Guide to Acne Scars and Treatments
Acne scars can be embarrassing and troublesome. They are a constant reminder of the pain an individual went through when they had active acne. Acne scars are the result of an inflamed cyst, papule or skin lesion. The pore becomes large with dead skin cells, bacteria and oil, and swells, which then causes a break in the follicle wall. If there is a deep break in the wall, the healthy skin tissue around the break will be destroyed. New collagen will be formed. In some individuals, too much new collagen is formed. This will create a raised tissue on the skin’s surface. This creates one type of acne scarring- Keloid or hypertrophic scarring. In other cases, atrophic or depressed scars will form. These develop when there is a loss of tissue and are more common than Keloid scarring. Under atrophic scarring, there are a few forms. Ice pick scarring leaves a small hole in the skin that looks like it has been stabbed by an icepick. These are commonly found on the cheeks. Boxcar scarring are depressed scars that are round or oval shaped, and look much like chicken pox scars. Rolling scars are scars under the skin’s surface that give a wave like appearance. They are common and tend to be wide and very shallow.
Acne Scar Treatment
The good news about acne scars is there are many treatments available that can help minimise the scarring. An individual can meet with their skin specialist to find the best treatment for their skin. Possible treatments for acne scarring include:
- CO2 Laser acne scar treatment- This treatment is done for icepick, boxcar and rolling scars. A laser is used to remove skin. The laser will be moved over the skin one to three times. It can take a few minutes to complete if the area is small or more than an hour if areas are larger. Local anesthesia will be used. Healing time takes ten to twenty one days, and the skin will remain pink for up to three months. A dressing will be applied to the skin, which will need to stay on for three days. Side effects do include milia, crusting and oozing of the skin, prolonged redness and either hypopigmentation or hyperpigmentation.
- Chemical Peels- Light or superficial chemical peels is a treatment done to help with acne scarring. The results are not permanent, so therefore should be done only on mild acne cases. A solution of BHA or AHA will be applied to the skin with a cotton ball and then will be neutralised. The process will remove the surface layer of skin, exfoliating the skin. Sunblock must be used after the process as the skin is very sensitive to the sun after this treatment. Possible side effects include peeling skin, redness of skin for a few days, itching, and hyperpigmentation (extremely rare).
- Skin needling- Skin needling is used to puncture the skin, which will give trauma to the skin. New Collagen will then be rebuilt in the skin, which will heal the existing acne scars. Recovery time is very short and no damage is done to the epidermis. There is redness of the skin and there could be possible bruising. Results can be seen in one or two sessions. It can take up to twelve months for the results to fully appear due to the collagen slowly rebuilding itself.
- Fractional Laser Treatment– This non-invasive procedure treats a fraction of the skin at a time. It is a great solution to acne scars. It can be used on any part of the body, and will target both the epidermis and the dermis. This process has a very fast healing time. Numbing cream will be applied to the area being treated. Once the numbing cream has numbed the skin, it is wiped off and a gliding gel is applied to the skin. The Fractional laser will be allowed to glide over the skin, and a cooling machine will be used to ease any discomfort. A full face will usually take about half an hour to complete. Skin will be pink for three to five days, with swelling being minimal, usually only lasting two to three days. A mild sunburn sensation will be felt for about an hour after the procedure is done.
- Dermabrasion- Superficial and deeper acne scars can be removed with dermabrasion. During the dermbrasion process, a high speed diamond or wire wheel brush or sandpaper will remove the surface of the skin. It is a heavy exfoliation of the skin. After the treatment, a dressing will need to be applied with petroleum jelly every day for two to four days. A wind burnt or red face can often be seen for up to nine months after the treatment is done. Repeat treatments may be needed. A crust forms on the skin after the procedure, and takes up to fourteen days to flake off. Side effects of dermabrasion include some pain, sun sensitivity, and hyperpigmentation or hypopigmentation. Dermabrasion can be used for boxcar, icepick and rolling scars.
- Subcision- Subscision is used for rolling scars. The scar will be cut away from the skin, and the blood will fill underneath the area cut and fill it in. The blood clot will help form connective tissue under the scar. This will then create a level surface. Bruising and swelling can be seen for up to two weeks, and multiple treatments are often needed, usually up to three. This process is often combined with laser resurfacing or dermabrasion.
- Dermal fillers– Dermal fillers are very effective for rolling scars, as well as some boxcar scars that are not as defined. Dermal fillers fill in depressed scars, with the dose varying due to where the scarring is, how big the scarring is, and what results an individual wants. Results can be seen immediately. Skin will be cleansed, then the face is iced. The skin specialist will then inject the solution chosen into the skin with a very fine needle. Dermal fillers only have a temporary effect, from a few months to a year or more. For twenty four hours, the patient will be asked to limit facial motion.
These are just many of the acne scar treatments that a skin specialist can offer. Many of the treatments described above work well by themselves, but can be paired up with different methods for an even greater effect. An example of this would be having fractional laser done on the acne scars and filling them in with dermal fillers. Using the two in combination will provide for smoother skin in which the dermal fillers will generally last longer.
To prevent acne scars, never pick or squeeze the acne. This may seem like a good idea to get the pus or bacteria out of the pimple, however, it could force the debris deeper into the skin, causing more inflammation and further damage to the skin. Picking the scab off acne will increases the chance of scarring due to the fact that the scab is the skin’s way of naturally bandaging the skin. Removing a scab that is not ready to fall off will prolong the healing process.
Another way to prevent acne scars is taking care of the skin to prevent future breakouts and inflammation of the skin. Should you have bad acne, you may wish to consult a skin specialist to find a treatment to get acne under control.