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Acne Scars and Effective Treatment (Acne)
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Acne Scars and Effective Treatment

Jerry K. L. Tan, MD, FRCPC

While pimples are often tempting to squeeze, this can lead to further complication such as scarring, hyperpigmentation, and persistent redness. Scars can develop from small or large pimples. When it comes to acne scar treatment, avoidance and early treatment is the best. Acne treatments are plentiful, and early treatment reduces the risk of scarring or other complications.

Acne scars can be treated, and will often enhance your self-image if you are embarrassed about your acne scar. For best results, the acne should be controlled before the treatment of acne scars begins. Treatments depend on the scar type and also on your skin type.

There are a variety of scar types, with varying ranges of severity. Stains and mild scars are very common, and often improve over time, especially with the use of skin care treatments such as alpha-hydroxy acids, exfoliating facials, and topical retinoids. Severe acne may require more aggressive treatment.

Here are the different types of acne scars:

Box car scars: These angular scars commonly occur on the temple and cheeks, and its appearance is similar to that of chicken pox. They can be superficial or deep.

Hypertrophic Scars: These are thickened or keloid scars.

Ice pick scars: These appear as deep pits, and are the most common form of acne scarring.

Rolling scars: These scars give the skin a wave-like appearance.

Below are some non-surgical acne scar treatments:

Chemical Peels: Peels can improve skin tone, and if done in a series, at least six times over a few weeks, can enhance your skin greatly. However, it will not remove the acne scars themselves.

Cover-up or skin camouflage: Camouflage foundations can hide acne scars, and improve the appearance of the skin. If your acne is active, it is important to use products that are non-comedogenic, and non-acnegenic.

Non-ablative collagenosis: This is a new technology that may show promise in treating acne scarring. In this procedure, laser or radiofrequency devices promote the enhancement of collagen formation without damaging the skin surface.

Skin fillers and injectables: Most effective for thumbprint or rolling scars, materials are injected into the depressed area of the scar, in order to elevate it to the level of the surrounding skin. Proper evaluation must take place first to ensure that the fillers will improve appearance. Many temporary and permanent fillers exist for this purpose, such as Artecoll®, HylaForm®, Restylane®, and Zyplast®.

Topical Creams: The use of topical creams such as Tretinoin, encourages collagen production, improving scars by causing exfoliation.

Below are some surgical options for removing acne scars:

Microdermabrasion: This process using aluminum crystals, promotes exfoliation of the skin, and is most effective for treating very fine scars. Best results are achieved after a minimum of six sessions every few weeks.

Photorejuvenation: This treatment improves minor cases of acne scarring, by using laser of broadband visible light, which promotes new collagen formation. 5 to 6 treatments are performed every three or four weeks in this procedure.

Resurfacing: These resurfacing treatments can be conducted through laser treatment or through microdermabrasion. Laser resurfacing involve removing the surface layer of the skin, via heat injury. The healing process allows for new collagen formation and less damaged skin to surface. Microdermabrasion is the mechanical process of stripping off the top layer of the skin via rotating brushes or wires, and is considered the primary treatment for scars. This process can be combined with other treatments such as fillers or excision.

Scar Revision: Most effective for the removal of boxcar and icepick scars, acne scars can be surgically removed. A punch closed with sutures, is used, and removed a week later, forming a less visible linear suture scar, which replaces the original scar. Subcision is a different technique which cuts the base of the scar using a sharp instrument. This improves the scar, and can also be combined with injectables to fill the subcised area.


acne,   acne scars,   chemical peels,   microdermabrasion,