The occurrence and incidence of scarring resulting from acne are still not well understood. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others. In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair.
Acne scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin, but scarring also may arise from more superficial inflamed lesions. Nevertheless, the only sure method of preventing or limiting the extent of acne scars is to treat acne early in its course, and as long as necessary. The more inflammation can be prevented or moderated, the more likely it is that scars can be prevented.
The following is a list of different types of acne scars:
The results of most treatments vary from 30 to 70% improvement. Any better result should be considered as a bonus.
- Ice-pick scars are acne scars associated with loss of tissue which usually occurs on the cheeks. They are usually small with a somewhat jagged edge and steep sides-like wounds from an ice pick.
- Keloidal acne scars are raised and thickened scars which commonly occur in darker skin type patients. They are quite a unique type of scarring that can grow and thicken with time, acting almost tumour-like. These scars are best treated with intralesional steroids, Titan infrared light, Laser Genesis, and injectable treatments. In severe cases, these scars may require surgical excision.
- Hypertrophic scars are raised and thickened scars, but do not grow and thicken with time like keloids do. These scars are best treated with Needling, fractionated treatments and some injectables may be necessary to break down the excess tissue.
- Rolling scars are the most common and most disfiguring form of acne scars. They are soft scars, superficial or deep, and are soft to the touch. They have gently sloping rolled edges that merge with normal skin. They are usually small, and either circular or linear in shape. In most cases, the lower part of this scar type is connected to the deeper fascia by collagen fibres.
- The Boxcar Acne scar is a depressed fibrotic scar that is usually quite large with sharp edges and steep sides. The base of these scars is firm to the touch. Ice-pick scars may evolve into depressed fibrotic scars over time.
- PIH or Post Inflammatory Pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people but can be seen in all skin types.
At Skin Renewal, a number of treatments are available for acne scars. The type of treatment selected should be the one that is best for you in terms of:
- your skin type
- your budget
- whether you can afford downtime
- what you want the treatment to accomplish
The objective of scar treatment is to give the skin a more acceptable physical appearance. Total restoration of the skin to the way it looked before you had acne is often not possible but scar treatment does usually improve the appearance of your skin.
The scar treatments that are currently available at Skin Renewal include:
- Radio Frequency Needling with Endymed Intensif and Secret RF
- Fractional treatments with Pearl Fractional, CO2 Fractional Laser, Fraxel DUAL and Endymed FSR (Fractional Skin Resurfacing)
- Laser toning treatment with Laser Genesis
- Micro-Needling with Dermapen
- Dermal Fillers are injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars which have caused indentation of the skin
- Keloidal acne scars are treated by injecting steroidal drugs or TAC and Botox into the scar after a Laser Genesis treatment
- Skin resurfacing treatments such as Pearl Laser, Limelight, PDL and deep chemical peels
At Skin Renewal all patients with skin conditions are treated holistically by our qualified medical doctors who have experience in treating acne and acne scarring. In other words, in an acne consultation at Skin Renewal, your doctor will take a comprehensive history to ensure that there are no underlying medical conditions which are contributing to your acne. If the acne can be controlled and managed, there will be a greater success in treating the existing scarring and preventing new scar formation from occurring.