Your Guide To Acne Scars Treatment

Acne scarring is the most undesirable lifetime psychological complication of ruptured acne. This abnormal process of the body to repair and heal damaged skin cells as a result of acne breakage has proven to be an emotional burden affecting the way people see themselves. Thanks to advances in acne scars treatment, the emotional misery does not have to last a lifetime.

Scarring occurs when papules, pustules, nodular and cystic acne erupt and break at the deeper dermal follicular wall. As acne breakouts occur, the dead skin cells, sebum, cellular debris and bacteria spread and destroy healthy keratinocytes or skin cells. This inhibits their ability to rejuvenate and fuse together normally. This forces the body to compensate by producing excessive fibrous collagen formation.

In fact, the severity of inflammation determines the degree of scarring. More inflammation means more damage to the follicular wall in the event of acne breakouts.

Classification of Acne Scars

Collagen build up is meant to repair damage skin tissues. However, this healing process cannot perfectly replicate normal skin rejuvenation. The fibrosis formation results to rough and jagged skin texture. When loss of skin tissue occurs, it leaves gaps and spaces that are visibly obvious. These scars are categorized as Atrophic acne scars. Examples of which are, Ice pick scars and Box car scars.

Ice pick scars are steep and narrow scars that measure less than 2mm in diameter. They are sharp and extend down into the dermis or even in the subcutaneous layer. They appear to have been “punctured” resembling an ice pick wound stab.

Box car scars have jagged, angular, bolt upright edges which may either be deep or shallow in depth.

Rolling scars are formed when collagen bands of tissues are formed on the dermis, which pulls and binds the epidermis to the deeper tissues of the skin. This creates a wave-like or rolling impression on the skin surface.

However, when there is excessive collagen build up on the skin surface, formation of keloidal or hypertropic acne scars arise. They appear as elevated, lumpy and thick scar tissues.

Treatments

Acne scar treatment is absolutely dependent on the type of scar and the depth involved. Different methods are used by trained professionals and dermatologists in lessening scar tissues.

Chemical resurfacing or Chemical peels uses exfoliants such as Glycolic Acid or Alpha Hydroxy Acids (AHA), Salicylic Acids, Phenol and other powerful synthetic and natural compounds. This non-invasive procedure involves controlled sloughing of scar tissues. Collateral damages on the surrounding healthy skin are common, however, normal rejuvenation and health skin growths take place after a few weeks of therapy. When undergoing this procedure, skin photosensitivity is common. It is advised to avoid prolonged exposure to the sun to prevent first degree sun burn.

Dermabrasion involves a guided and controlled mechanical exfoliation on the layers of the skin. There are various methods used. Manual Dermabrasion uses specially-manufactured sandpaper made of Silicone Carbide that cautiously abrades the mid-depth skin scars. It is often used adjunctly with other techniques such as Motorized Dermabrasion, and the use of infrared red wave length bands such Erbium:YAG and Carbon Dioxide or CO2 laser technology. Another abrasion technique is Motorized Dermabrasion. It uses a special wire brush that rapidly spins and revolves. This is effective for chafing off acne scars at the epidermis layer. Before any of these procedures are to be performed, local anesthesia is applied, as pain is expected because of friction. Post-procedure side effects include dermal photosensitivity, skin redness and dryness, a residual stinging sensation, as well as some bruising. Complete rejuvenation may take place in 2 weeks to a few months.

This procedure is helpful against superficial Ice pick scars. However, most Ice picks scars look narrower on the surface but they are wider at their base. Dermabrasion may not completely remove the scars but you will notice improvements. Skin looks smoother and more refined and less obvious than before.

Another option that may be used is Microdermabrasion, or also called as Micro-Resurfacing or Mechanical Exfoliation.. This procedure requires Aluminum Oxide crystals to be placed into the scar by a machine. Dead skin cells on the epidermis are absorbed by the oxide crystal compounds, and are then suctioned off. This rapid sloughing stimulates collagen production on the epidermis. Another medium may be used as well, such as Diamond Tips, Sodium Bicarbonate and Sodium Chloride Crytals. These are safe and there is no danger of accidental inhalation or absorption deep into the skin. However, this method is not suited for deep scars. It is useful only for shallow scars.

Laser resurfacing techniques or Laser peel, uses focused, infrared red light wave energy in eliminating superficial dead skin cells and fibrous scar tissues on the superficial and medial layers of the skin. This light energy wave action triggers new formation of skin cells. This procedure is generally safe as the light wave energy used is well-controlled and set to a level that is tolerated by the skin. To avoid complications such as erythema and skin dryness, collateral scarring, skin pigmentation problems and infection, a skillful and experienced physician is needed to make this procedure even safer. After the procedure, scars now look smoother and the depth becomes shallower. Full rejuvenation is usually completed within two weeks. However, when used for deep scars, results are less promising.

For severe and depressed scarring, acne scars treatment involves invasive procedures such as minor surgery and injections.

Dermal Filler. This technique uses substances that are compatible with human skin that “fills” the skin depression. This is done by injecting at the apex of the scar, filler substances such as hyaluronic acids, bovine collagens and cymetra, which is derived from human skin. It lifts the scar up, making it uniformly leveled with the surrounding skin surface. Results are temporary though, several sessions are needed for a couple of months.

Subcutaneous Incision is a minor surgery that uses cutting instruments such as a scalpel or needle that detaches the epidermis from the deep skin tissues of the dermis layer. This done by cutting off the collagen fibrous scar tissues that links the two skin layers together. Once the fibrous bands had been cleaved off, this instantaneously uplifts the depressed skin up. Subscision, its short cut name, is usually carried out the influence of local anesthesia.

Punch Excision is minor surgical procedure that removes scar tissues and surrounding healthy skin. The skin on the wound site is then sutured together. This leaves a surgical scar but it is less obvious than the scar that was excised. As the suture site heals, the skin site becomes smoother and even.

Punch Excision and Grafting. This is exactly the same procedure used during punch excision. The only difference is that a skin graft is used to cover the surgical site instead of a suture. The skin behind the patient’s own ear is usually used to graft the excision site.

Punch Elevation. This is another variation of punch excision. Scar removal is accomplished excising scar tissues below the scar site. The surgeon then elevates the skin, and joins the wound edges together with steri-tapes or skin glue. Skin rejuvenates in 3 weeks and scar tissues become less obvious in about a month after the procedure.

Corticosteroidal therapy. For hypertrophic acne scars, intralesional cortisol injection are effective in shrinking or condensing scar size. Topical steroidal creams and gels as well as tapes, which are filled with cortisol, are placed on the scar surface.

Generally, superficial scarring or top portions of deep scars are improved by chemical peels, dermabrasion, microdermabrasion and laser resurfacing. These procedures, with the exception of chemical resurfacing, are also applicable against mid-depth acne scars. For deep ice pick scars, punch techniques had proved their effectiveness in dissipating this kind of scar. For Box car scars, dermal fillers and punch elevation that elevate skin depressions at even with the skin surface are commonly performed. Subcision, which removes fibrous bands between the epidermis and dermis or subcutaneous layer, is the standard surgical intervention for Rolling scars.

Ultimately, the type of acne scars treatment to be performed is a call to be made by your dermatologist. With proper medical and surgical interventions, the journey in having a clearer, smoother and beautiful skin is never far away.