Acne Scar Treatment
Cystic acne, which is the severest form of acne, often results to deep and/or raised scars on the surface of the skin. Fortunately, there are countless of treatments available today which are mostly effective if given to the right candidates.
Different Types of Acne Scars
Doctors have identified four types of acne scar which are based on their appearance: ice pick, rolling, boxcar, and hypertropic (raised scar). In this way, they can determine the best scar treatment they can use to improve the appearance of the skin.
Considerations Before Having Any Treatment
Before treating the scars and blemishes, it is important to address first any active acne especially the pustules and cysts. In this way, the scar treatment can provide the best possible result.
Ideally, people with cystic acne and extensive pimples should visit their dermatologists who usually treat such conditions with stronger medications including oral and topical antibiotics, retinoid, and keratolytics.
Meanwhile, patients who are taking isotretinoin should only have laser resurfacing (and other related acne scar treatments) at least six months after stopping this medication.
Types of Acne Scar Treatments:
Laser Resurfacing and Augmentation
In this procedure which is performed under local anesthesia, a laser is used to remove the top layer of the skin so that new tissue can form. Many dermatologists favor this acne scar treatment because they find it easier to control the penetration depth of the laser compared with other technique.
To achieve a dramatic result, the laser is pass through the treated area two to three times. The length of procedure can last a few minutes when treating small areas or an hour for a more severe scarring.
The treatment may involve the use of Erbium (YAG), fractional laser, or CO2 (carbon dioxide) laser which can produce a better result, although it involves more serious side effects and longer recovery.
Fractional laser is the mildest form of laser skin resurfacing, which means that a person can expect less severe side effects; however, the results are less impressive than CO2 and Erbium (YAG) laser.
Facial fillers such as bovine collagen and natural fats are injected to the deep scar to make it flat. While these treatments often provide a noticeable result, they are not permanent and should be repeated every four months or so in order to maintain the skin’s smooth appearance.
Despite giving longer-lasting results, Gore-Tex and silicone are no longer popular as an acne scar treatment due to their potential side effects.
Types of Acne Scar Treatments:
Chemical Peel, Skin Needling, Punch Technique, And Cryosurgery
The skin is applied with one to two coats of tricolor acetic acid or TCA (10-40 percent) which is left for one to 10 minutes. In some cases, TCA with a concentration of more than 60 percent is applied directly to the scars in order to remove the top layers of the skin and encourage new tissue to grow.
Salicylic acid combined with glycolic acid is another solution used in chemical peeling which is more ideal in treating slight blemishes than severe acne scarring. Since acid may cause burns and other severe skin irritation, the medium to deep peel treatments should only be performed by dermatologists or licensed aestheticians.
Usually performed with the use of a roller with fine medical grade needles, the procedure can puncture the deeper layers of the skin at a controlled depth (while the top layer or epidermis remains intact), resulting to trauma which can encourage the body to produce more collagen and skin cells to heal the tissue. Most patients will need at least three sessions, performed about four weeks apart, to enjoy a noticeable improvement.
This treatment comes in three types: punch excision in which the scar is surgically removed before being sutured; punch grafting in which the tissue containing the scar is physically removed and is replaced with a patient’s own skin (often derived behind the ear); and punch elevation in which the deep scar is elevated using a cut from its center.
The treatment involves freezing the scar using cold liquid nitrogen, which is left for several seconds to two minutes on the surface of the skin. The goal is to damage the raised scar tissue and make it flat. For some patients, they will need steroid injection as an adjunct procedure.
Types of Acne Scar Treatments:
Dermabrasion, Steriod Injection, Cytotocic Injection, And Subcision
Usually performed under local anesthesia, this treatment involves freezing the skin (via a special spray) and then removing its top layer using a high-speed rotary device with an abrasive brush or wheel. The less invasive form of dermabrasion is called microdermabrasion in which tiny crystals gently slough off the top layer of the skin to make its surface smoother and younger looking.
This acne scar treatment, which is only applicable to hypertropic or raised scar, involves injecting steroids to the treated area in order to disrupt the body’s inflammatory response to minimize scarring.
Often performed in conjunction with steroid medications, this procedure involves injecting an antibiotic or Fluorouracil (a cancer drug) to a raised scar to reduce its appearance.
In this procedure, a doctor surgically separates the dermis (deeper layer of skin) and subcutaneous tissue, resulting to blood clot that can encourage the body to form connective tissue under the acne scar. In many cases, this is complemented with laser skin resurfacing or dermabrasion to further eliminate the irregularities.
Alternative Treatments, Ethnicity and Acne Scarring,
and Acne insurance Coverage
Most of the acne scar treatments stated above are more expensive compared with over-the-counter topical medications, however, these procedures often provide the best result and may be the only solution for severe facial scarring.
Ethnicity and Acne Scar
Dark-skinned individuals suffering from acne have a higher chance of developing hypertrophic scar, keloids and hyperpigmentation. In a study, African-Americans are five to 15 times more likely to develop raised scars from acne compared with Caucasians; for this reason, many dermatologists suggest that treating acne during its early stage before any discoloration and scarring develops is the best approach.
Meanwhile, the medium-depth chemical peel and microdermabrasion are usually considered safe and effective in treating acne scars of dark-skinned patients who are suffering from hyperpigmentation and crater-like acne. On the other hand, CO2 laser resurfacing may not be a good treatment for these people. However, Erbium laser resurfacing, which is less invasive than the CO2 laser, may work for some individuals with dark skin.
Acne Scar Treatments and Insurance Coverage
In general, acne scar treatments are not covered by insurance companies because these are solely performed to enhance one’s appearance. On the other hand, scars caused by burns and those which can result to physical impairments are sometimes covered by health insurance.