[Treatment] Infini Fractional Radiofrequency for Depressed Acne Scars in Singapore (The Clifford Clinic)

6:13 PM Cindity 3 Comments

Acne scars - they tell a story of the body's amazing ability to repair itself, and yet how our repair mechanism is not perfect. 
They have been with me for 6 long years and have never left since. 


How scarring is formed- the story of inflammation

When the skin is split, red blood cells form a blood clot which stops the bleeding while the skin turns red and swells. White blood cells fight infection from germs and starts to repair the wound. 
The edges of the wound are contracted and new granulation tissue proliferates to lay down epithelial tissue over the open wound. Next, fibroblast cells enter the wound to form new collagen matrix and blood vessels. Fibroblasts usually produce an organized network of collagen, however, collagen fibers are laid out haphazardly in an unorganized manner to close the wound immediately

http://www.clinimed.co.uk/Wound-Care/Education/Wound-Essentials/Phases-of-Wound-Healing.aspx
Collagen increases as the wound matures.

Scars are formed as the new tissue grows differently than the original tissue. Maturation happens when the wound is closed when the collagen remodels from type III to type I. Insufficient healing can result in atrophic scarring such as depressed acne scars.

Are we marked for life? - Why do scars remain when skin cells renew every 28 days

If only the top layer (epidermis) is removed, you probably won't have a scar. The deeper layers of skin in the dermis, do not go through cellular turnover and will remain. Cells from the dermis divide and give rise to the cells on the epithelial surface and pass down the same genetic material to the next. Even though individual cells within the skin periodically die and are replaced with new cells, the scar collagen remains. 

http://www.nbcnews.com/id/3076698/t/why-are-scars-permanent/#.Vwx53fl96Un
Different layers of the skin - the epidermis, dermis and the fat layer.
Depressed acne scars due to the destruction of collagen are caused by inflammatory acne. The major types of atrophic scars are ice pick, rolling, and boxcar. Milder procedures such as dermabrasion and chemical peels can improve scarring but often with sub-optimal outcomes. And while the ablative lasers have significant recovery, they are not without the disadvantages such as higher risk of hyperpigmentation and long recovery times. Many of us don't exactly have the luxury to stay at home or even worse tolerate the cost of additional problems caused by laser damage. 

My struggle with acne and pimples

I had terrible acne outbreaks as a teenager. Unfortunately, having told the falsehood that it will go away with time, I didn't manage to control it and it soon sprung into damaged skin. I'm East Asian with olive skin. Deciding to take on acne treatment and was the best decision that I had made for myself. Seeking to finally take steps to resolve my personal issue wasn't easy, treatments are always really expensive and it is harder to justify when it is just for vanity. On the acne forums, you see an individual with great results; and when you're set on doing that treatment, another post of damage precedes. Having better skincare helps with the overall complexion but they do nothing to the facial scars. 
This was taken in Aug 2015, before Venus Viva Radiofrequency
Box-car and ice-pick scar on my cheeks were left from teenage acne.

I thought everyone else was only looking at my pimple scars. But the truth is that the criticism is all from within. I layered on foundation and concealer and tried to cover up my insecurities. When I feel self-conscious, I avoided eye contact and just wanted to hide from the rest of the world. Ok, this is getting dramatic, but I know I'm not alone. Many underestimate the emotional damage that acne scarring can cause, and there are many others struggling with their scarring and acne every day. 
Less noticeable acne scars has definitely made me less conscious of myself. It was so difficult to deal with being different from others, I felt inferior to others who had perfect complexion when I had pockmarks and pigmentation on my face. I mourned from being the clear-faced girl before the onset of cystic acne.

Sadly, there is hardly anyone who would say that acne-scarring is more attractive than a flawless skin. I'm pretty sure that everyone would generally prefer if acne just didn't exist. Having acne doesn't automatically makes you ugly, but it does take away some of the confidence. Attractiveness is sometimes measured by your confidence and it is definitely easier to be confident when you have perfect skin.  I understand how it is like to hurt your self-esteem when you're positive that others that you meet will only see your scars and be repulsed by it. I've better come to accept myself over the years and realize that most people do not have perfect skin. There are more to a person than just your appearance. 

This was how my skin looked like before I went for the Infini fractional RF treatment at The Clifford Clinic:

Taken on November 2015
Taken on November 2015

Here's the big guns- Infini microneedle Fractional Radiofrequency 

Unlike laser, Radiofrequency (RF) is suitable for ethnic skin and the risk of post-inflammatory hyperpigmentation is lowered. It is even safe for use on patients with pigmented lesions and melasma. Radiofrequency works by heating the dermis to a certain temperature for collagen stimulation (40-45 degrees C) and contraction (65 degrees C). It is hard to heat the dermis to this temperature while avoiding a burn on the skin surface. Also, delivering heat energy from the skin surface is unpredictable due to individual differences in skin thickness, hydration, fat and collagen. The energy reaches the dermis in unknown and variable depths. But if the critical temperature is not attained, there is also no stimulation of collagen.

The Infini is one of the microneedling Fractional Radiofrequency devices in the market. The ability to set multiple needle depths per pass allows discrete electrothermal coagulation at different layers of the dermis. The insulated needles prevent electrothermal damage from occurring anywhere other than the tip of the needle. That means that the RF energy is localized and won't go on to heat up other parts of your face like the epidermis or fat layer. Surely no one wants some sunken cheeks. 

http://www.theclinique.net/procedures/what_s-new-and-hot/infini-skin-tightening/
Diagram from Dr. Weiner's white paper 
showing the unpredictability of the Mono and Bipolar transcutaneous RF devices vs. the controlled, precise thermal injury of the Infini with its insulated tips. 
The skin is penetrated with microneedles to bypass the skin surface and reaches to the dermis to deliver heat energy. The surface skin is safe as the needles are at a depth that will not heat the epidermis. The energy is transmitted between needles and only travels a very small distance to minimize discomfort. This results in collagen remodeling, collagen contraction, and stimulation. Most scar sufferers might have heard of micro-needling as well, this is the secondary benefit of Infini fractional RF where fibroblasts are mechanically stimulated to produce collagen. 
http://www.international.lutronic.com/infini


Unlike the superficial RF treatments in beauty salons that are unlikely to help against scarring, the Infini Fractional Radiofrequency can go up to 3.5 mm deep. That goes into the dermis to stimulate deep collagen production. 


The fractional RF energy is delivered through these gold-coated microneedles and creates controlled thermal coagulation points within the dermis. The length of the microneedles can be adjusted, which their depth is controlled by Dr. Gerard Ee. The 49-needle tip is used by Dr. Ee which can deliver more than 100, 000 thermal coagulation points in a 45-minute session! The treatment is usually very fast and takes about 15 minutes. The needles are only 200 microns and have variable depth of penetration from 0.5 to 3.5 mm to treat several different depths of the dermis. The needle tip of Infini RF is disposable and a new tip is used for each treatment. 

I know this might look a little scary and painful but Dr. Ee and his team have taken good measures to make sure this is as painless as possible. The medical assistant rubs the numbing cream into my skin twice before the procedure. Prior to Infini, local anesthesia is also injected into each side of the cheeks for the procedure to be as painless as possible. Dr. Ee went 4 rounds on the both sides of my cheeks, where my scars are the most prominent at.

With the numbing cream. Since this numbing cream is not white and just a little glossy, you can still do your stuff while waiting for it to take effect. 

Injection of local anesthesia. 


It felt like a stapler, which dispenses its needles into the skin to deliver the RF energy to break up the tethering fibres of the scar. Dr. Ee did 4 passes on my cheeks at different needle depths, 2.5, 2.0, 1.5 and 1.0 mm for different scar depths. The treatment only took about 15 minutes.

Infini Fractional RF treatment

Recovery

Now, I won't sugarcoat it. You won't look fabulous on the day itself, the amount of redness differs from individuals. This was how I looked immediately after the treatment. Infini does not cause any pin point red spots, just overall redness. Surprisingly, considering that it is a more invasive treatment than the Venus Viva, the downtime is just 2 days (I took a week for the scabs and redness of Venus Viva to dissipate). 

All redness has dissipated on Day 3
I was prescribed Foban cream, an antibiotic and Skinceuticals Phyto Corrective Serum to soothe the area.

I applied on the Foban cream and Skinceuticals Phyto Corrective Serum, day and night, for a week after the treatment. The Foban cream is an antibiotic while the serum soothes and cools the treated area. Like any intensive treatment, sunscreen of SPF25 and above is also applied on daily to protect the skin against UV damage.

Results

It has been difficult to document the results as the appearance of the scars are hugely dependent on the lighting and the overall skin condition. Atrophic and acne scars definitely look better when the skin is more hydrated and plump. 

Thanks to the photography room in The Clifford Clinic, the lighting and angle is consistent. So I'm here with some results to share! 

(click to zoom)





Verdict for Infini as an acne scar treatment 

Results are definitely more evident after 1-3 months, and full results take the 4-6 months to achieve. My skin quality has definitely improved, with shrinking of some of the more noticeable box scars (the prominent one on the left cheek and on certain clusters) from the treatment. The borders of the box car scars are softer, less stark, and the acne scar is more elevated.
I'm incredibly happy with the results and am really tempted to go for the second treatment of the Infini. Because it also firms up the skin to induce collagen growth, this could also be a good treatment for anti-ageing. Results are permanent and can be seen from the first treatment. 

The Clifford Clinic



The Clifford Clinic has chirpy staff and cozy ambiance, that makes patients feel welcomed and at ease with a spa-like setting. I find clinics that are too posh a little more daunting. HEHEH The face is a very intimate thing to us, and it is important to find a good doctor to entrust your face to. Also, aesthetic treatments no longer have to break a bank, your doctor should be willing to discuss your expectations and budget and work out a solution together with you. 
Having a chat with the nurses

Dressing room to remove makeup and cleanse face. They even have cute hairpins for you to keep your bangs up.
They also stock products from SkinCeuticals.


It is perfectly normal for us to look at ourselves in the mirror and pick out a thousand flaws. We are all insecure of ourselves. To better decide what you want or need, get a professional opinion. I was introduced to Dr. Gerard Ee, a really good looking and promising young man. And he is a real doctor too. 
Dr. Ee was also very reassuring and chatted with me throughout the process. He was trained as particularly as a dermatologist and is fully accredited in aesthetic procedures. Even good machines can be misused and results are more dependent on the Doctor that performs the treatment for you. You can't go wrong with a Doctor that treats acne and acne scarring specifically. 

There is also a photography room to document your results.
Dr. Gerard Ee was patient and has sat with me to scrutinize the photos, zooming in on each area of the skin to see the improvement in elevation. Located in the heart of Singapore, it is extremely convenient to just drop by The Clifford Clinic during lunchtime or after-work for better skin.  



The Clifford Clinic
24 Raffles Place
#01-03 Clifford Centre
Singapore 048621
(Exit A from Raffles MRT)

Opening hours:
Mon to Fri: 10am – 8pm
Sat: 10am – 2pm
Closed on Sundays and Public Holidays

More information can be found on their website www.cliffordclinic.com, and appointments or enquiries can be made through thecliffordclinic@gmail.com or (+65) 6532 2400

-


-


-


Most of us are just looking for (significant) improvement, there are no short of cases where people have improved their skin to a large extent, or to a point where they are comfortable with it. And, that's probably what we are all looking for. 

Everyone should be confident and feel good in your own skin. If there is anything you would like to improve, and that they are within your means, go for it. For me, it is improving my skin. Acne scarring has always been something that is disfiguring and lowers my self-esteem. After treatments and seeing results, I feel better about myself. And I think what you think about yourself is all that matters. All the best, friends!

Other treatments for acne scarring:

3 comments:

  1. Hi Cindy! Thanks for the detailed review. Likewise, I've very similar scarring to yours and have tried many laser treatments, from co2 to mixto (recovery was 7-10 days!). However, while there's improvement, I don't think the improvements were that significant (or maybe I had too high an expectation). However, with age and life experiences, I kinda grew to accept these scars and be contented. Anyway, I've tried needling before and I must say, it works pretty good..considering the low cost and relatively low downtime. How would u compare ur Infini results to needling? Thanks!

    ReplyDelete
    Replies
    1. Dear Steph, I understand how traumatizing the entire experience is! I hope your skin is looking great :)
      Infini or any other device such as RF or lasers are expected to work better than needling due to heat which is important for remodeling collagen. If you have ethnic skin where lasers may hyperpigment on (like me), infini is definitely a good option to try!

      All the best,
      Cindy

      Delete
  2. This comment has been removed by the author.

    ReplyDelete