The F.A.S.T. Procedure for Ance Scars.

Eric S. Schweiger, M.D. is an Assistant Clinical Professor of Dermatology at Mount Sinai Medical Center and founder of Schweiger Dermatology in New York City. Dr. Schweiger practices cosmetic dermatology, with a particular focus on laser and light based treatments for patients with acne and acne scarring. Dr. Schweiger has participated in numerous basic science and clinical research studies over the years and is frequently featured in the media.

New York, NY – Eric Schweiger, M.D., F.A.A.D., Board Certifed Dermatologist and renowned laser surgeon, has developed a new technique for the treatment of acne scars. The technique, coined the “F.A.S.T.” procedure, utilizes the most cutting edge laser technology (fractional CO2 laser) in a new and innovative way to treat acne scars that has not been done previously.

F.A.S.T., an acronym for Focal Acne Scar Treatment, utilizes very high laser energy levels (levels that in the past may have been considered too high to use on the face), to focally treat only the scarred areas. The new technique allows for improved efficacy, faster healing time and increased patient satisfaction.

The key to Dr. Schweiger’s F.A.S.T. procedure is the combination of high laser energy with low treatment area density (lower density than what was previously considered standard) and treatment to only the acne scarred area, while leaving the rest of the face untreated. “It is a double fractional approach” explains Dr. Schweiger. “We are using high dose fractionated laser to treat only a fraction of the face.”

In the past it has been presumed that when using lasers to treat the face (even fractionated lasers that leave areas intentionally untreated), that it was necessary to treat the entire face or the patient would be left with an uneven complextion forever. “Not so with the F.A.S.T. technique, we are finding patients of all skin colors are doing unbelievably well with a single treatment, and are not having permanent pigmentation problems” says Dr. Schweiger.

After F.A.S.T. treatment patients do have “grid marks” that look like little red boxes for 1-2 weeks over the treated area. For most patients post F.A.S.T. treatment, Dr Schweiger will perform a low dose treatment with the non-ablative Fraxel laser (erbium fractionated laser) to get the redness back to normal faster.

The theory behind F.A.S.T. treatment came to Dr. Schweiger after extensive use with both the Fractional CO2 and Fractional Erbium lasers over the years. Having treated over 500 patients with these lasers, Dr. Schweiger has gradually perfected different techniques to get optimal results. In addition, Dr. Schweiger’s knowledge and experience with an older technique using a similar theory to treat acne scars with chemical peels (CROSS method), further cemented that the F.A.S.T. technique was a logical way to aggressively and effectively treat acne scars. Dr. Schweiger has now treated several patients using this technique and all have had outstanding results. Other practitioners will surely adopt this technique after the results have been published. Currently, the first manuscript describing this technique is being finalized by Dr. Schweiger and will be submitted for publication in a peer reviewed medical journal shortly.

Background information:

While there are many options available for the treatment of acne scars, the gold standard for the treatment of acne scarring has evolved over time.  Acne scar treatments have transitioned from chemical peels to dermabrasion to traditional laser resurfacing.  Fractional ablative carbon dioxide lasers have emerged as the gold standard treatment for acne scarring in recent years due to their efficacy, safety and limited downtime.  Fractional ablative carbon dioxide laser resurfacing causes local damage to the skin, ablating the epidermis and portions of the dermis to stimulate the formation of new collagen.  The non-ablated areas of a fractional ablative laser treatment allow for fast tissue healing and minimal postoperative healing time.  Traditional fractional ablative carbon dioxide laser resurfacing is performed by treating the entire face, while covering the areas of acne scarring with the same ‘medium” energy level that is used over the whole treatment area.  The F.A.S.T. technique (Focal Acne Scar Treatment) suggests that treatment with increased energy levels  and lower density levels over only the areas of acne scarring allows for better efficacy, faster healing time and increased patient satisfaction.

The C.R.O.S.S. (Chemical Reconstruction of Skin Scars) method of trichloroacetic acid (TCA) treatment for acne scarring utilizes a similar philosophy of treating only the areas of acne scarring, while using a higher percentage of TCA than what is used in traditional peels.  The C.R.O.S.S. method had raised concern over the potential for uneven pigmentation secondary to localized treatment.  Peer-reviewed articles have stated that this phenomenon is not a major concern, though the potential for uneven pigmentation should be even lower when using a fractionated laser device (like in the F.A.S.T. method) than when using trichloroacetic acne.  Fractional laser treatments are predictable, replicable and precise treatments, which leave healthy intact skin between treated areas for safer treatments and faster healing.  The application of TCA is not as precisely replicable and does not have any method of preventing post-inflammatory pigment alteration. The post-treatment localized erythema that is sometimes seen after using the F.A.S.T. method can be easily remedied by incorporating one erbium Fraxel treatment into the treatment regimen one month after fractionated carbon dioxide ablative laser treatment using the F.A.S.T. method.

A series of patients have been treated with the F.A.S.T. method and the appearance of their acne scarring at their initial week one follow up visit was greatly reduced, when compared to the appearance of acne scarring in patients treated with lower levels of energy over the entire face.  Patient satisfaction was also much higher in patients treated with the F.A.S.T. method.  All patients noted improvement of their acne scarring, as well as minimal healing time.  Patients underwent one treatment with the erbium Fraxel laser one month after their fractional carbon dioxide ablative laser treatment using the F.A.S.T. method.  One treatment of erbium Fraxel laser cleared all areas of residual erythema.  We believe that the F.A.S.T. technique is effective and safe for the treatment of atrophic acne scars.