How to take care of acne scars – do they remain?

Acne is one of the most common and distressing skin problem in adolescents. There are raised bumps in the skin and some of them can be large and pus filled. These are quite often painful. The affected areas are the face, chest, upper back and arms.

Acne will resolve after a certain period of time but leaves behind scars. Do these scars go away? Some may look less conspicuous with time but most don’t fade away. Topical creams may not help much. However there are procedures that will help reduce scars considerably and improve the texture of the skin over the face.

As with any disease, prevention is always better than cure. The best way to prevent scars would be to see a dermatologist as soon as you start developing acne. By preventing new pimples you are preventing scars. Also I find that most with acne tend to pick on them or try to drain the pus from it. This will actually result in more inflammation. Squeezing a pimple can push the bacteria deeper resulting in more infection thereby more inflammation and ultimately more collagen damage and scarring.

There are many modalities that are used to treat scars effectively. Treatment has to be tailored to the individual patient based on the skin colour, scar type and the patient’s economic capacity. There are different types of acne scars which are atrophic scars (scars that are shallow), box scars (wide box shaped) and ice pick scars (narrow and deep).

Subcission

This is a simple method whereby the doctor undermines the acne scar with a fine needle. This breaks the fibrous strands of the scar and helps in collagen remodelling thus improving the appearance of the scar.

Fractional laser resurfacing

Fractional laser skin resurfacing treats microscopic columns of skin. It is a non-invasive treatment that uses a device to deliver a laser beam that targets a fraction of the skin at a time. These are called microthermal treatment zones (MTZs). Within each MTZ old epidermal pigmented cells are expelled and the collagen in the dermis is penetrated causing a reaction that leads to collagen remodelling and new collagen formation. This evens out the depressions in the skin.

Microneedling

Skin needling is a relatively simple, cost-effective technique used for the treatment of acne scarring. This treatment consists of a device with numerous needles with uniform length and diameter. These fine needles puncture the skin, resulting in increased dermal elastin and collagen, thereby collagen remodelling, and thickening of the epidermis (superficial layer of the skin) and dermis (layer of skin beneath the epidermis).

Chemical peels

These are solutions or creams that are applied on the skin. The most commonly used chemical peels in treating acne and acne scars include salicylic acid (SA), glycolic acid (GA), Jessner’s solution (JS), resorcinol, and trichloroacetic acid (TCA). They cause exfoliation of the dead superficial layers of the skin making it brighter and smoother.

Platelet rich plasma

Platelet rich plasma involves separating the platelets from the whole blood. This platelet concentrate which is rich in growth factors is injected into the scars. This helps in collagen remodelling and thereby improves the appearance of the scars. It is a safe and effective treatment as it involves the patient’s own blood. Combination of PRP with fractional lasers can further improve the results.

With so many treatment options the overall appearance of acne scars can be greatly improved. Best results are seen when two or more treatment modalities are combined. Your dermatologist will assess the nature of your skin, the type of scars and advise the procedures that would give you the best results. In darker skin types like ours there is a risk of post inflammatory hyperpigmentation. Therefore your dermatologist will prescribe certain creams for 4 weeks prior to your procedure. Strict sun protection 4 weeks before and after treatment is absolutely essential.

So acne scars need not dent your self-confidence anymore.