Acne Scarring
About Acne Scarring Treatments at Dermatology Associates of Atlanta
Acne occurs when excess sebum (oil) is produced by the skin or from bacteria growth which can affect people of all ages. Acne can appear anywhere on the body but is commonly found on the face, back, chest, and shoulders. Acne is a long lasting problem that generally occurs during puberty; many suffer both emotionally and physically, especially when there is long-term scarring of the skin.
The board certified dermatologists of Dermatology Associates of Atlanta treat numerous patients suffering from acne with very effective treatments including prescription acne medicines, topical solutions, antibiotics, retinoids, laser treatments, microdermabrasion, chemical peels, custom prescription compounds and more. Although personalized treatments can be helpful in resolving acne, for those that struggled with acne in the past and now have pitted scarring, acne scar treatment may be necessary. Unfortunately, many patients have tried multiple treatments which may have only brought minimal improvement and discouraged patients who then don’t know where to turn.
Dr. Edmond Griffin has been treating acne scars for over 35 years and has found that combining both non-surgical and surgical treatments often provides patients with the best results. Every acne scar case is different and specialized techniques used are customized for each patient’s unique needs. Most acne scars require more than one treatment, but every session should lead to improvement of the skin and a return to a clearer appearance.
Types of Acne Scars
- • Atrophic shallow areas with irregular borders.
- • Boxcar shallow depressions with broad bases, producing rolling scars which have very poorly defined borders.
- • Ice pick-shaped, deep, narrow pitted appearance; sometimes looks similar to dilated pores.
Acne Scarring Treatments
Our experienced dermatologists specialize in both non-surgical and surgical acne scarring treatments to help diminish the appearance of acne scars.
Non-surgical Treatments
Dermal Injections/Facial Fillers
Soft tissue fillers may be used for treatment of atrophic scars to fill pitted or depressed areas on the skin. The results are temporary and additional treatments are necessary; silicone has been suggested by some but in general is not used by most. A very promising filler is the use of the patients’ own blood product (natural growth factors) and fat cells.
Alloderm and fascia lata are commonly used products taken from another person, processed, then transferred safely to another person. This is used as a dermal filler after subcisions have created a pocket beneath the sunken scar. The subcisions break up the scar which is hard and fibrous and pulling downward. The fillers serve as a scaffold onto which cells grow into new collagen bundles to fill sunken areas and provide a smoother surface. Benefits of these long-term fillers include minimal reaction or infection risk as they become a permanent part of the skin.
Injections such as Cortisone or 5-Flurouracil can be injected into thickened scars which help flatten them and make them less itchy and red. For the redness, the Candela pulsed dye laser is frequently used and more recently BOTOX® has been injected into stubborn scars which helps soften them. For thickened scars, DOT laser is used first before the application of chemicals to help soften the scars.
Skin Resurfacing
Needling: A procedure that uses multiple needle injections to break up acne scars and stimulate new collagen formation, producing reorganization of the scarred collagen. For treating the face, the use of the Dermapen is showing good progress in softening the scars of acne.
Laser skin resurfacing: Through short bursts of high energy, fractionated lasers can treat targeted areas of the skin to promote collagen production. Following several laser treatments, atrophic post-acne scarring shows improved texture and appearance.
Chemical peels: Used for patients with atrophic acne scarring to remove superficial skin layers and promote collagen production. Peel strength can be customized for the patient’s needs to also treat deeper layers of the skin.
Microdermabrasion: A non-invasive treatment that uses crystals and a vacuum to remove dead skin cells. This treatment may be used in combination with other acne scarring treatments or for the most superficial, shallow acne scars. Unless vigorously performed, microdermabrasion will only produce minimal results.
Dermabrasion: A former acne scarring technique that uses a fast rotating wire brush to remove the top layer of skin. Now due to many problems with pigment, this technique is not used often.
Hand sanding: A newer form of dermabrasion that is recommended for some patients. This technique uses no electrical instruments, nor any freezing sprays decreasing the risk of pigment loss or a permanent change in pigmentation as previous dermabrasion techniques. This is also safe for patients of color; patients with different levels of pigment in their skin. While not only effective, this hand sanding technique is safe and can be repeated even for patients with the worst acne and the darkest skin.
Pulsed light sources and radio frequency energy may be used in combination with surgical techniques to help minimize scarring and create new, smooth skin.
Surgical Treatments
For more severe acne scarring such as box-shaped and ice pick scarring, surgical techniques can be used.
Punch grafting/floating: Small skin grafts are used to replace acne scarred skin. Sometimes used to treat deep, ice pick scarring, punch grafting provides the most optimal results in less mobile areas of the face such as the forehead. Punch floating is the treatment of choice for most ice pick scars and usually heals in several months without a trace of the circular incision used to make the punch.
Subcisions: A minor surgical procedure used for treating depressed acne scars. Using a micro blade or small needle to make small incisions that cut and separate fibrous bands and release the bound down scar, subcisions encourage wound healing for a smoother surface. This procedure is often combined with other treatments such as laser resurfacing for maximum effectiveness.
Fat transfer: A process that transplants fat from one part of the body to fill acne scar depressions. This procedure eliminates risk of rejection or immune reaction as it uses your own fat. It is rarely used alone and most often has growth factors from your own blood added to it. Sometimes the clot used to obtain the cytokines from the blood is used as a scaffold for new collagen to infiltrate.
Acne scar excision: A scar removal technique that cuts out individual scars. Excision is rarely a recommended technique for patients with ice pick or deep boxcar scars; sometimes it is the only treatment for very deep irregular shaped scars in difficult locations.
Acne Scarring FAQs
What causes acne scarring?
Acne is caused by hormonal issues or an overproduction of sebum (an oily liquid) or bacteria growth. Sebum, along with dead skin cells, travels through the follicles to the surface of the skin producing clogged pores. Acne scars develop where the resulting acne nodules or cysts once existed. Acne can develop in a variety of forms, mild to severe, and in most cases, severe nodules will likely lead to acne scarring without proper treatment. Since each case of acne is different, at Dermatology Associates of Atlanta treatment for acne scarring is customized for the patient’s specific type of skin and the depth of scarring present; a regimen is tailored for each individual to improve the skin’s texture and appearance.
How can acne scarring be prevented?
Generally, acne that appears may leave red or brownish blemishes on the skin but they typically will naturally fade over time. Since acne scars develop where acne lesions once existed, picking and squeezing at active acne only increases the chance of developing scar tissue resulting in visible scarring. Using oil-free sunscreen and make-up is also advised to reduce the amount of oil on the skin that could potentially clog your pores and create further acne. Your dermatologist may also recommend using face lotions and creams containing salicylic acid or benzoyl peroxide, which are active ingredients known to help treat acne and reduce the recurrence of future acne.
Who can have acne scarring?
Everyone who experiences acne is susceptible to developing acne scars; however, each individual’s skin is unique and not every case of acne is treated the same. Depending on skin sensitivity, the ease with which you’ve developed scarring previously, and the presence of acne sites, your acne may be more likely to result in scarring. It is best to treat acne once it starts to reduce the chance of acne scarring by seeking treatment from a board certified dermatologist.
What treatments are available for acne scarring?
With years of experience in acne scarring revision, our team provides patients with customized surgical and non-surgical treatments to improve the skin’s appearance. Specializing in non-surgical procedures such as chemical peels, microdermabrasion and skin resurfacing treatments, our specialists safely and effectively remove dead skin and top layers of the dermis to promote collagen production to minimize the appearance of acne scarring. To treat patients with severe acne scarring, surgical treatments like punch grafting and fat transfer reduce scarred skin and fills acne scar depressions to reveal smoother skin. Multiple treatments are needed to effectively treat acne scarring and our team often recommends combining non-surgical and surgical treatments for optimal results.
“How does Infini™ micro needling with RF minimize scars?
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