PracticalDermatology

Acne can leave both physical and mental scars, and Cosmetic Surgery Forum faculty member Mark B. Taylor, MD, a dermatologist in Salt Lake City, has pioneered an aggressive protocol that can smooth and fade all types of facial acne scars.

The process begins with an online consultation regarding the type and extent of the scarring, as many patients travel from other states or countries for the procedure, he says.

“We generate a treatment plan and cost estimate based on photos from the online consult,” Dr. Taylor says. Arrangements are made for travel/hotel and a confirmation visit to the office on the morning or day before treatment, he says, adding that patients must remain in Salt Lake City for one week following the procedure.

All prescriptions (except those for controlled substances) are called in to the patient’s home pharmacy for purchase prior to arrival, Dr. Taylor says.

Aggressive Protocol

The comprehensive procedure may include preoperative oral sedation and analgesia, topical anesthesia with lidocaine/tetracaine, marking of scars under harsh lighting, a light 20% Trichloroacetic Acid blending peel, and tangential resurfacing of rough scar borders and raised areas using a short-pulse erbium laser, he says.

Next, tumescent anesthesia is delivered to the entire area of scarring on the cheeks, temples, and forehead.

All rolling scars are subcised using the Taylor Liberator, a subcision tool that Dr. Taylor invented. “Subcision is followed by fractional ablative CO_{2, erbium, or pico/nanosecond 1064nm laser of the scarred areas,” he says.}

Dr. Taylor also performs punch excision and suturing of deeply pitted acne scars, followed by excision and suturing of larger box type and widely pitted acne scars as part of the procedure.

Images courtesy of Mark Taylor, MD

Healing and recovery

Dr. Taylor employs a variety of post-procedure interventions immediately following the procedure and in the days after to optimize healing. Some patients immediately may opt to receive platelet-rich plasma and/or umbilical cord stem cells, sourced from Predictive Biotech in Salt Lake City.

For all patients, “I use 810nm light for five minutes to reduce inflammation and swelling, oxygen dome, and 630nm red light to stimulate faster healing,” Dr. Taylor says.

Out of the office, patients apply clindamycin ointment and Vanicream ointment and an ExuDry Mask for the first night. “They return for cleansing and care instructions and additional oxygen dome and 630nm light the following day,” Dr. Taylor says. “Patients are seen in three to five days to assess healing and monitor for any complications.” Sutures are dissolvable Vicryl Rapide.

Aftercare plays a big role in optimizing the results and minimizing any risks, he says.

Typically, the patient flies home a week after treatment and is remotely followed for an additional period of time. “Patients are strictly forbidden to have any direct sun exposure until the skin has completely returned to normal color, which typically is a few weeks to a few months following the procedure,” Dr. Taylor says. After two weeks, patients can go outside if they wear a large hat and sunblock. Moreover, a face shield is used while driving to prevent post-inflammatory hyperpigmentation, he says.

Images courtesy of Mark Taylor, MD

Intense Procedure

“This combination treatment is intense but greatly appreciated by patients who have suffered all of their lives,” Dr. Taylor says. “I have had many people shed tears of joy and express to me how it changes their lives.”

Save the date: Cosmetic Surgery Forum 2021 will be held December 1-4 in Nashville. Visit CosmeticSurgeryForum.com

Mark B. Taylor, MD is a dermatologist at the Gateway Aesthetic Institute & Laser Center in Salt Lake City.

Joel Schlessinger, MD, is a dermatologist and general cosmetic surgeon in Omaha, NE and the Owner & CEO of LovelySkin.com. He is the founder of the Advanced Skin Research Center and the Cosmetic Surgery Forum.