Acne

Our Service Gallery
BMe, LP, PDT, Acne, Botox Filler, left, chin

BEFORE

Before: Cystic Acne with severe scarring

BMe, LP, PDT, Acne, Botox Filler, left, chin

AFTER

Several resurfacing and fractionated laser peels (ErbYag) as well as a few PDT sessions & some Hyaluronic Acid Fillers

Note:  Acne scarring is notoriously difficult to eradicate, even with excellent laser peels. Improvement is the best expectation.  True complex acne scarring may be improved upon. It is usually also associated with long, near complete remission in adult acne.  Dermal Hyaluronic Acid fillers are also invaluable in improving the contours of the resurfaced cheeks.
Acne

BEFORE

Red inflamed acne

Acne

AFTER

Acne much improved

Note: This young man had a session each of Photodynamic Therapy, Intense Pulsed Light and superficial Laser Peel to treat acne and acne scarring, with favorable results

WL, Acne, Acne Acarring, LP, Left

BEFORE

Complex acne scarring

WL, Acne, Acne Acarring, LP, Left

AFTER

Laser Resurfacing

Note:  This young farmer is exposed to a great deal of Ultraviolet light.  He is deeply disturbed by marked acne scarring which is clearly improved now after 2 Laser Resurfacing and 2 Fractionated Laser sessions.  He is happier with his skin now.
WL, Acne, Acne Acarring, LP, Right

BEFORE

Complex acne scarring

WL, Acne, Acne Acarring, LP, Right

AFTER

Laser Resurfacing

Note:  This young farmer is exposed to a great deal of Ultraviolet light.  He is deeply disturbed by marked acne scarring which is clearly improved now after 2 Laser Resurfacing and 2 Fractionated Laser sessions.  He is happier with his skin now.
YN, CP, Ance, Heperpig, Sun Damage

BEFORE

Acne, hyperpigmentation

YN, CP, Ance, Heperpig, Sun Damage

AFTER

3 Skin Medica Chemical Peels, (Vitalize x2, Rejuvenize x 1)

Note: This young woman needed a solution for acne and hyperpigmentation.  Given her dark skin type, she could not avail herself of many other light based modalities, but she embarked on a serial gentle skin peel called Vitalize Peel by Skin Medica.  She had some short-lived hypopigmentation on one occasion but that resolved within a couple of weeks.  So, acne is improved, the hyperpigmentation is much diminished, and her overall color is more in keeping with her neck.
YN, CP, Ance, Heperpig, Sun Damage-right

BEFORE

Acne, hyperpigmentation

YN, CP, Ance, Heperpig, Sun Damage-right

AFTER

3 Skin Medica Chemical Peels, (Vitalize x2, Rejuvenize x 1)

Note: This young woman needed a solution for acne and hyperpigmentation.  Given her dark skin type, she could not avail herself of many other light based modalities, but she embarked on a serial gentle skin peel called Vitalize Peel by Skin Medica.  She had some short-lived hypopigmentation on one occasion but that resolved within a couple of weeks.  So, acne is improved, the hyperpigmentation is much diminished, and her overall color is more in keeping with her neck. Note the fine lines around her eyes are even reduced.  Seen in person, she glows now.
WJu, Acne, PDT

BEFORE

Acne on chin

WJu, Acne, PDT

AFTER

1 session of Levulan Photodynamic Therapy

Note: The chin looks much better now that acne is much improved. The lesions now are smaller and short lived after just one session of Levulan Photodynamic Therapy. There is a favorable change in the appearance of her pores on the chin as well as blackheads are reduced in number and sebaceous glands are reduced in size.  The rest of her face was much brighter, smoother, and more even colored after the treatment as well.
BMe, LP, PDT, Acne, Botox Filler

BEFORE

Cystic Acne with severe scarring

BMe, LP, PDT, Acne, Botox Filler

AFTER

Several resurfacing and fractionated laser peels (ErbYag) as well as a few PDT sessions & some Hyaluronic Acid Fillers

Note:  Clearly this woman has suffered scarring cystic acne.  It left white scar mottle all over her forehead, cheeks, chin.  Keloid scarring is evident in between the eyes.  There is still some inflammatory acne that appears on a regular basis.  Like others with acne scarring, she was determined to finally halt acnebreakout, and smooth skin to more normal appearance.  It took several laser peels and some Hyaluronic Acid Fillers (Teosyal) to achieve the great improvement shown here.  She looks older, but better.  
BMe, LP, PDT, Acne, Botox Filler, left

BEFORE

Cystic Acne with severe scarring

BMe, LP, PDT, Acne, Botox Filler, left

AFTER

Several resurfacing and fractionated laser peels (ErbYag) as well as a few PDT sessions & some Hyaluronic Acid Fillers

Note:  Clearly this woman has suffered scarring cystic acne.  It left white scar mottle all over her forehead, cheeks, chin.  Keloid scarring is evident in between the eyes.  There is still some inflammatory acne that appears on a regular basis.  Like others with acne scarring, she was determined to finally halt acnebreakout, and smooth skin to more normal appearance.  It took several laser peels and some Hyaluronic Acid Fillers (Teosyal) to achieve the great improvement shown here.  She looks older, but better.
PN, Acne, PDT

BEFORE

Acne, acne scarring

PN, Acne, PDT

AFTER

Photodynamic Therapy

Note: This mid late 30’s woman looks rather impressive in her decouter after PDT. Her goal was reduction of acne and scarring which she achieved, however, even her early cleavage fine wrinkles, her neck creases, and sun damage pigment irregularities lessened as a side benefit.
HR, Check, Acne, LP, Hyperpigmentation

BEFORE

Acne, Hyperpigmentation Bumpy texture

HR, Check, Acne, LP, Hyperpigmentation

AFTER

Photodynamic Therapy and Profraction

Note: The cheeks in this comparison are improved by more radiance, smoother texture, more even color, and remission from inflammatory acne.  «Blackhead» counts are down, the goal of treatment.
HR, forehead, Acne, LP, Hyperpigmentation

BEFORE

Acne, Hyperpigmentation Bumpy texture

HR, forehead, Acne, LP, Hyperpigmentation

AFTER

Photodynamic Therapy and Profraction

Note: The forehead Before After comparison reveals a diminished concentration of open and closed «blackheads».  This is important in the treatment of acne.  Note the side benefit of healthier looking, more even colored skin.  The blackheads are clearly less inflamed as noted in the Before picture.  Hyperpigmentation due to sun damage is reduced.
Acne

BEFORE

nodulocystic acne with residual discolored skin

Acne

AFTER

PDT and Profraction, breakout pattern remitted for months, cosmetic improvement

Note: This young woman was not tolerant of the various acne topical and oral medications. She elected to proceed with light based acne therapy, including Levulan PDT and Profraction. Not only was the acne nicely remitted, but so too was her skin radiant and smooth.  What looks like acne is not always acne.  This young woman experienced breakout to her face that wasn’t always acne.  She had a Celiac condition that also breaks out on her face.
Acne, ThC

BEFORE

Acne

Acne, ThC

AFTER

Remission after combination therapy

Note:  This woman did serial microdermabrasions, IPL’s, and Retinoid creams.
SPe, Sundamage, Anti-aging

BEFORE

Severe Sun Damage causing pre-cancers of the skin, and other non-malignant brown and red marks

SPe, Sundamage, Anti-aging

AFTER

1 full face laser resurfacing procedure, & 1 Photodynamic Therapy session

Note:  This man presented in his 70’s with plenty of spots on his face and ears that were increasingly scabby, bumpy, red, and some were ulcerating. He was diagnosed with multiple pre-cancers and cancers of the skin.  These non-pigmented pre-cancers are often referred to by the public as «farmer’s cancers», because they are prevalent in farmers who have had a lifetime of heavy Ultraviolet exposure.  This man proceeded with the laser resurfacing to the full face with extra emphasis on visible lesions.  Then he elected to do the next level of treatment which addresses the microscopic «field» of the skin, before they become visible, that treatment being Photodynamic Therapy.  He did two such PDT sessions and is very happy with the healthful change in his skin.  The picture speaks for itself.  His ears were the most seriously affected, and the site with the ultimate greatest improvement.  He was pro-active and avoided the requirement for surgery to his ears.
DSa, LP, Anti-aging, acne

BEFORE

Dense Blackheads, dull skin, scarring, age related volume loss

DSa, LP, Anti-aging, acne

AFTER

Combination ErbYag Midi Laser Peel

Note: This young woman had an unusually prominent pattern of dense blackheads on her face.  Even though she wasn’t getting much acne breakout, the blackheads were visible and conspicuous.  She was so relieved to discover that this Combination Erb Yag laser peel was successful in reducing to about 15% of the original density of blackheads, while the face filled out and her skin firmed up, rounded out, texture became softer, color more even.  She is very pleased, receiving a number of compliments beginning around three months after the laser peel.  The compliments will keep coming as the skin gets increasingly attractive.
Acne, FAn

BEFORE

Melasma, acne, enlarged pores

Acne, FAn

AFTER

Profraction

Note: Reduction in the hyperpigmentation pattern of melasma, subdued inflammatory acne, smoother texture 3 months after only one Profraction.
BMa, f.face LP

BEFORE

Combination Erb Yag Laser Resurfacing with Fractionation

BMa, f.face LP

AFTER

10 months later

Note:  Acne scarring and hyperpigmentation were prominent on this Phillippina but clearly the Combination Midi Erb Yag Laser Resurfacing with Fractionation has diminished the scarring quite happily for her.  She did experience the transient hyperpigmentation, not unexpected for a young darker skinned woman, but this is transient and resolves spontaneously in most by 3 months or so.  She looks healthier and more youthful.
BMa, checks, left

BEFORE

Acne Scarring

BMa, checks, left

AFTER

10 months after Midi Combination Laser Resurfacing

Note:  Acne scarring is notoriously difficult to treat.  This young woman had good improvement with just one treatment, now smoother, fewer dark marks.   She could do a second with expected greater improvement.
BMa, checks, right

BEFORE

Acne Scarring

BMa, checks, right

AFTER

10 months after Midi Combination Laser Resurfacing

Note:  Acne scarring is notoriously difficult to treat.  This young woman had good improvement with just one treatment, now smoother, fewer dark marks.   She could do a second with expected greater improvement.
SDa, Acne, Anti-aging, LP

BEFORE

Large, prominent pores and dense «blackheads»

SDa, Acne, Anti-aging, LP

AFTER

Deep Laser Peel, only one month after, still pink

Note:  This young woman was thrilled to smooth pores, pitted scars and remove a large fraction of her dense and very prominent «blackheads».  See the various parts of the face before and after to scrutinize the dramatic reduction in blackhead prominence and density.  Also note the improvement in acne scarring on her chin.  The depressed scars are diminished, and the chin is more rounded, less indrawn.  The skin is still pink but that is because she is still in the first month after a deep laser peel.  The results will visibly improve over the next 5 months as the pink fades to natural radiant skin tones.
SDa, Acne, Anti-aging, LP forehead

BEFORE

Large, prominent pores and dense «blackheads»

SDa, Acne, Anti-aging, LP forehead

AFTER

Deep Laser Peel, only one month after, still pink

Note:  This young woman was thrilled to smooth pores, pitted scars and remove a large fraction of her dense and very prominent «blackheads».  See the various parts of the face before and after to scrutinize the dramatic reduction in blackhead prominence and density.  Also note the improvement in acne scarring on her chin.  The depressed scars are diminished, and the chin is more rounded, less indrawn.  The skin is still pink but that is because she is still in the first month after a deep laser peel.  The results will visibly improve over the next 5 months as the pink fades to natural radiant skin tones.
SDa, Acne, Anti-aging, LP, half face

BEFORE

Large, prominent pores and dense «blackheads»

SDa, Acne, Anti-aging, LP, half face

AFTER

Deep Laser Peel, only one month after, still pink

Note:  This young woman was thrilled to smooth pores, pitted scars and remove a large fraction of her dense and very prominent «blackheads».  See the various parts of the face before and after to scrutinize the dramatic reduction in blackhead prominence and density.  Also note the improvement in acne scarring on her chin.  The depressed scars are diminished, and the chin is more rounded, less indrawn.  The skin is still pink but that is because she is still in the first month after a deep laser peel.  The results will visibly improve over the next 5 months as the pink fades to natural radiant skin tones.
SDa, Acne, Anti-aging, LP, left check

BEFORE

Large, prominent pores and dense «blackheads»

SDa, Acne, Anti-aging, LP, left check

AFTER

Deep Laser Peel, only one month after, still pink

Note:  The Chicken Pox will begin to visibly improve between 2 - 6 months as collagen is just beginning to appear in the microscope. This young woman was thrilled to smooth pores, pitted scars and remove a large fraction of her dense and very prominent «blackheads».  See the various parts of the face before and after to scrutinize the dramatic reduction in blackhead prominence and density.  Also note the improvement in acne scarring on her chin.  The  depressed scars are diminished, and the chin is more rounded, less indrawn.  The skin is still pink but that is because she is still in the first month after a deep laser peel.  The results will visibly improve over the next 5 months as the pink fades to natural radiant skin tones.
SDa, Acne, Anti-aging, LP, right check

BEFORE

Large, prominent pores and dense «blackheads»

SDa, Acne, Anti-aging, LP, right check

AFTER

Deep Laser Peel, only one month after, still pink

Note:  The Chicken Pox will begin to visibly improve between 2 - 6 months as collagen is just beginning to appear in the microscope. This young woman was thrilled to smooth pores, pitted scars and remove a large fraction of her dense and very prominent «blackheads».  See the various parts of the face before and after to scrutinize the dramatic reduction in blackhead prominence and density.  Also note the improvement in acne scarring on her chin.  The  depressed scars are diminished, and the chin is more rounded, less indrawn.  The skin is still pink but that is because she is still in the first month after a deep laser peel.  The results will visibly improve over the next 5 months as the pink fades to natural radiant skin tones.
BA, Acne, C.peel, scaring, anti-aging, pigm

BEFORE

Comedones (blackheads), Acne scarring in the temples

BA, Acne, C.peel, scaring, anti-aging, pigm

AFTER

3xVitalize Peel, Retinoid Therapy

Note:  It is only one month since the beginning of therapy, still early in terms of skin remodelling. The skin is dry in the after picture because it has been stimulated by peels x 3 and Retinoid.  However, it is encouraging to note that the skin texture & dated acne scarring is considerably improved after only the first month.  Visible improvement in scars and fine lines due to aging is something that is usually noticed around the third month.  Skin turnover is high, collagen synthesis is accelerated, and tissue water will soon expand the skin to yield smoother fuller surface and contours.  Initially, there may be some generalized superficial hyperpigmentation after skin peels, but this is transient, usually resolved 1 - 3 months afterward, leaving skin smooth, radiant, even colored after a few months.  Like planting a seed, the fruit is harvested months later.
MTa, Acne, PDT, Anti-aging, chin

BEFORE

Inflammatory Acne with Scarring

MTa, Acne, PDT, Anti-aging, chin

AFTER

2 Photodynamic Therapy sessions

Note: There is much less breakout and more radiant, healthy looking skin after two PDT’s in the past 3 months.  She is thrilled because the breakouts are small and infrequent, much reduced. She is receiving compliments from others who have known her.  Note the radiance of her skin now, as the skin has plumped out.  This treatment does reduce the appearance of age, although this was not the indication for this young woman with adult acne.  She is committed to remitted acne and clear skin.  She will improve with more time, and she may finish off with a laser peel to smooth texture, and eradicate the blocked pores.  The pigment marks will be removed, scars will be softened, fine lines will diminish, skin will plump up and radiate.
MTa, Acne, PDT, Anti-aging, mouth

BEFORE

Inflammatory Acne with Scarring

MTa, Acne, PDT, Anti-aging, mouth

AFTER

2 Photodynamic Therapy sessions

Note: There is much less breakout and more radiant, healthy looking skin after two PDT’s in the past 3 months.  She is thrilled because the breakouts are small and infrequent, much reduced. She is receiving compliments from others who have known her. Note the radiance of her skin now, as the skin has plumped out.  This treatment does reduce the appearance of age, although this was not the indication for this young woman with adult acne.  She is committed to remitted acne and clear skin.  She will improve with more time, and she may finish off with a laser peel to smooth texture, and eradicate the blocked pores.  The pigment marks will be removed, scars will be softened, fine lines will diminish, skin will plump up and radiate.
Acne, EB

BEFORE

Nodulocystic Acne with Scarring

Acne, EB

AFTER

1 Profraction and 3 PDT's

Note: This young man was thrilled to see long term remission, possibly cure, for his nodulo-cystic scarring acne after 3 sessions of PDT and 1 Profraction. The acne pimples became fewer and smaller as he did each PDT, and then they stopped after the Profraction (Fractionated Erb-Yag Laser Peel).  Meanwhile, the acne scarring smoothed and pigment marks resolved, nearly completely after just one Profraction.  This regime of PDT plus Profraction as treatment for severe acne, without pills, has been very effective in the majority of our patients.
WCh, PDT

BEFORE

Peri- Oral Dermatitis

WCh, PDT

AFTER

Photodynamic Therapy session x1

Note: This is Peri-Oral Dermatitis in a 39 year old woman.  This is not acne, but often may be confused for acne. It is difficult to treat.  Topicals are helpful but don’t usually suffice to resolve the condition, so the next line of therapy is generally oral antibiotics.  Sometimes it is difficult to withdraw from oral antibiotics without relapse, so long term oral low dose antibiotic is the usual next therapy that keeps the blemishes quiet. Although Photodynamic Therapy is not curative, it can and usually does attain long term suppression with nice glow and more uniformly colored firmer, younger looking skin.  The treatment may be done as needed with greater, longer remission each treatment.  Patients come off their oral antibiotics and are generally thrilled to replace oral medication with a physical therapy such as PDT that remits the dermatitis and produces cosmetically beautiful skin as a side benefit.
SJo, Fillers

BEFORE

Acne and Aging

SJo, Fillers

AFTER

Subtle benefit after Juvederm, VitCE, Retinoid

Note: This young woman was annoyed by the appearance of aging and mottled dull acne prone skin that kept blemishing around her mouth.  She elected to do some Hyaluronic Acid Fillers, in this case Juvederm to her face to lift and brighten her skin. Notice that she looks so much more glowy on her face after fillers.  This is typical after fillers.  And there is a subtle increase in the fullness of the skin, and lips which is attractive and natural looking.  No one would ever guess that she has «had work»!  She was also provided some skin topicals by the MD which is also contributing to the more uniform colored glowing skin.  She is very pleased.
WCh, PDT full face

BEFORE

Peri- Oral Dermatitis

WCh, PDT full face

AFTER

Photodynamic Therapy session x1

Note: This is Peri-Oral Dermatitis in a 39 year old woman.  This is not acne, but often may be confused for acne. It is difficult to treat.  Topicals are helpful but don’t usually suffice to resolve the condition, so the next line of therapy is generally oral antibiotics.  Sometimes it is difficult to withdraw from oral antibiotics without relapse, so long term oral low dose antibiotic is the usual next therapy that keeps the blemishes quiet.  Although Photodynamic Therapy is not curative, it can and usually does attain long term suppression with nice glow and more uniformly colored firmer, younger looking skin.  The treatment may be done as needed with greater, longer remission each treatment. Patients come off their oral antibiotics and are generally thrilled to replace oral medication with a physical therapy such as PDT that remits the dermatitis and produces cosmetically beautiful skin as a side benefit.

RW,-before, Acne, melasma hyperpigmentation, sun damage, agingBEFORE

Acne, melasma, hyperpigmentation, sun damage, aging

RW,-after, 30 days after PDTAFTER

30 days after PDT

Note:  This patient was thrilled to report reduction in acne, hyperpigmentation, 30 days  after one PDT session.  She notes that the skin is brighter, smoother, and she is younger  looking.  The downtime was quite tolerable for 4 days.
Acne, MI

BEFORE

Cystic Acne, dyspigmentation

Acne, MI

AFTER

Fractionated Laser Peel, (Profraction)

Note: This woman was very pleased after a small amount of dermal filler and a fractionated laser peel on her full face.  There was great relief for her to finally obtain relief from nodulo-cystic acne and some of the resulting pigment marks.  Despite her dark skin pigment, she had no complications.
Laser Peel, ML

BEFORE

Melasma

Laser Peel, ML

AFTER

Profraction Therapy: Reduction in hyper- pigmentation of upper lip

Note: The pigment improved over and under her lips, and so too did the acne.  The skin is remodelled by the laser peel bringing about turnover of the brown pigment blotches, and removal of the clogs within the pores.  Notice how much better she looks on her cheeks.  Even her glow is back.
Acne, OJ

BEFORE

Nodulocystic Acne Sebaceous gland enlargement

Acne, OJ

AFTER

Photodynamic Therapy x 2 Fractionated and full resurfacing x3

Note: This young woman was committed to improving her skin, finally, after many years of dissatisfaction with break-out, blackheads, oil gland enlargement, pigment marks, and scarring. She is now so much more attractive in her skin that she is receiving compliments from all of her contacts. She feels more confident and looks forward to more social life, something she put off in the past.
WK, PDT, Acne

BEFORE

Acne, age 23

WK, PDT, Acne

AFTER

Approx 2 years after PDT

Note: This young woman is experiencing a sustained remission after one PDT.
SJ, LP

BEFORE

Acne Scarring

SJ, LP

AFTER

Smoother

Note:  After one moderate depth laser peel and about 6.5 weeks of skin remodelling time, it can be seen that there is softening and smoothing of the skin surface in this acne scarred young woman.  Her skin is clearly smoother, more even colored, and more radiant.  Remodelling time after a laser peel continues for approximately 6 months until it is complete, so she has 4.5 months before she will fully realize the potential of her laser peel for scar revision.