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Acne Scar Treatment - Guide On How To Choose The Right Treatment

Updated on March 18, 2011

For starter, acne scars divide into two main categories – raised and depressed scars. Raised acne scars form above the surface of the skin. After a period of time, they grow bigger, more visible and can become painful and itchy. Depressed acne scars are similar to pits or depressions on the skin. As you get older, depressed acne scars will become even more visible. The type of acne scar treatment you and your dermatologist choose has to depend on what type of acne scars do you have. Check your scars. What type are they?

Hypertrophic scar
Hypertrophic scar

Acne Scar Treatment For Raised Acne Scars

There are two types of raised acne scars – a keloid and hypertrophic scar. A keloid is also referred to as „a scar that does not know when to stop“. Meaning it grows above the rest of the skin. Usually they are big, smooth on the top, very thick, purple or pink color are appear more in people with Asian, Latino and African origin. They can form anywhere on your body, but most commonly can be seen on shoulders, chest and upper back. It is easier to apply an acne scar treatment to keloids when they start appearing and the treatment is more effective.

If you have an older keloid (several years) then it could be more challenging to cure them and you are probably going to be seeing your dermatologist a lot. Hypertrophic scars unlike keloids are in line with the margin of the wound. Generally they are more red and become less visible as the time goes by. Before you and your dermatologist decide what acne scar treatment plan to apply there are a few factors which have to be considered: the scar location on your body, how big it is and how old is it. Based on these factors, the dermatologist will form acne scar treatment plan.

1. Acne Scar Treatment: Injections

More precisely intralesional injections are used to flat raised acne scars. Injections of corticosteroids can shrink raised scars and make it feel smoother. Injections of interferon will soften thick scars. The patient will receive several injections every couple of weeks (most commonly every 2-3 weeks), but that will depend on previously mentioned factors. If there are no visible changes regarding a particular scar after receiving 4th injection, then the dermatologist will stop with this type of acne scar treatment and advise you surgery.

2. Acne Scar Treatment: Surgery

This is not a complicated surgery, you do not have to go to the hospital as this can be done in dermatologist’s office, and after the surgery you can go home immediately. If you have a hypertrophic scar then surgery as acne scar treatment alone will be enough for scar removal. However, if you have a keloid, then surgery will not be enough. Unfortunately, it is very common for keloids to come back (45%-100%). That is why dermatologists use other types of acne scar treatment along with acne surgery. The additional acne scar treatment can be used after and prior to the surgery and may include:

  • Injections – this is one of the most effective acne scar methods for raised type of scar, particularly keloids. A patient receives either an injection of interferon or corticosteroids. The frequency of receiving injections is usually once a moth for several month after the surgery.
  • Pressure – this acne scar treatment requires wearing a pressure device or pressure garment which forms pressure to the keloid to prevent it from coming back.
  • Radiation – Several research studies have shown that when radiation is used as a form of acne scar treatment it can stop raised scars from returning.

3. Acne Scar Treatment: Laser Therapy

More and more dermatologists are using this type of acne scar treatment. The pulsed dye laser (PDL) will flatten both types of raised scars, reduce the color and stop the pain and the itching. If you have a lighter skin, apply IPL ( intense pulsed laser).

4. Acne Scar Treatment: Cryotherapy

What this method does is that is freezes the raised scar which leads to its death and eventually it falls off. Cryotherapy is applied in series. For best results, it is used in a combination with injections of corticosteroids. But, there is one disadvantage. Cryotherapy may cause that the treated area looks lighter than the surrounding skin.

5. Acne Scar Treatment: Creams & Gels

Many of these products can be used at home without a prescription. Gels and creams which contain silicone can minimize the itch. Gels and creams which contain tretinoin (you need prescription for this one) when used twice a day can reduce itch, pain and the size of the scar. A dermatologist may proscribe you with a corticosteroid along with tretinoin which gives better results. In order for creams and gels to work they have to be applied constantly. However, no cream or gel as acne scar treatment can remove the scar, it can only ease the discomfort and reduce the size of it.

Rolling scars
Rolling scars
Ice pick scars
Ice pick scars
Boxcar scars
Boxcar scars
Laser skin resurfacing
Laser skin resurfacing

Acne Scar Treatment For Depressed Acne Scars

There are three types of depressed acne scars: rolling scars, boxcar scars and icepick scars. Rolling acne scars look have a more wavy texture. Boxcar acne scars look like large enormous pores. Icepick acne scars leave deep pits with narrow openings. Acne scar treatments for depressed scars include:

1. Acne Scar Treatment: Surgery

One of the most effective methods when talking about treating depressed acne scars. What the dermatologist will do is switch a deep big scar with a smaller one which will be less visible and disappear after some time. When your treated scar heals after the surgery, the the dermatologist may use if necessary a laser therapy to diminish the scar.Usually a patient is given a local anesthesia or light sedation ( the patient is awake). It is possible that you will not be able to see instant results. You may experience some bruising for 2 weeks at most depending on the scar itself.

2. Acne Scar Treatment: Laser Skin Resurfacing

Laser skin resurfacing is an effective way of treating depressed acne scars. Studies have shown that it performs best on shallow boxcar scars and icepick scars. The least improvement was on deep boxcar scars, but still the final outcome was good. The recovery time depends which type of laser did the dermatologist use. Ablative laser will create noticeable wounds. Generally, people are fully recovered after 2 weeks and that is also the time they see first results.

3. Acne Scar Treatment: Fillers

This has become very popular acne scar treatment. They are effective and there is no recovery process, however they are only temporary. Your dermatologist can inject collagen, your own fat, hyaluronic acid, PMMA (polymethylmethacrylate) or another filler to plump up the scars. PMMA is the only permanent filler. Fillers last anywhere from 3-6 months. If you use your own fat to fill the scars the effect will last about 1-3 years, but to do that the dermatologist has to do a liposuction which requires a recovery process. After applying a filler acne scar treatment you can get back to your daily chores immediately. Swelling and bruising are normal, but do not touch treated area for 3 days.

Chemical peel
Chemical peel

4. Acne Scar Treatment : Chemical Peels

It is intended to peel of the upper skin layer. Some stronger chemical peels can even penetrate deeper into the skin. The only side effect is redness which depends on the strength of the chemical peel itself. In the next 2 weeks, new skin will grow. Chemical peels do require some upkeep, but you will be given detailed instructions. Most important thing is to avoid the sun to prevent infection.

5. Acne Scar Treatment : Microdermabrasion

This is a painless acne scar treatment and it is only used for extremely mild acne scars. Microdermabrasion will remove the upper skin layer, after that the skin will recover on itself and scars will be far less visible. Your skin may be pink or slightly red and you will be given instructions to stay away from the sun to avoid any possible side effects.

6. Acne Scar Treatment : Dermabrasion

Actually dermabrasion has not as used as much because it has been replaced by laser skin resurfacing but this does not main that it is not an effective technique for some acne scars. This is not done at dermatologist’s office, it is performed in a surgical center. It has to be performed very carefully, and if the entire face is treated then it will last about 2 hours. Expect to be recovering in the comfort of your home up to 7 days. You will get instructions on the follow-up care to get optimal results and prevent any side effects. It takes about 10 days for new skin to grow, and it keeps improving over the course of next couple of months.


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    • camdjohnston12 profile image

      camdjohnston12 6 years ago

      This is great information. I am glad to visit this page.

    • fucsia profile image

      fucsia 6 years ago

      Very detailed and useful page! Thanks for sharing!