Acne scars are stubborn, difficult to treat and prominent on the face as constant reminders of what acne left behind. There are many ways to effectively treat acne scars, and other ways that are not as effective. It is only through a proper assessment of a patient’s scars, that a correct treatment approach can be implemented to achieve desired results. It’s also important to take care of post-breakout skin in order to avoid having to deal with deep and harder-to-treat scarring.
Acne scars can seem like one skin problem after another. First, it’s difficult enough to deal with acne, a common skin disorder that plagues many teenagers and even some people into their adulthood. Then, after the blemishes, whiteheads, blackheads, inflamed pimples, and nodules have finally disappeared, scars remain on the skin. Many are discouraged by futile attempts at scar treatment, especially because acne is the most common skin disorder affecting adolescents and young adults.
- Boxcar: Round, or oval depressions with steep vertical sides appear wider than ice pick scars and give the skin a pit appearance. Inflammatory breakouts destroy collagen, which leave behind a depressed area. They can vary from superficial to severe pits, depending on how much tissue was lost in the breakout. Laser resurfacing is the best course of treatment for boxcar scars because they address the damaged layer of skin by stimulating new collagen production.
- Rolling: Characterized by wave-like or rolling undulations across an otherwise normal layer of skin. They arise when fibrous bands of tissue develop between the skin and subcutaneous layer, which pull on the epidermis. This pulling of the top layer of skin into the deeper structures creates the uneven rolling. In this case, subcision is the best treatment option. A small needle is inserted underneath the rolling scar to lift up the skin. This stimulates normal tissue to regenerate and lift the scarred area, which allows the skin to naturally heal back into an even layer.
- Ice Pick: Dark, very narrow scars that extend into the dermis. The skin appears as if it has been pierced by a sharp instrument, which has left small deep, holes into the skin. They typically develop after an infection from a cyst or deeply inflamed blemish.
Ice pick scars are best treated with punch excision, a surgical procedure used for deep acne scars. There will be a scar following the procedure, however it will eventually fade and become less noticeable than the original acne scar. The new scar will be able to respond to laser therapies such as Fraxel Re:store treatments much better than the acne scar.
Lasers are a commonly used modality in the treatment of acne scars. Laser resurfacing, such as Fraxel, has revolutionized the treatment of acne scars, as well as wrinkles, surgical scars, melasma and other skin conditions. This laser utilizes a wavelength that penetrates deep into the tissue to create tiny zones of micro-damage. The new damage stimulates a healing process, in which the body naturally creates new collagen and elastin that remodels the skin’s surface and leaves behind a smoother surface. Recovery is minimal with a sunburn-like condition that lasts up to a few days after treatment.
The V-Beam, also known as the pulsed dye laser, is another non-invasive treatment option for acne scars. Instead of addressing deep pits and uneven surfaces, V-Beam most affectively treats the redness from breakout inflammation. The redness left behind from acne is a result of tiny broken capillaries at the site of the healed acne lesion, which is more common and more visibly noticeable with newer acne scars. The V-Beam laser treats the red acne scar with its dual cooling and deep heating process that targets and treats the broken vessels within one to three treatments.
It’s important that patients understand that microdermabrasion and chemical peels aren’t the ideal treatments for acne scars, they are more effective as an exfoliating treatments that is used to gently sand the skin, followed by a small vacuum that sucks up dead cells and debris. It works best for superficial wrinkles and scars.