Acne scars are caused by the body’s inflammatory response to acne lesions. The best way to prevent scars is to treat acne early, and as long as necessary. If scars form, a number of effective treatments are available.
Scars form at the site of an injury to tissue. Two types of true scars exist, as discussed later: (1) depressed areas such as ice-pick scars, and (2) raised thickened tissue such as keloids.
Acne scars associated with loss of tissue – similar to scars that result from chicken pox – are more common than keloids and hypertrophic scars.
Scars associated with loss of tissue are:
Thanks to the refinement of a number of dermatologic surgical techniques, scars can be treated with a variety of safe, effective procedures that improve the appearance of a patient’s skin and boost the patient’s self-esteem. The following are common techniques and procedures used to improve scarring:
Dermabrasion: The dermatologist removes or “abrades” the skin with a rotary instrument. The skin undergoes a “remodeling” process as it heals, resulting in a smoother and fresher appearance. This procedure is avoided in darker skinned individuals because of the risk of hyperpigmentation.
Punch Excision or Replacement Graft: Punch excision of each individual scar is a technique for ice pick scars. In this procedure, each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with the punched skin glued or sutured at skin level, or the resulting hole may simply be closed with a suture or with a small skin graft.
Subcision: A technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus elevating a depressed scar. Occasionally, a filler substance can be placed to elevate the depressed scar after subcision.
Soft Tissue Fillers: Collagen-related fillers are injected in small quantities below the surface of the skin to elevate depressed scars. This is often coupled with subcision which lifts the scar and allows a space for the filler to occupy.
Chemical Peeling: By applying a chemical solution to the skin, mild scarring and certain types of acne may be treated. Chemical peeling enables new, regenerated skin to appear, improving the appearance of the condition.
Your dermatologist will choose the technique or combination of treatment approaches based upon the nature of the scarring, the patient’s medical history.