Acne patients often have many different sorts of scars. Different types of scars often require different treatments for optimum results. Scars that form deep pits are called ‘ice pick scars‘ and are a classic sign of acne scarring. Scars with a more angular edge, that are either shallow or deep, are called boxcar scars and commonly occur on the temple and cheeks. Scars that create a largely indented area are known as rolling scars. There are now many different ways to treat acne scars, and many patients require a combination of treatments to achieve the best results.
Dr Patrick Treacy was amongst the first to use CO2 fractionalsied resurfacing for ance scarring over 11 years ago. Ailesbury also uses dermaroller and microneedling.
- Ice-pick scars – these are deep, narrow, pitted scars
- Rolling scars – broad depressions with sloping edge
- Boxcar scars – broad depressions with with sharply defined edges
- Atrophic scars – flat, thin scars or depressed scars
- Hypertrophic or keloid scars – thick lumpy scars
How do you treat acne scars?
Ice pick and boxcar scars
- Laser resurfacing
- Punch grafting for deep scars
- TCA CROSS (Chemical Reconstruction Of Skin Scarring) uses precisely placed 50–100% trichloracetic acid
- Subcision®: a surgical technique in which the fibrous band under the scar is divided, allowing the skin to return to its normal position
- Larger scars can be excised (cut out) and the defect closed to form a scar in a thin line
Atrophic and rolling scars
- Soft tissue augmentation techniques such as hyaluronic acid, collagen, gelatin matrix and fat implants
- Skin needling
- Laser resurfacing (Er:YAG and ablative fractional lasers)
- Potent topical steroids applied under occlusion to the scar for a few weeks
- Intralesional steroid injections into the body of the scar
- Silicone gel dressings applied for 24 hours a day continously for some months
- Skin needling
- Cryotherapy (freezing)
- Surgical revision
Unfortunately, hypertrophic or keloid scars are particularly prone to recur even after apparently successful treatment.
Courtesy of DermNet NZ