When acne breakouts penetrate the skin deeply, they damage the skin and the tissue beneath it. As the acne clears, the body tries to repair this damage by produces collagen to give support to the skin. When the body produces too little or too much collagen, a scar is formed. Type of scar depends on how much collagen your body makes.
Depressed acne scars: If the body produces too little collagen, depressions or pits form as the skin heals. Depressed (atrophic) scars are of 3 types.
- Boxcar acne scars: Broader scars with deep, defined edges (like a box).
- Icepick acne scars: Tiny dots, or deeper, narrow scars.
- Rolling acne scars: These look like small waves in the skin.
Raised acne scars (Keloid or hypertrophic scars): form when the body produces too much collagen as it tries to heal the skin and underlying tissue. Raised(hypertrophic) acne scars are more common on the back and chest.
There are many treatment options, which can significantly diminish depressed and raised acne scars.
Treatment for depressed acne scars
- Acne scar surgeries
- Collagen-induction therapy i.e microneedling(Dermaroller)
- Dermal Fillers
- Resurfacing: Fractional Laser therapy
- Skin tightening-Microneedling radiofrequency
Treatment for raised acne scars
- Acne scar surgery-excision
- Cryosurgery
- Fractional Laser therapy
- Injections (corticosteroids, 5-FU)
- Silicon gels and dressing
Some people are more likely to see scars when their acne clears. The risk increases when a person:
- Has inflammatory (swollen, reddish, and painful) acne, such as acne cysts and nodules. These types of acne tend to be deep and damage the skin.
- Delays treatment or does not treat inflammatory (redness and swelling) acne. The longer a person has inflammatory acne, the greater the risk of scarring.
- Picks, squeezes, or pops acne. This increases inflammation, which increases the risk of scarring.
- Has a blood relative with acne scars.
It is possible to prevent acne scars with effective acne treatment. Waiting to treat acne until it becomes severe can lead to extensive scarring.
Depressed Acne scars:
Best results often come from combining 2 or more treatments.
- Acne scar surgeries Subcision for rolling acne scars by breaking fibrous bands of tissue under the skin to create a less-noticeable scar which should fade with time. Lifting the scar and bringing it closer to the surface of the skin tends to make it less noticeable.
- Punch excision: A small, sharp punch instrument is used to cut out boxcar acne scars. The surrounding skin is then sutured together.
- Punch graft: Follows the same process as a punch excision, but instead of sutures, skin from another body area is grafted to the scar.
Resurfacing procedures: Using concentrated pulses of light, laser resurfacing causes micro-damage to the skin, which kick starts the body’s healing response. As new collagen production is simulated, the tone and texture of your skin improves resulting in a smoother, more youthful look. Laser resurfacing works well for treating acne scars that are nearly flat (not too deep).
Indicated for treating depressed acne scars and contouring scar edges to make them less noticeable.
Dermal fillers: Dermatologists use fillers to plump depressed acne scars., but not icepick scars.
Skin tightening: Microneedling radiofrequency is used to tighten the skin. As the skin tightens, depressed acne scars become less noticeable, including deep icepick and boxcar scars.
Collagen-induction therapy: also known as “needling” or “micro-needling, encourages your body to make more collagen.
In this procedure, a
dermatologist moves a sterile, handheld needle-studded roller across the depressed acne scars which puncture the skin. As the skin heals, it produces more collagen.
Raised acne scars: Treatment can ease pain and diminish scars
Intralesional Injections: Injecting medicine directly into the scars can soften and flatten raised, thick scars.
Acne scar surgery, followed by intralesional injections:
Combining acne scar surgery with intralesional injections of corticosteroids and 5-FU s remains one of the most effective treatments for raised scars.
Cryosurgery Freezing the tissue causes it to die and gradually fall off.
Silicon Scar gels and dressings can help reduce the itch and discomfort as well as shrink, flatten, and fade raised scars.
Most treatments can reduce the size and visibility of acne scars making them barely noticeable.
