Acne scars are emotionally and psychologically challenging affecting quality of life and self esteem. Let us understand acne scars better before knowing treatment options.
Acne arises from a sebaceous gland (oil gland) present in Dermis of skin ( 2nd layer). Any inflammation in this layer can lead to scarring as this is the permanent layer of skin compared to outer layer. So, when acne appears there is lot of inflammation with infection and pus formation. In uncontrolled acne these become bigger with cluster of acne leading to scarring. Body tend to heal these acne with fibrosis and permanent band formation which will keep anchoring skin to deeper structures.
There are four types of scars generally described
- Rolling scars: respond best to treatment
- Ice pick scars: respond poorly to treatment
- Box scars: respond moderately to treatment
- Hypertrophic or Keloidal - Resistent to treatment. These scars can’t be treated by applying any creams over the skin as the problem is fibrous bands beneath the skin, so treatment should also be beneath the skin.
Best treatment options for acne scars.
In my experience acne scars respond best to following treatments.
- MNRF (Micro Needle Radiofrequency)-In this treatment Radiofrequency is used through gold plated sterile needles. This works on the principle of micro needling with heat energy which breaks fibrous bands by coagulation of proteins leading to collagen remodeling. Need 4-8 sitting at a gap of 4-6 weeks for optimal results.
- Lasers- Erbium glass and Co2 laser are proven lasers for acne scar treatment. They work on the principle of thermal energy and collagen remodeling. They also need 4-8 sessions for good results.
- Dermaroller – In this treatment a one time use sterile dermaroller is used .The roller is rolled over concerned area multiple times in a specified manner causing micro injury and collagen remodeling.
- Subcision – It is done with a needle where a sterile needle is passed at the scar level to cut the fibrous bands and release the pull .
- Other treatment options- PRP, Microdermaberation, Chemical peels ,Dermaberation and Dermal fillers.
All these treatment are done by applying local Anesthetic cream 45 mins before treatment.
All these treatment have down time of 3-7 days as there can be redness and swelling.
Contra indications for acne scar treatment
- Keloidal tendency
- Active vitiligo
- Local infections
- Pregnancy and lactation
- Other medications and health conditions etc
So, let your dermatologist take a call on treatment options.