How to get rid of Acne Scars?
The answer to how to treat acne scars depends on the type. There are multiple treatments with varying effectiveness, but the best treatment depends on the kind.
List of treatments to get rid of acne scars.
1. Laser scar removal. Fractional CO2 laser resurfacing, ablative Erbium laser.
2. Radio-frequency (RF) – eMatrix (eTwo) especially useful for young scars with residual acne.
3. Subcision and other surgical treatments. In clinic procedure to release tethered scars.
4. Dermal Filler. Most versatile treatment, immediate effects are achieved with subcision.
5. Peels for Acne Scars and TCA cross. Superficial Chemical Peels do not affect acne scars; you require more specialised peels to give efficient collagen remodelling. 70 – 100% TCA Cross useful for treating deep acne scars.
6. PRP treatment. Collagen stimulating effect, more efficient than needling, often used in combination with other therapies.
7. Needling acne scars. Entry level treatment. Skin needling is outdated, though it does have a therapeutic effect.
8. Microdermabrasion for acne scars. Microdermabrasion does not affect repairing acne scars.
Types of Acne Scars
Acne scars are divided into categories. Accurate assessment of acne scars is required to develop a treatment plan. It is important to use direct and indirect light observe facial expression and to feel the quality of skin before making a scar revision plan.
Broadly speaking there are atrophic and hypertrophic acne scars. Just meaning they are scooped out, or they are raised up. Most acne scars are atrophic.
Atrophic Acne Scars
Atrophic means there has been a loss of collagen in the underlying dermis, appearing as an indent in the skin. Atrophic scars are highlighted with indirect light angled across the skin. These injuries require increasing collagen or filler into the dermis to return smooth skin surface.
Tethered scars are attached to the underlying muscle. When you animate, the scar pulls to the attached site. Tethered acne scars require surgical procedures such as subcision.
Ice Pick Scar
A small thick scar, which is tethered to the underlying tissue. Treated with TCA cross or punch excision.
Box Car Scar
These have scar indentation and can be treated with lasers, radio-frequency and TCA cross.
Rolling Acne Scar
These are the hardest to treat. They require subcision, dermal filler, radio-frequency and fractional laser.
Laser Acne Scar Removal
The rule with acne scars is to treat the more profound injuries first, so releasing tethered and ice-pick scars with subcision or other surgical means.
The range of lasers for treating acne scars includes fully ablative lasers like Erbium which are useful for treating boxcar scarring and fractional CO2 which gives an overall improvement in skin texture and quality.
Fraxel 1550 laser is OK for treating acne scars, but other lasers provide a much better result.
Dermal Filler For Acne Scars
Dermal fillers are the most versatile treatment for acne scars, and when combined with subcision are excellent for treating atrophic, rolling and tethered acne scars. This process releases and raises up the injury. The results are instantaneous; there is no downtime.
Subcision involves introducing a needle under the skin, moving this under the tethered scar and breaking the bonds. Subcision is used to free the surface and result in instantaneous raising up.
Subcision and TCA cross can be combined. Sometimes surgical excision of scars is required.
Radiofrequency – eMatrix, eTwo
The eMatrix sublative radio-frequency uses pins that rest on the skin and energy pulsed into the dermis. It does not penetrate the skin but works on heat energy creating a controlled dermal injury. The thermal energy breaks down scar collagen and stimulates fibroblasts to produce healthy collagen to plump up the skin for acne scar removal. Healthy collagen is particularly useful for new acne scars as it treats both acne and scarring, and prevents formation.
Skin Needling for Acne Scars
Skin needling does help with acne scars. However, the outcome is merely ok. Avoid the old skin rollers with newer Dermapen or other radio frequency dermal stamping, causing less trauma to the surface, faster healing. Darker skin types are safe to treat with non-laser treatments like dermal stamping. These technologies are useful for rolling acne scars.
TCA cross is a 100% TCA solution that is typically applied using a toothpick or fine needle. It is used for ice pick scar where the tether lies deep in the dermis. The TCA breaks down the scar collagen and stimulates new collagen production. Pitted scars and enlarged pore are also treated with TCA cross. Healing takes 4-5 days, and the process of collagen replenishment occurs over weeks to months after treatments.