How Do Doctors Treat Acne Scars?
About Acne Scarring
When it comes to addressing acne scarring, there's not a single treatment that's best for everyone. Numerous treatments can help improve the overall complexion, but there are various in-office procedures that are more appropriate for some types of acne scarring than others. The American Academy of Dermatology states that you should speak with your dermatologist about treating acne scars if they cause you to be depressed, self-conscious, less confident, or if you feel acne scarring limits you in a social or occupational setting.
Techniques for New Skin Growth
Three methods of reducing acne scars focus on removing the layer of scarred skin and permitting new skin growth. Laser skin resurfacing has supplanted the older method of dermabrasion as a way of treating acne scars, notes the AAD. This treatment smooths out depressed scars--icepick and shallow boxcar scars, as well as "rolling" acne scars. An ablative laser is used to direct an intense beam of light at the skin, destroying the outer layer of skin and heating the underlying layer to stimulate the growth of a new skin layer.
Dermabrasion is typically performed in a surgical center. The skin is sterilized and anesthetized. Patients may be given a sedative or put under general anesthesia. The outer layer of the skin is painstakingly removed with a hand-held device with a sharp rotating blade. Chemical peels are another option for large areas of acne scarring. A dermatologist applies a high-potency acid to the skin, which causes the outer skin layer to blister and peel away, revealing a layer of fresh, new skin.
The AAD warns that laser resurfacing, dermabrasion and chemical peels do cause wounding, so healing time is involved. These more invasive methods also may require specific home-care techniques, such as washing the face appropriately and use of antibiotic ointments, bandages and sunscreens.
Plumping & Leveling: One Scar at a Time
The AAD states that fillers--injections of collagens, hyaluronic acid, polymethylmethacrylate (PMMA), and even fat from your own body--are becoming increasingly popular for treating depressed acne scars, as they offer rapid results and often allow patients to return to normal activities the same day of treatment. Fillers "plump" up depressed areas in the skin, but most are temporary, lasting between three and six months, although use of the patient's own fat gives longer results that last between one and three years. PMMA is the only filler that yields permanent results.
Acne scar surgery is the only effective method of reducing the presence of very deep scars (such as ice pick scars). Through punch excision surgery, the scar may be simply be removed using a round cookie-cutter surgical instrument. Punch elevation involves removing the acne scar and elevating the tissue so that the skin is level, and punch grafting removes and scar and fills the depression with a segment of the patient's own skin. Subcutaneous incision involves separating scar tissue from the rest of the skin and raising the skin to flatten out the surface. These procedures result in a scar that's less noticeable and which can be blended into the rest of the patient's skin using laser resurfacing.
Microdermabrasion and nonablative laser treatments are less intrusive, but the AAD notes that more than one treatment is required before results are noticed. Microdermabrasion may be appropriate for very shallow acne scars, rendering them less noticeable. This procedure involves directing small crystals onto the skin by a hand-held instrument which lightly abrade the skin's surface. A vacuum then removes the crystals and skin cells. Skin may be slightly reddened, but the procedure doesn't result in visible wounds. Similarly, nonablative laser treatments heat the outer layer of skin only, resulting in new skin formation and acne scars that are less obvious.
The AAD cautions you not to use any type of "do it yourself" home treatment, such as microdermabrasion or chemical peels. If these are done incorrectly, you can make your skin look even worse. For the best results, consult with your dermatologist to develop a comprehensive plan appropriate for your type of acne scarring.
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