Severe Acne Scar Treatments
If your acne is particularly severe, it's likely that scars will remain after your skin has cleared. The American Academy of Dermatology (AAD) also states that family history makes some patients genetically predisposed to more profound scarring. Although the AAD lists several medical treatments that can be helpful, skin may never look the same as it did before acne scarring occurred. Only a dermatologist can make appropriate recommendations as to which type of treatment is best for you.
The AAD indicates that an effective treatment for many acne scars is laser resurfacing, in which laser technology is used to destroy the epidermis and heat the layer of skin underneath, resulting in new skin growth. The AAD indicates that laser resurfacing yields good results for icepick scars, shallow boxcar scars and some rolling scars. However, deeper boxcar scars are less affected.
Patients need time to heal after this procedure, and during this time, special care must be taken to ensure that wounded skin does not become infected. Application of topical antibiotic medication and bandaging is required. The AAD indicates that total recovery time is around two weeks. Improvement to the complexion may be noted for up to 18 months.
Mayo Clinic experts list dermabrasion (dermaplaning) as a severe acne scar treatment. This treatment is also performed by a dermatologist, who removes the outer layer of scarred skin using a hand-held device with sharp, rotating blades. The AAD indicates that unlike laser resurfacing, dermabrasion is considered a surgical procedure. Patients may even require general anesthesia.
As with laser resurfacing, the skin must be tended to carefully after the procedure. The AAD indicates that patients may experience up to seven days of home recovery time, with new skin growth emerging after around 10 days. Gradual improvement is noted over the course of many months, during which time redness and inflammation may continue to be noted. Dermabrasion may not be appropriate for those with dark brown or black skin, warns the American Society of Plastic Surgeons, as it can cause changes in skin tone.
Large, deep acne scars may require individual attention through different types of acne surgeries--punch graft, punch excision, punch elevation and subcutaneous incision. The AAD indicates that these surgeries, which are performed in a dermatologist's office, result in smaller, less noticeable scars that are likely to fade. Laser resurfacing may be used to reduce the appearance of the smaller scars that remain after acne surgery. Improvement may not be noted for up to two weeks, warns the AAD. During this time, patients must make sure to apply fresh bandages and care for wounds according to their dermatologists' instructions.
Injectible fillers can be used to augment depressed acne scars. Depending on the type of filler used, results can be temporary or permanent, notes the AAD. Collagen, hyaluronic acid, the patient's own fat and polymethylmethacrylate (the only permanent filler) can be used. Patients find augmentation a desirable option, as the procedure is quick and results in few side effects other than temporary redness, inflammation and sometimes bruising. The Mayo Clinic points out that most types of fillers are temporary, making repeat treatments necessary.
Depending on the extent and type of acne scarring, chemical peels may be used as part of the patient's overall treatment plan. During this acne scar treatment, a dermatologist applies a potent acid to the skin which destroys the outer layer of skin (stronger chemical peels may penetrate deeper layers of skin). After treatment, the epidermis sloughs off, revealing a new layer of skin. Depending on the strength of the acid used, new skin can emerge after only one day or after two weeks. The AAD notes that patients will be instructed on how to care for their skin at home, which may include special methods of washing and use of sun protection.
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