Scarring from acne is often inevitable. To choose the best treatment for acne scars, your dermatologist will need to evaluate several factors. Factors to consider include
- the depth of the scar – a deeper scar is likely to require more aggressive scar removal treatment;
- the type of indentation the scar has left;
- the amount of tissue damage overlying the scar;
- the length of time the scar has been present;
- the degree of improvement expected from the treatment;
- the change of your appearance after treatment.
The advice most doctors would like to give to acne sufferers is to seek treatment as soon as possible. Early treatment of acne usually results in little or no physical scarring. It is much easier to prevent acne from scarring than to find the best treatment for acne scars.
However, scarring from acne is inevitable in many cases and people with acne scarring may consider using a combination of some of the treatments for acne scars which are outlined below.
1) Topical Creams (Tretinoin)
Doctors sometimes prescribe topical creams containing tretinoin to be applied directly to acne scars. Used as a non-surgical treatment for very fine acne scarring, these topical creams stimulate collagen production in the skin and may also be applied to depressed scars before another treatment is used.
Acid is applied to the skin to accelerate the removal of old dead skin cells from the skin surface. This promotes new cell growth. Superficial peels remove the top layer of skin cells, and may take at least six weeks before any improvement is visible. Medium peels penetrate the skin deeper. Treatment may have to be repeated every 6 – 12 months to sustain results. Unlike superficial and medium peels, deep peels are a one-off treatment. Deep peels penetrate the dermis and is left on the face for 30 minutes.
3) Punch Techniques
Punch techniques are most suited for icepick scars. A punch biopsy tool resembling a pastry cutter is used to remove the acne scars. Punch techniques include punch excision, punch elevation and punch replacement.
4) Skin Fillers
Skin fillers plump up, or fill out the skin where the scar has caused it to sink. Fillers are composed of collagen, the person’s own fat, and polymer implants, which are injected directly into the scar.
Dermabrasion is recommended on acne skin that is no longer active. Dermabrasion removes the surface of the skin, making shallow and nodular scars less obvious. Dermabrasion using a dermatome stimulates the production of collagen and promotes the healing of the skin.
Microdermabrasion is suitable for shallow acne scars and involves spraying a fine jet of minute crystals across the person’s face to stimulate collagen growth and realign the skin’s cells in the epidermis.
7) Laser Treatments For Acne Scars
Laser treatments are most suited to shallow scars. There are many different types of laser treatments – ablative treatment or laser resurfacing, non-ablative laser or subsurfacing treatemtn, carbon dioxide laser, erbium YAG laser and the long-pulsed erbium YAG laser.
Which is the best laser treatment for acne scars? The best laser treatment for acne scars for you will depend on the type and extent of acne scarring you have, as well as how much down time you can spare after treatment.
A specialized sterile needle with a cutting blade at the tip is inserted into the base of the acne scar. The fibrous strands of scar tissue are cut, encouraging collagen fibers to fill the depressed area of the scar and raising the sunken skin to the surface. Following subcision, the skin is often swollen for three to four days and there can be a lot of deep bruising which may last for about two weeks.
Developed in Germany, the Dermaroller is a small metal wheel which is studded with over 100 1.5mm needles. This is rolled up and down the scarred area leaving thousands of punctures which generate lots of new collagen production. The skin is very red for up to four days after treatment but soon settles with no long-term problems. This acne scar removal method is not widely used although it is extremely effective in the treatment of acne scars.
10) Trichloracetic Acid (TCA) CROSS Technique
CROSS is one of the few methods that can effectively treat boxcar scars. CROSS refers to the cross-sectional reconstruction of skin scars. It is a technique developed in Korea and involves the careful application of 100% TCA, using a sharpened orange stick, tot he base of boxcar scars. This causes an injury to the skin and considerable, very local, production of collagen.
Very often, the best treatment for acne scars will involve a combination of acne scar treatments. Whichever acne scar treatment you choose, be sure to get a qualified dermatologist or therapist to administer the acne scar treatment for you.