Acne scars not only the skin. It also damages self- confidence and reduces sense of wellbeing. Unfortunately, despite many recent advances in the treatment of acne, acne scarring still remains one of the most common causes of facial scarring.
Though acne scarring is happily no longer a problem without a solution, it is important to understand that there is still no “one size fits all” solution, that no single treatment can correct every acne scar. This is because acne scarring comes in a variety of shapes, sizes and degrees of severity and each type of scar responds best to a particular treatment.
As many people with acne scarring have a combination of different scar types, best outcomes are sometimes achieved only by using a combination of targeted treatments. Treatment options for acne scarring include e lasers, dermal fillers, TCA Cross, subcision, skin needling, cortisone injections, microdermabrasion, punch excision and surgery.
It is also important to be realistic about acne scarring treatments. Expectations of 30-70% improvement after a course of treatments are realistic. Expectations of 100% eradication are not, as the reality is that many scars can’t be completely erased.
Acne Scarring Treatments at A Glance
Many sufferers need a combination of treatments to achieve optimum results.
- Skin Needling:
Skin needling stimulates the body’s own natural healing processes to restore lost collagen and elastin in rolling and boxcar acne scars. Ultra fine, medical quality needles attached to a battery operated pen create multiple skin punctures in the skin that induce a wound healing response. This results in new collagen and elastin production that helps smooth and repair acne scars. Skin needling can be performed on both small or large areas of the face and is suitable for all skin types, including darker skin. This means skin needling may be a safer alternative than laser for patients with Asian, Indian or African backgrounds. Medical grade skin needling treatments performed at the clinic can be augmented by skin rolling at home between visits.
A variety of lasers are used to treat acne scarring. Vascular lasers reduce red scars and help soften keloid and hypertrophic scarring. Fraxel laser resurfacing improves skin smoothness as well as stimulating dermal collagen to tighten.
- TCA Cross:
TCA Cross stands for Trichloracetic acid (TCA) chemical reconstruction of skin scarring (CROSS). It involves careful placement of strong acid directly into ice pick scars to induce new collagen and elastin production that help lift the scar and normalise skin texture. Healing is rapid and complications are rare because treatment is focused on individual scars whilst leaving adjacent healthy skin untreated.
Subcision is used to treat larger rolling or boxcar scars. A sharp needle undermines the scar and is manoeuvred to break fibrous bands of scar tissue that are tethering the skin to underlying structures. Subcision also helps induce new collagen formation and is often combined with skin needling, TCA CROSS or laser treatments.
- Cortisone injections:
Steroid creams, injections and impregnated tapes can also be beneficial for treating keloidal scars. Cortisone helps shrink thickened, raised fibrous scar tissue.
- Dermal Fillers:
Dermal fillers are smooth gels made up of our body’s own natural skin components. When injected beneath the base of shallow, saucer-shaped depressed acne scars fillers uplift the indented scar tissue and create a smoother skin surface. Dermal fillers offer a temporary solution with the advantage that they are extremely safe and involve almost no downtime.
Microdermabrasion is a minimal downtime treatment that uses a combination of diamond brushes and suction to help improve minor acne scarring. Recent studies confirm that microscopic exam of treated tissue shows significant improvement.
- Chemical peels:
Chemical peels are another method of treating the most superficial acne scars. Generally, medium to deep chemical peels are required to achieve a significant result, but a series of more superficial chemical peels could help achieve some improvement in milder acne scarring without significant downtime.
- Punch excision:
Ice pick acne scars are often deep with hard, irregular jagged borders that are resistant to other treatment options. Simple excision of these scars and closure of the wound with a single stitch removes the scar completely and replaces it with a fine, uniform line.
Some patients report improvement in rolling scars, especially if relatively new, following application of silicone gels or tapes. Products that have been shown to stimulate collagen formation such as Ultraceuticals Vitamin C preparations and/or Vitamin A derivatives which help with exfoliation as well as stimulate collagen, are also to be encouraged as complementary to other acne scarring treatments.