Blemishes on skins definitely put a dent on one’s self-worth and self-esteem. While acne can be regarded as a form of skin disease, marks left by it on the skin are different because they become permanent; and are sometimes too difficult to treat. Luckily, dermatology has brought forth excellent procedures improving skins’ textures and greatly lightening scars. In this article, the main focus will be on the finest dermatological procedures recommended for the treatment of acne scars: how they work; their benefits; and considerations involved. 

Understanding Acne Scars

The skin heals in response to acne lesions, and such scarring is termed acne scars. There are two types of acne scars: 

  • Atrophic scars: These scars appear as depressions on the skin and are sub classified into: 

Ice pick scars: Deep, narrow, and pitted scars. 

Boxcar scars: Broad depressions with well-defined edges. 

Rolling scars: Wave-like depressions with sloping edges. 

  • Hypertrophic and keloid scars:Hypertrophic scars are more prominent acne scars caused by extra collagen supposedly deposited during healing. Knowing the type of acne scar is necessary for determining a decent therapy. 

Top Dermatological Procedures for Acne Scars

1. Laser Resurfacing 

Laser treatments are among the most effective for treating acne scars. There are mainly two types of lasers worked with in this application:  

  • In the ablative laser type (CO2 and Erbium YAG), it destroys layers of damaged skin, therefore stimulating collagen production leading to  smoother skin (Manstein et al. 2021).  
  • Non-ablative lasers (such as Fraxel and Nd:YAG) penetrate the skin without removing any skin layers, promoting collagen remodeling with minimal downtime (Wang et al. 2022). 

2. Microneedling 

Microneedling is a procedure whereby tiny needles create micro-injuries to the skin, hence triggering the natural healing response of the body and collagen production. Studies have reported considerable improvement of atrophic scars with microneedling, most notably in conjunction with platelet-rich plasma PRP treatment (El-Domyati et al., 2020). 

3. Chemical Peels 

Chemical peel procedures are done using several types of acids like trichloroacetic (TCA), glycolic, and salicylic acid so that exfoliation, and thereby superficial scarring, can be reduced. Medium-depth type of peel, specifically with TCA CROSS (Chemical Reconstruction of Skin Scars), is more effective against ice pick scars (Leheta et al., 2019). 

4. Subcision 

Subcision is a minor surgical procedure designed to treat rolling scars. It involves the insertion of a needle under the scar to break fibrotic strands holding the skin down in order to allow collagen to fill up any depressed area over time (Rendon et al., 2021). Subcision is also used in conjunction with fillers or microneedling to optimize outcomes. 

5. Dermal Fillers 

Fillers based on hyaluronic acid will be injected into atrophic scars to fill them temporarily and also smoothen skin texture. They are particularly useful for rolling and boxcar scars (Juhasz & Cohen, 2021). Even though their effect is temporary, they can give an instant cosmetic improvement. 

6. Radiofrequency Microneedling 

The Radiofrequency Microneedling (RF) microneedling procedure consist of conventional microneedling in conjunction with RF energy for heating the skin to stimulate collagen production and tightening. This method is preferable for treating deep acne scars and can be safely used in darker skin types with a low risk of inducing hyperpigmentation (Gold et al. 2020). 

7. Dermabrasion and Microdermabrasion 

  • Dermabrasion involves the removal of the outer layers of skin using a rotating abrasive device and is efficient in the treatment of more severe scars (Katsambas et al., 2020).  
  • Microdermabrasion is a milder form of abrasiveness that removes dead skin cells from the surface of the skin and is better suited for very mild scars. 

Choosing the Right Treatment 

Acne scar treatment options vary according to the type of scar, skin type, severity, and patient preferences. Usually, best results would emerge from a combination of treatment modalities. For instance, a combination of laser resurfacing and microneedling, or, conversely, subcision and fillers usually accomplishes better improvement than any single one of these procedures alone. 

Today, treatment advances in dermatology greatly enhance the possibilities with acne scar correction. Laser therapy, microneedling, and subcision are only a few of the techniques that can be used to treat several types of acne scars. Consulting a dermatologist is necessary so that one can really find out the best way according to whether or not the individual has skin concerns. There is always the advancement in research and technology, and with time, the acne treatment options will keep improving to better cater to the needs of patients who want smoother skin. 

References

  1. El-Domyati, M., Abdel-Wahab, H., & Medhat, W. (2020). Microneedling combined with platelet-rich plasma for atrophic acne scars: A randomized split-face clinical study. Journal of Dermatological Treatment, 31(6), 648-654. https://doi.org/10.1080/09546634.2019.1590532 
  2. Gold, M. H., Biron, J. A., & Hanke, C. W. (2020). Radiofrequency microneedling: A review of technique and applications. Dermatologic Surgery, 46(9), 1191-1200. https://doi.org/10.1097/DSS.0000000000002549 
  3. Juhasz, M. L., & Cohen, J. L. (2021). Dermal fillers for the treatment of acne scars: A review. Journal of Clinical and Aesthetic Dermatology, 14(5), 30-35. https://doi.org/10.25251/jcad.14.5.3 
  4. Katsambas, A., Dessinioti, C., & Antoniou, C. (2020). Dermabrasion and microdermabrasion for acne scars: Efficacy and limitations. Clinics in Dermatology, 38(2), 231-237. https://doi.org/10.1016/j.clindermatol.2019.11.008 
  5. Leheta, T. M., Abdel Hay, R. M., & Hegazy, R. A. (2019). TCA CROSS technique for atrophic acne scars: A comparative study with fractional CO2 laser. Journal of Cosmetic Dermatology, 18(6), 1678-1684. https://doi.org/10.1111/jocd.12985 
  6. Manstein, D., Herron, G. S., Sink, R. K., Tanner, H., & Anderson, R. R. (2021). Fractional photothermolysis: A new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers in Surgery and Medicine, 53(3), 238-245. https://doi.org/10.1002/lsm.23498 
  7. Rendon, M. I., Torres, A. E., & Bruce, S. (2021). Subcision: An effective treatment for rolling acne scars. Dermatologic Clinics, 39(1), 79-88. https://doi.org/10.1016/j.det.2020.08.003 
  8. Wang, Y., Li, Y., & Wu, X. (2022). Fractional laser therapy for acne scars: A systematic review and meta-analysis. Aesthetic Surgery Journal, 42(1), 56-68. https://doi.org/10.1093/asj/sjaa254 

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