Acne is a common skin condition, especially among teenagers. However, not everyone develops the scarring that can occur after outbreaks, and it can be almost impossible to predict which patients will scar. Because there are many ways to treat acne scarring, it is important that patients choose a cosmetic surgeon who is skilled at a wide variety of procedures.
There are many different types of acne scars. Deep narrow pits that develop following an acne lesion are called “ice pick scars”, and are a classic sign of acne scarring. Angular scars (boxcar scars) usually occur on the temple and cheeks, and can be either superficial or deep. Scars that give the skin an undulating appearance are known as “rolling scars”. Many people require a combination of treatments for the best results.
Dr. Daniels is skilled in diagnosing and treating all types of acne and can develop a comprehensive treatment plan to improve the texture and overall appearance of your skin. We have the most recent and innovative techniques and equipment needed to treat our patients.
Rolling Acne Scars
Rolling acne scars are the subtle or sometimes pronounced undulations that occur in acne prone skin. These are often the scars that are the most noticeable in various types of room lighting. Injections with soft tissue fillers, such as Restylane, may provide temporary relief from rolling scars. In addition to Restylane, other injectable substances such as Silicone can be used to improve the appearance of depressed scars. It is often best to use this therapy in combination with other cosmetic procedures for acne scars. Scars can be dramatically improved with fractional resurfacing using the Fraxel laser or the Lumenis’ Active/Deep FX laser. These are safe and effective devices that help to rebuild new collagen and smooth the surface of the skin.
Boxcar Acne Scars
Boxcar Scars are usually small, clearly defined indentations in the skin. They can occur anywhere on the face, most notably on the temples and cheeks. Treatment of shallow boxcar scars can be accomplished with laser resurfacing, but deeper boxcar scars are best removed surgically. Direct excision with suturing can remove the depressed area of skin bringing normal skin together creating a smoother surface. Boxcar scars also respond nicely to a combination of fillers and fractional resurfacing.
Ice Pick Acne Scars
Ice pick scars are the most difficult type of acne scars to treat. Surgical removal of the scars is a definitive treatment, however many patients benefit from laser resurfacing following the surgical excision. The Cross method is a technique whereby 90% Trichloroacetic acid (TCA), a solution used for chemical peels, is applied to the individual scars. The treated area will be red and small crusts form which last 4-7 days. Trichloroacetic acid stimulates the growth of new collagen and after four to six treatments the appearance of the scars is improved.
Laser Resurfacing for Acne Scars
Laser resurfacing is one of the most useful techniques in the treatment of acne scarring. With this procedure, thin layers of skin are removed, layer after layer, until the scars improve or disappear. At the same time the skin tightens to help smooth out the scars. Laser resurfacing is great for treating shallow “boxcar” and “rolling” acne scars, as well as smoothing and tightening scars that have been treated with other surgical modalities such as subcision and excision. For individuals who are interested in a laser procedure for acne scars, but are interested in a less invasive procedure, fractional resurfacing offers the potential for significant improvement.
Fractional Laser Resurfacing
Dr. Daniels is thrilled to be able to offer two effective options in fractional resurfacing technology. Fraxel:Restore and Lumenis’ Active/Deep Fx both work similarly to traditional laser resurfacing, but are gentler, less involved, and have a shorter downtime after treatment. Each helps to stimulate new collagen to grow, eventually leading to smoother and more beautiful skin. There are several differences between these lasers, Dr. Daniels will evaluate your skin and develop a treatment plan that is most beneficial for you. For more information on fractional resurfacing see the “Fractional Resurfacing” information sheet.
Acne scarring is an unfortunate complication of acne breakouts, however with recent advancements in technology there are now very safe and effective treatments to improve the appearance of your skin.