Dr. Jason Emer develops cutting-edge combination treatments to repair atrophic, hypertrophic, keloid, boxcar, and ice pick acne scars
For those struggling with acne—particularly those with deep, painful histories of severe scarring and discoloration—board-certified dermatologist Dr. Jason Emer provides a meticulous, multi-layered methodology that is found nowhere else in the world. A renowned laser, acne scarring, and skin care expert located in Beverly Hills / West Hollywood in Los Angeles, California, Dr. Emer has an intention-driven, strategic approach to acne treatments: Each scar is treated individually based on its appearance and root cause. For lasting, dramatic improvements, scars are treated with a patient-tailored combination of procedures. Dr. Emer draws upon numerous cutting-edge modalities as well as his own wealth of experience to create a personalized treatment plan that suits your unique condition and repairs every category of scars.
Every face is unique, and every scar is unique.
Both deserve a tailored and personalized approach.
What causes acne to scar?
Scars are our body’s natural response to trauma, and acne scars are no different. When acne damages the skin and the tissue beneath it, our bodies are quick to respond and repair the damage caused. Depending on the amount of collagen our bodies produce as a result of the trauma, the repaired area can appear as a depression or as a raised scar.
When our bodies overproduce collagen in an attempt to heal the damaged skin and tissue, it creates a raised acne scar. On the other hand, when our bodies produce an insufficient amount of collagen, this creates a pit or depression in the skin.
As we age, we begin to lose collagen, so our acne scars become more visible to the world. Still, at any age, acne scars can cause physical pain, emotional anguish, and (most commonly) a lack of self-confidence. Regardless of the circumstances, Dr. Jason Emer has the expertise, vision and artistry necessary to treat every type of scar, to alleviate any pain and discomfort you may be experiencing, and to restore your confidence so that you can feel comfortable in your skin and with your skin — its appearance, complexion, pigmentation, touch, and texture.
Hypertrophic & Keloid Acne Scars
Thick, raised, and dark red to purple in color, hypertrophic and keloid acne scars may occur for a number of reasons: chronic inflammation, cystic acne flares, surgery or skin trauma, excessive collagen production during the acne healing process, or pure bad luck. Hypertrophic scars tend to be milder and less noticeable than keloids, but both can be sources of irritation and embarrassment.
Hypertrophic & Keloid Acne Scar Treatments
To improve the look and feel of hypertrophic and keloid scars, acne scarring specialist Dr. Jason Emer employs various treatments in a patient-tailored, combination approach:
- Initial treatments for thickened, discolored scars include topical therapies. Dr. Emer’s team customizes the proper combination of silicone-based scar gels with natural growth factors to accelerate the healing process; Vitamin A derivatives, such as retinol and tretinoin; and antioxidants like Vitamin C. Topical steroids are occasionally employed for their anti-inflammatory effects.
- LED Light Therapy reduces inflammation and blood vessel dilation, which decreases redness and halts further thickening of the irregular collagen.
- LightStim LED therapy can also reduce inflammation, diminish pore size and smooth skin texture when incorporated into your daily, at-home skin care regimen.
- Intralesional injections, such as steroids (kenalog), fluorouracil (5FU), hyaluronidase, and collagenase are used to soften the scar, disrupt the disordered connective tissue, and shrink the scars.
- Vascular lasers—including the Yellow Laser, Laser Genesis, Excel V, Aerolase, and pulsed-dye laser (Vbeam)—transmit high-pulsed energy deep into the scar to shrink the thickened collagen and decrease discoloration. By selectively targeting undesired or abnormal blood vessels in the skin, vascular lasers provide dramatic improvements in the treatment of discoloration and pigmentation, scars, rosacea, veins and stretch marks.
- Intensed Pulsed Light (IPL) therapy can also improve the appearance of hypertrophic scars and keloids as well as reduce the scars’ height, hardness, and discoloration.
- Dr. Emer uses fractional lasers, such as the non-ablative Fraxel or Icon lasers, ablative CO2 laser, or ablative Erbium laser, to resurface the scar’s texture.
- Fractional radiofrequency (RF) treatments, such as Skinfinity and Venus Viva, are effective in treating acne scarring, particularly in patients with darker skin tones. Due to the increased risk of post-inflammatory hyperpigmentation, dark-skinned individuals should not obtain laser treatments unless the skin has been pretreated with peels and/or skin care and determined to be ready for treatment by Dr. Emer.
- Microneedling with platelet-rich plasma (PRP) and/or stem cells (ACell) helps to speed up the healing process and is an effective complement to laser treatments and topical therapies. Both stem cells and PRP can build and repair damaged areas, allowing for a natural improvement over time.
Atrophic Acne Scars
Also known as “rolling” or “boxcar” scars, atrophic scars give the appearance of sunken, pitted indentations in the skin. Atrophic scars are often more visible in side or overhead light—often casting a shadow in the divots and pock marks in your skin—and can appear worse when makeup is applied. To address these depressed scars, Dr. Jason Emer uses a custom, 3-step approach and a variety of minimally invasive procedures.
Atrophic Acne Scar Treatments
As with hypertrophic and keloid acne scars, atrophic scars require a masterful combination approach in order to expertly lift, plump, and remodel these depressed scars and to improve the overall texture of your skin.
- To begin, Dr. Jason Emer injects soft tissue fillers—such as Sculptra, Bellafill, silicone, or hyaluronic acid-based fillers like Juvederm, Restylane, or Belotero—to plump and lift the scars and build collagen long-term.
- Dr. Emer also injects fat (ideally extracted from your own body) under the scars to fill out larger depressions and indentations. In those instances where excess fat cannot be retrieved from your body, Dr. Emer may propose Renuva Adipose Matrix, a purified synthetic matrix of fat cells that integrates into your tissue as if it was your own. Over time, the fat cells permanently fill the space beneath the scars, smoothing their appearance.
- Dr. Emer then uses an advanced subcision technique used to release tethered scars that are bound down and depressed due to an underlying scar tissue. In this procedure, a sharp needle is used to pierce the surface of the scar, break the connective tissue or fibrotic bands beneath the skin, and lift and flatten the scar. A cannula may be used in those instances where less trauma is desired or a larger area needs to be treated conservatively.
- Lastly, a customized combination of lasers, peels, fillers, microneedling with PRP, and fractional RF or microneedling RF treatments are employed to resurface the skin’s texture. With his vast knowledge and experience, Dr. Emer determines the precise combination of techniques and treatments based on your specific skin type, the severity of the scars, and the anticipated downtime.
Ice Pick Acne Scars
Characterized by very deep, narrow pits in the skin’s surface, ice pick scars (also known as pox scars) are stubborn, highly noticeable scars that, due to their depth, do not respond well to lasers or peels alone. While laser treatments are often employed in acne treatments, the lasers only burn the top layer of skin, leaving these ice pick scars untreated.
Ice Pick Acne Scar Treatments
To treat ice pick scars, Dr. Emer employs a groundbreaking approach involving a series of procedures that do more than address the surface of the skin. These focused treatments go much deeper in order to produce dramatic improvements.
- Treatment typically begins with TCA Cross, a procedure in which trichloroacetic acid (a highly concentrated chemical commonly referred to as TCA) is applied with a toothpick, cotton swab or needle to the crater of each scar; the chemical activates and burns the base of the scar, causing the scar to cave in on itself, triggering gradual collagen formation, and prompting a controlled microscab to form. Once the scab peels and the skin heals naturally—which can take up to 6 weeks—patients find that they have smoother skin and filled-in ice pick scars. Based on the depth and condition of the ice pick scars, 3 or more separate spot treatments with TCA may be necessary to see substantial improvement. Meticulous technique and skill is required for the TCA cross procedure to ensure that there is no additional scarring, pigmentation changes, or worsening of the scars. For this reason, it is highly recommended that you obtain this treatment in the care of a board-certified dermatologist like Dr. Jason Emer who specializes in a range of acne scarring treatments.
2. An alternative to TCA Cross is punch excision, in which the troublesome pore is surgically removed from the skin. Using a punch biopsy tool, Dr. Emer carefully cuts around the ice pick scar, removes the scar itself, and sutures it closed. After 5 to 7 days, the sutures are removed, and the deep, round scar is converted to a flat line scar that can then be lasered, peeled, or microneedled for further improvement.
3. Following the TCA Cross procedure, Dr. Emer’s patients are encouraged to maintain a regular skin care regimen for at least 4 to 6 weeks to ensure optimal results. The skin care protocol involves daily application of:
4. Dr. Emer often combines TCA Cross with multi-depth microneedling RF or Fractora Skin Remodeling to encourage cellular turnover. Additionally, injectables like Bellafill, an FDA-approved filler, can plump and lift the scars and also build its own long-term collagen.
5. Once the collagen fills up the depths of the scars, then Dr. Emer may perform a customized combination of surface treatments—such as peels, lasers and radiofrequency treatments—to achieve a smoother skin texture.
Potent chemicals like TCA can often result in hyperpigmentation. Therefore, individuals with darker skin are often treated with lightening peels and antioxidants prior to treatment. Moreover, following the TCA procedure, Dr. Emer proposes a customized skin care regimen specifically for darker skin tones, which typically includes silicone-based scar gels, natural growth factors, vitamin C, kojic acid, and hydroquinone with retinol.
Long-term Improvement to Tone & Texture
Even after your acne scars dissipate, you may still struggle with the signs of scarring, pigmentation, and irregular texture. For this reason, Dr. Emer complements his effective, short-term solutions with customized, long-term treatment plans to achieve further improvement over time. Involving a combination of energy-based treatments, regular maintenance, at-home care (such as dermarolling), and prolonged skin care, this long-term strategy is the key to continued progress and success.
Skin Care Regimen
Following each treatment, our aestheticians will gladly provide you with skin care product recommendations that will continue to improve the quality of your skin. Our serums, cleansers and creams are exclusive medical-grade products, and our skin care regimen recommendations are tailored to each patient’s treatment plan, needs, and lifestyle.
In addition to treating acne scars, Dr. Emer also advises that his clients adopt preventative measures, including facials, peels, lasers, microneedling, and skin care regimens, to protect the skin and ward off future acne breakouts.
- • AquaGold
- • Enlighten Peel
- • RevePeel
- • Cosmelan
- • Dermarolling
- • SaltFacial
- • DermalInfusion/SilkPeel
- • Microneedling/PRP
- • Fractora RF Skin Remodeling
- • Fraxel Laser
- • Clear + Brilliant Laser
To determine which preventative treatments and skin care products would be most beneficial to you, schedule a Virtual Consultation with Dr. Emer to obtain one-on-one skin care advice and monthly treatment plans.
Are Acne Scarring treatments safe for everyone?
No, not all acne scarring treatments are safe for all skin types. For this reason, it’s critical that you consult with an experienced and board-certified dermatologist before beginning any form of acne scar treatment. Dr. Jason Emer is uniquely qualified to treat these conditions and is aware of the potential risks and side effects involved with any and all acne scarring treatments.
For instance, inflammatory peel treatments are ideal for treating shallow acne scars and superficial textural issues on patients with lighter skin tones. Only certain peels—such as salicylic, glycolic, and retinol peels—are safe and effective for individuals with darker skin tones.
Dermabrasion is another form of acne treatment intended to treat moderate to deep scars. In this minimally invasive treatment, the superficial layer of skin is scraped or sandpapered (i.e. removed) to prompt the growth of new, smoother skin. While effective, this painful procedure is uncommon due to the risks of permanent pigmentation alteration as well as prolonged redness. Therefore, Dr. Emer encourages his patients to opt for fractional lasers, fractional RF or microneedling RF in a series of treatments to combat those moderate to severe acne scars.
How does Dr. Emer do it differently?
To obtain substantial improvements, Dr. Emer combines numerous treatments to address the underlying acne while also improving the color, texture, and tone of the skin.
For example, Dr. Emer often follows TCA CROSS, which involves the deposit of a high volume of trichloroacetic acid (TCA) onto the acne scar, with Bellafill injections and CO2 laser treatments. When injected beneath the scars, the Bellafill will plump up the skin underneath, thereby reducing the appearance of the scars. The CO2 laser resurfaces the skin and stimulates collagen production. Following the CO2 laser procedure, Dr. Emer and his highly skilled nurses and physician assistants may perform a microneedling treatment and/or employ LightStim LED therapy to reduce inflammation.
To build collagen in acne scars, Dr. Emer relies on a range of treatments, customizing his approach to each patient’s needs. Microneedling, microneedling with radiofrequency, PRP and Sculptra injections, CO2 laser resurfacing, fractional radiofrequency, and thread lifting with smooth internal threads are all collectively beneficial in collagen production.
To enhance his results with acne scarring, Dr. Emer also incorporates medication such as Isotretinoin, a Vitamin A derivative and an extremely beneficial resource for individuals with visible scarring and painful, cystic, or pustular acne causing scarring and discoloration. When used in conjunction with energy-based and/or skin care treatments, Isotretinoin can in fact accelerate improvement, reduce redness, and soften acne scars. Dr. Emer’s unique treatment plan for patients with severe acne is to combine the Isotretinoin medication with Clear + Brilliant or Venus Viva as well as dermal heating lasers, such as excel V, Laser Genesis, or the Aerolase Microsecond YAG laser, all of which can decrease inflammation, improve skin texture and speed up the acne resolution. Bi-monthly Salt Facial and SilkPeel treatments keep the skin hydrated and prevent irritation while using the medication.
As always, Dr. Emer is equipped with the most advanced, most powerful lasers available, which treat a range of skin conditions. With his broad scientific knowledge and depth of experience, Dr. Emer is able to single out which laser treatments will provide the specific results desired based on your unique skin condition, skin type, and your history of acne scarring.
I want clearer, smoother skin with reduced acne scarring!
To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge to schedule an appointment. Call 424-800-4140 or email us at [email protected].