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Acne Scars Management: A Review of Medical Treatments

Acne is the most common skin disease in the world, affecting more than 50 million Americans in the United States alone. Acne often begins around puberty and it can affect people until they are in their early 20s. There are some adults who continue to get acne well into their 30s, 40s and even 50s. It is also possible to get acne for the first time as an adult.

What causes acne?

There are about 2,500 to 6,000 sebaceous glands per square of the skin. These glands secrete an oily matter called sebum. When sebum, dead skin cells and bacteria are stuck in the pores or hair follicles, inflammation may occur, leading to acne.

Sometimes when there is a breakage in the wall of the pore, deeper lesions may occur, resulting in more serious inflammation of the skin. 

acne treatment

These blockages and inflammation of the pores result in acneic skin, ranging from blackheads and whiteheads, to pimples, pustules and cystic acne. 

How about acne scars?

Scarring of the skin is often a result of poor management of acne vulgaris. The general lack of knowledge about how to care for acneic skin as a teenager can have disastrous consequences, often leading to permanent scarring of the skin. 

The body reacts to these lesions by forming new collagen fibers in an attempt to repair the damage caused by the inflammation. Unfortunately, the newly formed skin is often not as smooth or flawless as before.

Treatments for acne scars

The following treatments are suitable for mild acne scars.

CHEMICAL PEELS remove superficial layer of old skin by applying a thin layer of strong acid on the skin. The new skin that replaces the old skin is usually softer and smoother. However, with newer, more advanced technology, chemical peels are rarely used for the sole purpose of acne treatment.

  • Cost: $
  • Effectiveness: 1/5
  • Downtime: 2/5

MICRODERMABRASION is a therapist treatment that involves using a machine with a pen-like device that has an end with tiny rough particles to gently abrade the uppermost layer of the skin. 

Microdermabrasion
  • Cost: $
  • Effectiveness: 1/5
  • Downtime: 1/5

The following treatments are suitable for moderate acne scars.

LASER SKIN RESURFACING is a technique that directs short, concentrated pulsating beams of light on the skin to precisely remove superficial layer of the skin. Such ablative laser treatments are usually carbon dioxide (CO2) or Erbium. 

If you have active acne or if you have dark skin, you may not be a suitable candidate for skin resurfacing treatment.  

  • Cost: $$$
  • Effectiveness: 3.5/5
  • Downtime: 4.5/5

PICO LASER may yield better results with less downtime as compared to skin resurfacing treatments. Pico laser delivers short laser pulses that are 10 times shorter in duration than a traditional Q-switched laser. This means that more laser pulses can be delivered with each pulse staying on the skin for a shorter period of time, causing less damage to the skin tissue.

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The aim of Pico laser treatment is to stimulate collagen and elastin production with increased precision, causing less damage to the surrounding healthy skin.

  • Cost: $$$$
  • Effectiveness: 3.5/5
  • Downtime: 3/5

The following treatments are suitable for severe acne scars.

PUNCH EXCISION involves creating a punch-like hole into the skin to specifically remove a deep acne scar and then stitching the wound. When the wound heals, the appearance of the deep pitted scars will be less visible.

  • Cost: $$
  • Effectiveness: 4/5
  • Downtime: 5/5

MICRONEEDLING is a procedure that uses micro-needles to create tiny puncture wounds in a controlled manner. INFINI is an excellent microneedling treatment that administers tiny amount of radiofrequency energy into the dermis with an adjustable depth of 0.5mm to 3.5mm to stimulate collagen production and elastic fibers to reduce scar tissue.

People with deeper, more severe scars will benefit from INFINI scar treatment because it can reach the fibrous scar tissue that is often found in the deeper layers of the skin. INFINI uses flow needled technology to deliver radiofrequency waves to stimulate collagen production to plump up the skin during the recovery process.

  • Cost: $$$$
  • Effectiveness: 4.5/5
  • Downtime: 4.5/5
Subcision

SUBCISION is a low-cost, simple solution in which a special needle is used to break down the fibrous bands of tissue that is pulling down the skin, giving rise to uneven appearance and indentation of the skin. 

Once the fibrous bands are broken down, the skin will heal and newer collagen will be produced, plumping the skin to improve the overall appearance of the skin.

  • Cost: $$
  • Effectiveness: 4.5/5
  • Downtime: 4.5/5

DERMAL FILLERS can drastically and immediately improve the skin’s appearance. The doctor injects a suitable soft filler directly into the acne scar to plump up the skin. 

Hyaluronic acid fillers such as Restylane and Belotero fillers are used to fill the depression on the skin. However, doctors can also use another type of fillers called Rejuran or Rejuran S to fill deep pitted scars. Rejuran Healer contains polynucleotides which are DNA compounds to repair damaged cells and stimulate collagen production. Rejuran S is a more concentrated version of Rejuran Healer, which makes it ideal for treating acne scars.

  • Cost: $$$$
  • Effectiveness: 4.5/5
  • Downtime: 3/5

Most people have different types of scars and it may require different treatments to provide a more effective and holistic treatment. Speak to your doctor today to understand what scars you have and work out a treatment plan that is suits you in terms of your budget and expectation. 

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