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Surgical Excision

Punch techniques help to effectively treat different types of acne scars. 

Punch techniques are useful in treating:

  • Rolling scars
  • Tethered boxcar scars with altered skin texture
  • Deep ice pick scars

However, punch techniques should not be used in conditions such as:

  • Keloid scars
  • Active bacterial or fungal infection
  • History of herpes simplex virus infection
  • Pregnant women
  • History of eczema, psoriasis and other chronic skin conditions
  • History of actinic (solar) keratosis 
  • Medical disorders such as scleroderma, collagen vascular diseases, bleeding disorders, heart disease, etc
  • Patients with diabetes and those on immunosuppressive therapy, who are therefore more likely to have decreased wound healing
  • Patients with moles or warts in the treatment area

PRE-PROCEDURE:

  • Your doctor will explain the procedure to you step-by-step and address all your concerns. 
  • After that, he will take your consent and the procedure will begin. 

How does the procedure work? 

  • Firstly, your doctor will ensure that all instruments are sterilised. 
  • He will wear sterilised gloves and mask himself. 
  • For any of the punch techniques, he will first inject local anaesthesia over the treatment area. 
  • Thereafter, depending on the type of scar, dermatologists use different types of punch techniques for treatment, such as:

Punch excision & elevation

In this technique, your doctor cuts into the skin in order to remove the acne scar and then closes the wound with stitches. In other words, excise and suture. 

Punch elevation and punch floating

In contrast, to punch excision, no tissue is removed here. Rather, following the punch, the depressed scar floats upwards. It is then then fixed in place. As a result, it appears much less recessed or pronounced on the face. 

Punch replacement and grafting 

This is one of the simplest and least expensive of all the grafting procedures. 

Your doctor will use a small instrument to punch a hole in the skin, remove the scar, and subsequently replace it with a plug of new skin. In fact, doctors take this graft from the patient’s own body, usually from the area behind the ear. 

Punch incision and elevation

When the depressed scar has a normal texture, your doctor will incise it upto the subcutaneous tissue, that is to say, till just below the skin. After that, he will elevate it to the level of surrounding skin. 

  • Furthermore, one session lasts for about 1-2 hours with an average downtime of 5-7 days after one session. 
  • Meanwhile, most cases require only one session, though the number may vary occasionally. 
  • Dermatologists often use punch techniques are in combination with platelet-rich plasma (PRP) therapy for increased effectiveness. 

POST-PROCEDURE CARE:

  • You may experience persistent heat and redness after the procedure, however, it usually resolves within 24 hours. You can use an ice pack or a cooling gel to help relieve it. 
  • Doctors advise you to not use any glycolic acid products, retinoids or alcohol-based products for at least 48 hours after treatment. 
  • In the same vein, don’t use any exfoliating or peeling treatments for at least a week after treatment.
  • Also, avoid friction of any kind over the treated area, so don’t rub over it, touch it frequently, or wear tight clothing. 
  • Your doctor may prescribe anti-inflammatory medications and antibiotics to reduce pain, swelling, and the chances of infection. 
  • Apply moisturiser twice a day to hydrate and moisturise your skin.  Similarly, hydrate your body by drinking plenty of water. It helps facilitate healing. 
  • In order to reduce adverse pigmentary changes, avoid direct sun exposure and apply sunblock with SPF>30.
  • Meanwhile, avoid hot baths, steam baths, saunas, and swimming in strongly chlorinated water. 
  • Likewise, avoid vigorous activities, smoking, and alcohol consumption. 
  • Above all, leave any skin responses alone. They are typically temporary and will subside.

BENEFITS:

  • Firstly, it is a one-time procedure and repeat sessions are rarely required. 
  • US FDA approved treatment
  • Secondly, it uses the body’s own skin fat & cells for grafting, hence rules out any allergic reaction. 
  • Thirdly, there are fewer chances of disturbance of epidermal cells which usually crust, thereby minting the skin’s integrity. 
  • Above all, it is a US FDA approved treatment that is both safe and effective.

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BEFORE & AFTER

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