The best way to remove acne scars is to prevent them from occurring. Acne scarring is the result of uncontrolled cystic or nodular acne. Often these cysts will rupture, causing damage to the structures beneath the skin and leaving behind visible marks of their once painful existence. The scars left behind can lead the bearer to have physical, social and self esteem issues. Fortunately there are treatments available to reduce and remove the visibility of these disfigurements.
There are four types of acne scars; Ice pick, boxcar, rolling and hypertrophic or keloid. The different types of scars require different treatments. Hypertrophic or keloid scars result when an overproduction of collagen is made by the body during the healing process. They appear as a raised thick mark on the skin. Surgical removal to revise the scar will usually respond with another keloid. Treatment of choice is the injection of a long lasting corticosteroid. The steroid injection help to decrease the thickness and flatten out the keloid, making it appear less noticeable.
Rolling scars can be treated by surgical and non surgical means. The best results for rolling scars are with combination therapies. For severe rolling scars, a subcutaneous excision or subcision can be performed. Done under local anesthesia, a special needle is inserted under the skin and moved in a back and forth motion. This breaks up the fibrous tissue that makes up the scarring and rolling appearance. Blood fills the space between the dermis and subcutaneous causing the area to flatten and smooth itself out. Post treatment sports bruising and swelling for a few days. Often more than one treatment is necessary to smooth all areas. Laser skin resurfacing with fractional lasers can be done afterward to give the skin a more even smoother appearance.
Ice Pick and Boxcar scars are depressions in the skin. Ice pick scars get their name because the mark is deep and pointed at the base of the scar, as if made by an ice pick. Boxcar scars are generally wider and with a flatter base than ice pick scars. Non surgical procedures such as dermal fillers or fat transfers can be a simple and effective way to treat some of these acne scars. Both types can also be effectively treated with punch excisions or punch elevations. Punch excisions use a cookie cutter like device, the diameter of the scar, to punch out or remove the scar. The physician will then either suture the area closed or fill the area with a skin graft (most often taken from behind the ear). A punch elevation is begun the same way as the excision however instead of suturing the area shut or filling the area with another piece of skin, the base of the scar is brought up to the surface and then sutured in place. Occasionally the healing of each of these will leave the skin texture or color uneven. When this occurs skin resurfacing with fractional lasers may correct the discrepancy.
Chemical peels can also reduce the appearance of acne scars. The severity of the scarring will determine the depth of the peel the physician will use. Microdermabrasion is another quick treatment that can be done to decrease the severity of the scars. Both remove layers of the epidermis and stimulate the collagen beneath the skin surface to produce a plumping effect for the skin and decrease the depth of the scars. Several treatments are often needed for noticeable improvements.
Non ablative laser treatments can minimize acne scars with quick recovery times. Fractional lasers partially ablate the epidermal layer of skin, decreasing the depth of the scar and stimulating collagen below the skin surface. 2-4 days of redness and swelling may result with best outcomes noted 4-6 weeks later. 2-4 treatments are often needed for best results.
When the scarring is severe surgical methods can be taken to lessen or even remove the scarring. Dermabrasion or CO2 laser will ablate the top layers of skin, going deeper than the other treatments. These procedures are done under anesthesia with several days to weeks of recovery time. Not every treatment is right for every person and combinations of treatments tend to be more effective. Consult with a dermatologist or cosmetic physician to determine which therapy is right for you. |
