sensitized skin cannot be treated with very damaging procedures. So even though they're icepick and boxcar scars, we can't use procedures that are too damaging

and we must adjust the energy level. If we do, these types of cases will get better. For this next case, the scars are very wide and the skin is lumpy with certain lighting. But they aren't very deep scars.

And the edges are not sharp but shallow. Although the scars are wide and lumpy, it is smoothing out with continued treatment. I'm still treating him to this day. The next case is the same. His scars are lumpy when viewing his profile

but the scar borders are smoothing out and the skin surface is evening out. Same with the other side. He is getting much better in person. Same for the next case. His scars were quite severe

as you see, his scars were severe and wide, but they weren't that deep based on my standards. If you see the surface, the areas that are lumpy under lighting are slowly smoothing out. Whether you view from the front, the side, or the other side,

his scars are smoothing out nicely. This next case is a very difficult one. He is past his 30s, his scars are deep, the borders are sharp, there are many icepick and boxcar scars,

and the scars are tethered. When the bottom is densely tethered, it won't rise up no matter how many lasers you use. In these cases, you must undergo procedures to release the scar fibers. For me, I treat the entire scar area to release the tethering.

Then, depending on the depth, I used three lasers to target the deep, middle, and surface layers. For this case, I used CureJet, JuveLook, and lasers. For these tethered scars, using just lasers won't help so you must combine other treatments. For reference, I didn't use shouldering treatments for any of these cases

I first encourage the scars to fill up through treatments. If they don't smooth out completely, I may eventually need to resort to shouldering. I don't resort to that at first. If I clean up the surface through shouldering, it may appear smooth at first, but it may eventually become lumpy.

So my first goal is to make the scars rise and fill out. So similarly, in this case, just receiving lasers isn't enough to raise the scars. So I release the tethering with CureJet, use it together with JuveLook skin booster, and use lasers per depth level.

I treated this patient four times in three-month intervals. So his scars are smoothing out. This case is the same. His scars are almost indistinguishable from his pores. In this case, this patient was older,

the scars were deep, and scars were narrow, making this a difficult case. If you compare with the previous case, although they're also tethered scars, as there are many deep, pore-like scars,

this case takes longer to heal even after four treatment sessions. Although the previous case looked more severe, as I said, depth is very important. As depth is more important than severity or width, even small scars will take longer to smooth out if they are deep. This person received four treatments in 3-month sessions

but he's gotten much better. The last case is the same. I've treated this patient four times‚Äî ‚Äîand I think he's in his 30s. In person, the tethering is more severe, the scars are deep,

and he had many icepick and boxcar scars. You must release the tethering for these cases. I released the tethering, injected JuveLook to help the healing, and the laser is also important, I treated him every 3 months.

I've mentioned this in the past, but I have patients whom I treat every 1-2 months and patients I treat every 3 months. How I set that standard is if they have acute scars, if they are in their early 20s,

or are in their "golden time." For those with a have a higher chance of a quick recovery, I tend to see them relatively more often, once a month on the fast end, once every 2-3 months on the slow end. But some people have missed their golden time. Their scars are already too deep, tethered, and sharply-defined.

But these people don't need to come often. Reason being, before, we would damage the skin with lasers, wait for it to heal, and repeat. Since it was believed to take one month for the damage to heal, we would repeat the cycle. For the method I suggested,

we inject beneficial ingredients underneath the scar and stimulate the untethered scars with lasers so it not only has an effect for one month, but continues to regenerate for 2 or 3+ more months. So for these old, tethered, severe scars, I treat Korean residents once every 3 months

and I have overseas patients whom I treat every 6 months. So keep that in mind. It's the same for severe, tethered scars. So the four factors for predicting how scars will heal are: shape, depth, tethering, and age. I believe these are the most important factors.

But even among these, there is one I feel is the most important. I will reveal it after treating more patients and gaining certainty. I evaluate cases based on these four factors but there are exceptions. Other than those exceptions,

the other cases are proceeding as expected. I showcased a variety of cases today. Among the cases, there were patients in their 20s and mid-30s. As you may have felt, there were no examples in their 40s or 50s. This is because it's a whole other level.

When there is a chance next time, I will share cases involving 40-50 year old patients. It actually took a long time to prepare for this video. It took time to receive consent, which we received from each of the 10 patients, and it took time for me to personally mosaic the images,

so it took a month. As these preparations took a long time, if this video was helpful, please like and subscribe. If many people liked it, I'll prepare another video in the future. This has been Dermatologist Dr. Kwon Inkyuk of Oganacell Dermatology Dongdaemun.

Thank you.

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