Acne can be a difficult condition to live with, and when/if it goes away the individual can be left with lifelong scarring. However, not all hope is lost. Acne scars can fade and disappear over time. In fact, it can take up to 2 years for a scar to fully heal after passing through the different stages of wound healing.
If you’re still left with noticeable scarring, you may wish to seek some professional treatment. This guide will explain about the different types of scarring and the latest acne scar treatments available.
Types of Acne Scar
Rolling scars- irregular edges, can appear as linear shapes as several scars merge together.
Ice pick- Small, deep scars, base of scar usually not visible.
Hypertrophic or Keloid Scar- Hypertrophic scars are a raised scar that stays the same width as the original scar-more common in males. Keloid scarring is an uncontrolled overgrowth of scar tissue and needs specialist treatment by a dermatologist- more common in dark skin types.
Box car- irregular shaped deep scars with a well-defined border
Treatments Available
1. Subcision
A specialist technique to break through scar tissue beneath the area that may be pulling the scar downwards. This releases any tethering and also stimulates new collagen formation to lift the scar. Generally offered by dermatologists or medical aesthetics clinics.
2. Microneedling
Microneedling is one of the safest and most effective treatments for acne scars. A roller or pen device is used to create tiny punctures in the skin over the scarred areas. As these areas heal, the body produces more collagen to heal the punctures. This leads to an increase in collagen and elastin to soften the appearance of scars. DIY Microneedling for acne is not safe and not recommended as a home treatment to the depth of needle penetration required, risk of infection and the need for topical numbing cream.
3. Laser Resurfacing
The epidermis in an acne scar is typically thinner than surrounding skin. When a scar forms, the new skin is much weaker and thinner than normal healthy tissue with lower levels of disorganised collagen. Laser treatment can help acne scars by thickening the epidermis and stimulating more collagen formation. There are a wide variety of Lasers to treat acne and rejuvenate the skin, however, those that target the epidermis and deeper layers will give the best results. These are known as ablative lasers, for example a CO2 laser or Er:YAG laser.
4. Microdermabrasion
An abrasive tool, usually a diamond tipped pen device or a device that blasts fine crystals onto the skin is used to remove the dead skin in the stratum corneum, the very top layer of skin. This creates instantly smoother, brighter skin to reduce the appearance of superficial scars. This technique works best in lighter skin types. Will require a course of initial treatment followed by regular maintenance.
5. Chemical Peels
Chemical peels can help with acne scarring and work similarly to microdermabrasion, but can vary in the depth of penetration. A superficial lactic acid chemical peel will remove the dead layer of skin on the surface but therefore only give superficial results. Deeper chemical peels cause a controlled chemical injury in the dermis which triggers production of more collagen and elastin to repair. The deeper the peel, generally the more flaking, redness and discomfort is to be expected, but with enhanced results at the end. Some clinics will offer a high strength TCA peel to spot treat ice pick scars. Expect to have an initial course of treatment followed by regular maintenance peels. Deeper peels require less frequent treatment.
6. Retinoids
A retinoid is a product applied to the skin that stimulates cell turnover, effectively a type of chemical exfoliant. As the skin regenerates faster, the level of collagen in the skin increases, leading to firmer, smoother skin and reduced scarring. Retinoids can frequently trigger a reaction when applied that includes itching, dryness and flaking. This is an expected reaction for new users, and those with sensitive skin. The side effects generally disappear with regular use. High strength will give the best results but with the most side effects. Continuous treatment is required to maintain the results. Some of the most potent formulations will contain Retinol, Adapalene or Tretinoin (the latter being the strongest formulation but prescription only for this reason).
7. Dermal Fillers
For deeper scars a small amount of dermal filler can be placed underneath the scar to lift the sunken area. This works best in combination with subcision to stimulate collagen. Treatment will last approx 6 months.
Whilst all of these treatments may be helpful to make your scars less visible, prevention is always better than cure. Here are some tips to prevent widespread scarring:
Seek medical advice early on if it's more than just a few scattered spots here and there, don't leave it years before getting any help and advice. Shop bought remedies for acne can help with mild breakouts but stronger, prescription strength products are more likely to help reduce the severity of breakouts. Your local GP will have a wide range of medications that can help. Lots of private medical aesthetics or skin clinics also offer high strength skincare that can help with acne, some may also offer prescription medications.
Acne is a long-term chronic condition for some that can be managed, but needs persistence with treatments, and lots of trial and error to find something that works for you.
If you have severe acne with large purple bumps or cysts, you may be better cared for by a dermatologist who can prescribe specialist medication. This type of acne is most likely to leave widespread scarring.
And finally- DO NOT PICK! Whilst this may be instantly satisfying, you'll regret it once that tiny spot turns into a huge scar-worthy cyst, with lots of little friends around it as the bacteria has been spread and driven further into the skin.
You can book an appointment with a Registered Nurse Prescriber at Skin Redefined for an acne treatment plan, whether it's for active acne or scarring. The clinic offers a wide range of treatments that can help. You can view the treatments available on the website link below:
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