Acne Scarring Treatments

A Common Skin Condition

Acne is a common skin condition and sometimes one of the most traumatic elements of our teenage years. Eventually, either through treatment or time, we will outgrow the development of new pimples but in some patients the permanent scarring that is left behind is as a troublesome reminder of those turbulent years. Treatment of any type of scar, and especially acne scars, requires a well trained cosmetic surgeon who can identify the type of scarring that has taken place and the most appropriate treatment.

Many types of acne scars may persist, ranging from the deep pits of “ice-pick” scars, the angulated “box car” scars, to the undulating “rolling” scars. Each of these types of scars requires a different combination of treatments to obtain optimal results. Permanent facial scars are traumatic enough and we believe you need a physician that you can trust to provide the expertise to maximally improve your skin.

A Combination Approach

Scars of all types, traumatic, accidental, acne, old and new, can often benefit from surgical intervention. Cosmetic treatments include surgical revision and excision, intralesional or topical therapies, and laser therapy. Most patients will require a combination approach.

The physicians at Surgical Dermatology Group will provide you with extensive education to make an informed decision.  The most effective procedures are:

 

  • Dermabrasion. This procedure involves removing the top layer of skin with a rapidly rotating wire brush. Surface scars may be completely removed, and deeper acne scars may appear less noticeable.
  • Laser treatments. In laser resurfacing, a laser beam destroys the outer layer of skin. As the wound heals, new skin forms. Less intense lasers cause less damage, but are also less effective.
  • Other energy-based procedures. Pulsed light sources and radiofrequency devices help create new skin without damaging the outer layer of skin. After several treatments, acne scars may appear less noticeable.
  • Surgery. In some cases, surgery to remove deeply indented acne scars is an option. A minor procedure, called punch excision, cuts out individual acne scars. Stitches or a skin graft repairs the hole left at the scar site.
  • Tissue fillers. Injecting collagen or fat under the skin and into the acne scars can fill out or stretch the skin, making acne scars less noticeable. Results are temporary, so you’d need to repeat the injections periodically.
  • Chemical peels. Chemical peels are often used to minimize sun-damaged skin, irregular pigment, and superficial scars. The top layer of skin is removed with a chemical application to the skin. By removing the top layer, the skin regenerates, often improving its appearance.
  • Punch grafts. Punch grafts are small skin grafts used to replace scarred skin. A hole is punched in the skin to remove the scar, which is then replaced with unscarred skin. Punch grafts can help treat deep acne scars.

Specific procedures to minimize acne scars will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Severity of the scar
  • Type of scar
  • Your tolerance for specific medications, procedures, or therapies
  • Your opinion or preference

Fortunately, most scars do improve and at Surgical Dermatology Group, we have a wide armamentarium in which to treat all types of scars. To determine what’s best for you, discuss the pros and cons of each procedure with one of our providers.


References:
1. Harmon, CB, Dermabrasion. Fundamentals of Cosmetic Surgery. Dermatologic Clinics, July 2001, Volume 19-3. WB Saunders Company.
2. Harmon CB. Dermabrasion of surgical, traumatic and acne scars. Dermatologic Surgery: Current Techniques in Procedural Dermatology, 3rd Edition, Revised and Expanded. L Ratz, H Roenigk, R Roenigk eds, Marcel Dekker, New York, 2006.