Acne scar treatments are available for acne scars through a dermatological surgery. The treatment selected should be the one that is best for you your skin. In addition, there is the possibility that some types of treatment may result in more scarring if you are susceptible to scar formation.
A decision to seek dermatological surgical treatment for acne scars also depends on:
The way you feel about acne scars. Do acne scars psychologically or emotionally affect your life? Are you willing to "live with your scars" and wait for them to fade overtime? These are personal decisions only you can make.
The severity of your acne scars. Is scarring substantially disfiguring, even by objective assessment?
A dermatologist's expert opinion whether scar treatment is justified in your particular case, and what scar treatment will be most effective for you.
Before committing to treatment of acne scars, you should have a frank discussion with your dermatologist about those questions, and any others you feel are important. You need to tell the dermatologist how you feel about your acne scars. The dermatologist needs to conduct a full examination and decide whether acne scar treatment can, or should, be undertaken.
The objective of acne scar treatment is to give the skin a more acceptable physical appearance. Total restoration of the skin, to the way it looked before you had acne, is often not possible, but scar treatment does usually improve the appearance of your skin.
The acne scar treatments that are available includes the following:
Collagen, a normal substance of the body, is injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Collagen treatment usually does not work as well for ice pick scars and keloids. Collagen drawn from cows or other nonhuman sources cannot be used in people with autoimmune diseases. Human collagen or fascia is helpful for those allergic to cow-derived collagen. Cosmetic benefit from collagen injection usually lasts 3 to 6 months. Extra collagen injections to keep the cosmetic benefit are given at extra cost.
Autologous fat transfer:
Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to lift depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring from nodulocystic acne. Because the fat is reabsorbed into the skin over 6 to 18 months, the procedure usually repeated. Longer lasting results may be achieved with multiple fat-transfer procedures.
This is thought to be the most effective treatment for acne scars. Under local anesthetic, a high-speed brush or fraise used to remove surface skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced. Dermabrasion does not work for all kinds of scars; for example, it may make ice pick scars more noticeable if the scars are wider under the skin than at the surface. In darker-skinned people, dermabrasion may cause changes in pigmentation that need extra treatment.
This new technique is a surface form of dermabrasion. Rather than a high-speed brush, microdermabrasion uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. Only the surface cells of the skin are removed, so no extra wound is created. Multiple procedures are often needed but scars may not be significantly improved.
Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions. The laser used is determined by the results the laser treatment aims to carry out. Tissue may be removed with more powerful instruments such as the carbon dioxide laser. Sometimes, a single treatment is all that will be necessary to achieve permanent results. Because the skin absorbs powerful bursts of energy from the laser, there may be post treatment redness for several months.
Some ice pick scars may be removed by "punch" excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus raising a depressed scar.
Skin grafting may be necessary under certain conditions; for example, sometimes dermabrasion unroofs massive and extensive tunnels (also called sinus tracts) caused by inflammatory reaction to sebum and bacteria in sebaceous follicles. Skin grafting may be needed to close the defect of the unroofed sinus tracts.
Treatment of keloids:
Surgical removal is seldom if ever used to treat keloids. A person whose skin has a tendency to form keloids from acne damage may also form keloids in response to skin surgery. Sometimes keloids are treated by injecting steroid drugs into the skin around the keloid. Topical retinoic acid may be applied directly on the keloid. Occasionally the best treatment for keloids in a susceptible person is no treatment at all.
In summary, acne scars are caused by the body's immune response to acne. The best way to prevent scars is to treat acne early, and as long as necessary. If scars form, effective treatments are available. Dermatological surgery treatments should be discussed with a dermatologist and a doctor.