Top Four Things About Acne Scarring
- There are different types of acne scars
- Different types of scars require different treatments
- Active acne needs to be controlled
- Scarring is often associated with pigmentation that needs treatment
Types Of Acne Scars
There are various types of acne scars and many different methods of classifying them. Many patients have a combination of several different types of acne scars at the same time. Essentially acne scars can be considered to be either raised, flat or depressed.
Raised Acne Scars
When acne causes raised scars these may be either hypertrophic when they are enlarged but confined to original area of acne or keloid when the scarring extends beyond the original area of acne. The choice of treatment depends on how raised the scars are and can include local treatment such as corticosteroid injections or more generalised treatment such as FRAXEL laser treatment.
Flat scarring also called macular scarring is largely a problem of pigmentation rather than changes in skin texture.
Initial treatment options include topical depigmenting creams such as hydroquinone or superficial peels. Resistant macular scarring often requires laser based treatments in particular the REV-LITE laser which can target both pigmentation and scarring at the same time.
Depressed Acne Scars
Acne scars can cause various types of indentations in the skin such as rolling undulations (rolling scars) punched out depressions with sharp vertical edges (boxcar scars), deep scars with loss of subcutaneous tissue (deep divots) and deep small holes in the skin (ice pick scars).
If the depressions are very superficial then peels and microdermabrasion can be effective in smoothing the skin surface.
For deeper depressions where it is necessary to promote collagen production, the use of skin needling devices can provide very effective treatment with minimal downtime.
Certain types of severely depressed acne scarring may require surgery such as subcision which aims to release depressed scars from underlying structures and fat grafts to fill very deep scars that have lost supporting tissue.