Millions of people have scars from the long-lasting inflammation caused by acne. Scars occur most frequently in those with moderate to severe acne. It remains unknown why some people develop scars when others don’t. Many treatment options are available to diminish the scars’ appearance. Depending on the type and severity of scarring, improvement can be seen in 4 to 6 weeks.
TYPES OF ACNE SCARS
- Icepick. These deep pits in the skin are a classic sign of acne scarring. They are the most common type of acne scar and usually occur on the cheek. They may be shallow or deep and may be hard or soft to the touch.
- Boxcar. These depressed, crater-like scars are larger than icepick scars.
- Rolling scars. These are curved indentations on the skin.
- Hypertrophic scars. These are elevations or areas of skin thickening. Large hypertrophic scars may be referred to as “keloids” and tend to run in families.
The recommended treatment will depend upon the type of scar being treated, your skin type, your tendency to scar, and cost. Different treatments may be combined for optimal effect.
At Arizona Advanced Dermatology we offer numerous treatment options for acne scars. A consultation with one of our doctors can help identify which procedure(s) are best for you.
The Fraxel laser is currently the most common procedure used to improve acne scars. The advantages are that the procedure is relatively painless, is associated with very little “down time”, and has very little risks. Typically 3-4 procedures are required to get the most improvement. This procedure is safe for any skin type. “Ice Pick” scars typically don’t improve with Fraxel® laser.
This procedure, lasting about 10-20 minutes, uses a machine to propel small crystals through a vacuum tube onto the skin. This removes superficial layers of the skin, stimulating new skin cell growth and improving skin tone. There are few side effects and almost no recovery time, but it can only treat superficial scars. As many as six treatments may be required, 1-2 weeks apart.
Excision and Punch Replacement Graft
A scar, or cluster of small scars, is removed with a scalpel. The resulting “hole” is either sewn together or replaced with a patch of normal skin from elsewhere on the body. This treatment is particularly effective for ice-pick or boxcar scars.
Different types of “fillers” can be injected beneath a depressed scar to elevate it to the level of the surrounding skin. This treatment is most effective for rolling scars. The benefit from soft tissue fillers usually lasts 3 to 18 months, depending on the material used. Treatment must be repeated to maintain the appearance.
Chemicals are applied to the skin to remove the top layer and generate new skin growth beneath the scars. This lifts the scar to the level of the surrounding skin, minimizing its appearance. In general, “medium” or “deep” peels are used to treat acne, meaning that the peel is designed to affect the deeper layers of the skin. Deep peels may cause lightening of the skin and a change in skin texture. Bandages may be required for several days.
Laser Skin Resurfacing
This removes the top portion of the scars and creates heat in the deeper layers of the skin. This heat causes the skin to tighten and smooth out the scar. The result is the smoothing out of the skin. Laser resurfacing is particularly helpful for boxcar scars and further improvement of scars treated by other methods. In some cases, only a single treatment is required; however, final results may not be seen for 12-18 months. Redness following treatment may last for several months.