Is there hope for acne scars?

Is there hope for acne scars?

Most people recover completely from acne without any permanent scarring. Those with severe acne are not as lucky. They are left with disfiguring acne scars of various types that can leave them feeling self-conscious about their appearance. Picking, pressing or rubbing of pimples or whiteheads increases the possibility of scar formation.

When acne clears up, pink, red, or dark spots often appear on the skin. The good news is that these are not scars and will eventually fade. To be classified as scar, the skin defect has to persist for at least a year. Topical products with lightening and exfoliating ingredients like Retinol-C serum, NanoWhite cream, and AcneX soap can lighten these dark spots. Multiple sessions of mild glycolic peel combined with diamond peel may provide faster relief than topical medication.

Acne scars take several shapes. The back and chest get the hypertrophic scar, which is thick and lumpy. The face usually gets the depressed types of acne scars, named after their shapes.  The first is an ice pick scar, which is deep pitted with steep edges. The second is a boxcar scar, which has sharp, square sides to it.  The third is a rolling scar, which has wide, shallow and curved indentation.

Most successful acne scar treatments may take multiple sessions over a period of several months before significant improvement can be seen. The basic steps of acne scar removal may include a combination of the following procedures:

Dermal fillers: These are substance that can be injected into depressed scars to plump them up to the level of the surrounding skin. Hyaluronic acid injectable like Restylane and Juvederm are good fillers for shallow to deep acne scars. They can last from 3 to 18 months, depending on the material used. Your own fat, taken from another part of the body, can also be used as dermal filler and can last from 1 to 3 years. Ice pick scars may require dermal fillers.

Chemical peels: A chemical solution like trichloroacetic acid (TCA) or glycolic acid is used to peel away the outer layers of skin. The solutions are available in several strengths, and used according to the degree of peeling desired. A series of 4 to 6 superficial peels are effective for improving discoloration from acne, while medium depth peels or a deep peel can improve the appearance of atrophic acne scars. Healing can take from 3 days to 3 weeks depending on the depth of peeling. Avoiding unnecessary sun exposure, wearing sunscreen daily during the healing period and following post-care instructions are important to prevent unwanted side effects.

Fractional laser is available
 at SkinStation. 

Fractional lasers: Excellent results can be achieved for the boxcar and rolling acne scars with ablative fractional lasers using CO2 or Er:YAG. These lasers are called “fractional” because they work by resurfacing only a “fraction” of the skin at a time, leaving the surrounding area intact for faster healing. These lasers poke tiny microscopic holes in the skin down past the epidermis and into the dermis, causing new collagen to form, which fills in the acne scars and smoothens skin. The same basic principle is the basis for micro-needling procedure (dermaroller or auto stamping) which we call the COLLAGENESIS in SkinStation, but more sessions are needed to approximate the same benefits one can get from fractional laser resurfacing.

Scar surgery: The goal of scar surgery is to raise the scar to the level of the surrounding skin, thereby creating a smooth appearance.  Sometimes the scar is actually cut out and the edges of the remaining skin are brought together.  Fillers may be used to raise the affected area. 

Before committing to any medical treatment for acne scar, be sure you have all the knowledge you need to make an educated decision.  Have your free consultation with the doctors at SkinStation so that you fully understand the risks and benefits of each treatment option.

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This was published in the July 17, 2012 issue of Manila Bulletin Lifestyle Section. The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission for his achievements in the field of cosmetic chemistry. He can be reached at fred.reyes@skinstation.ph.