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Best Skin Treatments for Acne Scars

Acne in itself can be upsetting, so it’s salt in the wound when it leaves a seemingly permanent mark. Below is a comprehensive list of the different types of acne scar treatment available that can help reduce their impact.


What causes acne scarring?

Who is most susceptible to acne scars?

Types of acne scars

Acne scar treatments

Prevention is better than cure

Forewarned is forearmed

What causes acne scarring?

When body tissue is injured or damaged, the body rushes its “repair team” to the injury site. This specialised team includes white blood cells and a range of inflammatory molecules that work to fight infection and heal the damaged tissue. Once the infection is gone, however, the tissue can’t always be restored to its former state. The result can be a scar.

Who is most susceptible to acne scars?

How and why people get acne scars is not completely understood. Because acne scarring differs from person to person, it’s likely that some people are simply more prone to scarring than others. People who are susceptible to scarring often find a genetic link as well – both the severity of scarring and the type of scarring can “run in the family.”

The ‘lifetime’ of individual scars can also vary quite a lot too; some people’s acne scars can last a lifetime with little change, while others diminish over time. We do know that scarring occurs most frequently in people who have the most severe forms of inflammatory acne, involving deep nodular lesions.

Types of acne scars

Acne scars come in two forms: those caused by increased tissue formation (keloid or hypertrophic scars) and those caused by tissue loss. This piece will mostly focus on acne scarring treatments for scars caused by tissue loss.

According to The Australasian College of Dermatologists, these are the main types of scaring caused by tissue loss:

  • Box car: The depth of these scars is shallow to medium, with well-defined edges. They are most commonly located on the cheeks and temples.
  • Ice-pick: They are deep and narrow and go to the lower layer of the skin.
  • Rolling, atrophic and depressed: These start as small depressions in the skin, with some being tethered to deeper skin structures.
  • Mixed: A mix of acne scars is the most common form. As with most scarring this type requires a tailored solution.
  • Macular: These scars usually appear on the cheeks and forehead and look like red areas. These type of scarring can fade by itself within six months to a year.

Different scar types require different treatments, so it is vital that you seek the advice of a medical professional or dermatologist.

Acne scar treatments

There are many ways to treat acne scarring, depending on the severity of the scarring at hand. Let’s dive into some of the more common acne scar removal treatments first.

Dermabrasion

A spinning instrument, often a brush, is used to remove several layers of skin. Essentially, it’s used to resurface the skin and help reduce the appearance of acne scars.

There is a substantial recovery time required for dermabrasion, as it is quite an intensive process for your skin. Laser has become the preferred form of treatment over the harshness of dermabrasion as well as deep chemical peels.

Microdermabrasion

This is a gentler alternative to dermabrasion. With microdermabrasion a jet of crystals, as opposed to a spinning instrument, is used to exfoliate the skin.

While it still removes and renews the skin, microdermabrasion only works with the surface layer of the skin. It’s generally only recommended for very light acne scarring.

Chemical peels

Chemical peels come in three levels: superficial, medium and deep. For light acne scarring, superficial is a good starting point.

Chemical peels help regenerate the skin by creating a controlled wound. This helps with collagen remodelling, which can be used to treat a number of things, including sun-damaged skin, wrinkles and some acne scarring.

Superficial chemical peels generally include alpha-hydroxy (AHA) peels, beta-hydroxy (BHA) peels and retinoic acid peels. They require little to no downtime but are not ideal for deeper scarring.

For medium to deep peels, there is more recovery time required. Also, generally, the deeper the peel, the greater the recovery time and potential for side effects and complications.

Also, the darker your skin tone, the more likelihood there will be complications after the peel (for example, treated skin may become darker than the untreated skin). Rather than deep chemical peels, some professionals suggest laser skin resurfacing.

Laser

There are multiple laser options out there to reduce acne scarring. We’ll work with the overarching treatments available: namely non-fractional and fractional.

Non-fractional: These lasers remove the top layer of the skin via vapourisation. This helps create smoother new skin and lessen the appearance of scars. There is usually a recovery time of around two weeks for this type of laser treatment.

Fractional: This treatment goes deeper into the skin than non-fractional laser treatments. By going deeper, the lasers can help stimulate the production of new collagen and raise indented scars to the level of the “normal” skin.

Within these two categories you’ll find options that will work for different types of acne scarring.

Radiofrequency

This treatment uses radiofrequency energy to remodel collagen and scars. This method is delivered into the deeper layers of the skin and helps break down and heal scar tissue, leaving minimal damage to the surface layers of the skin. This method is best for mild to moderate acne scarring, though it can be used in tandem with other treatments for some severe cases, and usually requires multiple treatments.

Surgical skin needling

Surgical skin needling punctures the skin to help stimulate collagen production which can help plump indented or atrophic scars. Rolling needles over your face might sound archaic, but it has proven to be effective, though there is considerable recovery time and risk involved.

Micro-needling

Much in the same vein as surgical skin needling, micro-needling punctures the skin to help with collagen production. Micro-needling needles are much finer than the needles used in surgical skin needling and it is a less invasive procedure. That being said, it will take more time to achieve the same results as surgical skin-needling.

Dermal fillers

Another option on how to treat acne scars are fillers. Yes, they get a work out on the red carpet for plumping lips and laugh lines, but they can also help plump out “craters” or indented scars.

One important thing to note is that dermal filling requires ongoing treatments to maintain results.

Treatment for keloid or hypertrophic acne scarring

There are laser options for keloid and hypertrophic acne scarring. Steroids, cryotherapy, skin needling and surgery are some other potential means of treating these raised scars.

As with the above, advice should be sought by a medical professional or dermatologist before undergoing any treatment.

It should also be noted that hypertrophic and keloid scars are prone to recur even after a successful treatment.

Prevention is better than cure

To prevent future scarring, your best bet is to prevent future breakouts. There are many ways to manage acne, which you can find in one of our previously written articles called, How to Cope With Adults Breakouts and How to Prevent Pimple & Acne.

There is also one hard and fast rule that you need to stick to: do not pop, pick or prick your pimples. As tempting as it may be. If you leave your pimples to heal by themselves they will disappear by themselves. If you pop, pick or prick, you’re opening up the door to more scarring.

In addition, a high-protection sunscreen should be part of your daily routine. Sun exposure not only breaks down collagen, but it can cause pigmentation to worsen.

Forewarned is forearmed

There is no one-size-fits-all cure for acne scarring. It is vital that you seek the advice of a dermatologist or medical professional before undergoing any treatment. This way they can create a plan that will work with your skin type, the type of acne scarring that needs to be treated and your lifestyle.

Some other factors you need to consider and chat with a professional about are your expectations versus the reality of the procedure’s efficacy, potential side effects, and the recovery time that is required. It’s always best to go in knowing the right questions to ask.

References:
https://www.thevictoriancosmeticinstitute.com.au/detail/acne-scarring-treatment

https://www.thevictoriancosmeticinstitute.com.au/detail/chemical-peels

https://www.elle.com/uk/beauty/skin/a34439/how-to-get-rid-of-acne-scars

https://www.dermnetnz.org/topics/acne-scarring

https://www.proactiv.com.au/physical-effects-of-acne.aspx

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