Acne eruptions can be frustrating enough, but the scar tissue that acne leaves behind feels really awful. Acne scars reduce one’s quality of life and have significant emotional and psychological effects leading to social embarrassment and withdrawal, decreased confidence, low self-esteem, and depression.
It is important to understand that before starting the treatment for acne scars, you should first treat the acne since new acne can lead to new scars, and thus defeat the entire goal of treating acne scarring.
What are acne scars?
Acne scars are the irregularities in the skin surface occurring after the healing of acne lesions. They are seen as holes and depressions in the skin, varying in shape, size and depth.
They are classified into different types of acne scars namely, ice-pick scars, rolling scars, and boxcar scars. These are type of atrophic scars. In some individuals, acne may also result in raised scars and thick scars which may be hypertrophic or keloidal. Keloidal scars are more common in type 4 and above skin type.
Why do they occur?
Acne scars occur as a result of skin inflammation associated with deep and severe acne.
When the skin heals and attempts to repair these deep lesions, it heals by forming new collagen fibres. These repairs usually aren't as smooth and flawless as the original skin, causing acne scarring. Popping or scratching the acne lesions can also increase the chance of scarring.
How are acne scars different from acne spots?
Acne scars are different than dark spots from acne.
Scars are the irregularities in the skin surface seen as holes and depressions. There can be elevated acne scars as well. Scars require tissue to be damaged or overgrown. Scars are difficult to fully remove, and while they may fade over time, they usually remain visible.
Where as dark spots from acne are flat lesions. They don’t indicate any long-term damage to your skin cells, pores, or follicles. It can take a sometime, but dark spots tend to become lighter with duration, and eventually go away completely. It can take anywhere from 3 months to 2 years for them to vanish from view.
How to identify ice pick scars?
Ice pick scars are more deep than wide. They are narrow (usually less than 2mm in diameter) with deep vertical walls, which are wide at the surface and narrow at the base.
How to identify rolling scars?
These are distensible depressed scars with sloping edges, usually wider than 4 - 5mm.
How to identify boxcar scars?
Boxcar scars are circular depressions with sharply defined vertical edges. They vary in depth and diameter from 1.5 - 4mm.
Who is a good candidate for acne scar treatment?
Anyone who is positively motivated and wants to improve their aesthetic appearance can undergo acne scar treatment. People with active acne lesions are not suitable for scar treatment. In such cases, it is advisable to first get the acne treated and then proceed for scar improvement.
How can I get rid of acne scars?
The choice of treatment for acne scars depends on the types and severity of scars. Because no one ever has just one type of scars, therefore, usually a combination of different treatment modalities is required for best results.
Options for mild acne scarring include:
Microdermabrasion - applies tiny rough particles from a special machine to remove the top layer of skin.
The appearance of moderate to severe acne scars can benefit from the following procedures:
Dermabrasion - is the surgical removal or exfoliation of the outer layer of skin on acne scars.
Microneedling - is a procedure that uses small needles to create controlled micro-injury to the skin. This helps to stimulate the body’s own collagen production and smooth acne scarring.
Laser Treatment - uses a focussed beam of light to treat the acne, simultaneously preserving the normal surrounding tissue. It works best when combined with other modalities of treatments.
Laser Resurfacing - uses a laser to remove the scarred upper layers of skin and encourage new healthy collagen to grow in its place.
Subcision - is a simple, low-cost solution to severe acne scarring whereby a needle is used to break apart the fibrous bands of tissue that prevent the skin from laying in its natural position
TCA CROSS - This is a type of chemical peels used for icepick scars.
Dermal fillers - improve the skin’s appearance by injecting a filler directly into the acne scar.
Excision and punch replacement graft - involves cutting into the skin to remove the acne scar and then stitching the wound. In punch replacement grafting, the scar is removed with a special tool, and a skin graft – usually taken from behind the ear – fills the wound.
What is the best treatment option?
There is no single best treatment. What will give you the best results will depend on the type and severity of your scars. So it is highly recommended that you visit an experienced dermatologist for careful assessment and detailed discussion about the therapeutic options.
When can I expect the results?
You can start to notice changes after the first session itself. Collagen remodelling is a gradual and continuous process, so the improvement continues to occur for up to one year after the treatment ends. Best results can be appreciated at the end of 9-12 months.
Can I get a complete healing of scars?
Unfortunately, the scars can not be treated a hundred percent, but they can be reduced by a significant amount so much so that can no longer be appreciated at distance, and do not cause social embarrassment.
Are the results permanent?
Yes. The results you get after completion of treatment are permanent.
How can I prevent acne scars?
The best way to prevent scar formation is to get your acne treated during early stages itself to minimise the extent and duration of inflammation which reduces scarring.
Is laser treatment for acne scars permanent?
Yes! The results of laser treatment are permanent. However it is important to note that complete laser treatment cycle takes about 6 to 8 sessions for best result.
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