Acne and Scars

Acne Scar Treatment

Overview

Acne scarring may greatly affect the quality of life for many people. Some patients are very self-conscious about their scars, which may decrease confidence and self-esteem.

There are different types of acne scars, each with its own range of specific treatment options. Some acne scars are deep and narrow, so called “ice pick” scars.  Others are wide and shallow, commonly referred to as “boxcar scars.”  Still others cars are raised and wavelike and are called “rolling scars.” Most patients have a combination of the scars and benefit from a multimodal treatment approach for the best results.

Surgical excision

Some scars are best treated by surgical removing the old scar and restitching the skin back together. This works well for ice pick scars, some boxcar scars, and larger scars from accidents and prior trauma. Following surgical removal, most patients benefit from a skin resurfacing procedure using the fractional carbon dioxide laser 2-3 months later.

Laser Resurfacing

Laser resurfacing is one of the most powerful techniques for treating acne scarring. The laser smooths and tightens scars, blends the edges of the scar with the normal skin, and stimulates collagen production, lifting up shallow scars. Laser resurfacing is frequently combined with other treatments to provide optimal results.

Some patients may decide to have multiple laser treatments at mild settings to minimize the downtime after treatment. After laser treatment, there is mild redness similar to that from a sunburn. Most patients require 5-6 treatment sessions and will see a gradual smoothing and softening of the acne scarring.

Dermabrasion

This technique “sands” away layers of skin and is best for raised scars.  Dermabrasion is also commonly used to blend in the edges of a scar with normal skin. Dermabrasion works well in the treatment of boxcar scars.

Subcision

Subcision is a technique where a surgical needle is used to break up the fibrous scar bands tethering or binding down a scar. This treatment is best for depressed, boxcar scars.

Intralesional steroid therapy

Injection with droplets of steroid is often used to soften and flatten raised scars.

Soft tissue filler injections

Injection with soft tissue fillers such as Restylane and Juevederm is a temporary measure to fill in depressed scars or camouflage rolling scars. Silicone, which is a permanent filler, may also used in a similar manner. As silicone is a permanent filler, only microdroplets of silicone are injected, and 2-3 sessions may be needed for optimal results.