For decades, acne was considered a rite of passage – and the residual scars served as a near-constant and unwanted reminder of breakouts past. As many as 20 million Americans have acne that is bad enough to cause scars, but an influx of new treatments are is helping diminish the physical and emotional scars associated with acne.
“Acne scarring is a problem that has plagued plastic surgeons and dermatologists for a long time, without many easy and effective treatments,“ says Anthony Youn, MD a board-certified plastic surgeon in Troy, Michigan. “These new treatments give practitioners several options in their armamentarium to treat a troublesome and frustrating cosmetic problem.”
Soft Tissue Fillers
Bellafill®, a semi-permanent polymethylmethacrylate (PMMA) collagen filler, recently scored the US Food and Drug Administration’s nod for the correction of acne scars.The type of acne scars that are best treated with Bellafill are depressed and need to be filled. These may include rolling, boxcar, and ice pick scars. Boxcar scars have sharp cliff-drop-like vertical margins and a large, flat base. Rolling scars are wide and shallow and create a wave-like appearance. Ice pick scars are deep and narrow and form pits in the skin. Bellafill restores volume from the inside-out and the outside- in. The injections stimulate the body’s own collagen production, while filling in the scars.
Lasers and Energy–Based Devices
Syneron-Candela’s Sublative technology uses bi-polar fractional radiofrequency (RF) to treat depressed acne scars. The RF energy is delivered beneath the surface of the skin to maximize collagen production while leaving the top layer of the skin intact. There is minimal injury to the skin as the scar remodeling takes place under the surface. Several treatments may be needed to minimize acne scars. “As an early adopter of the Sublative technology it’s been a real delight to have been at the forefront of this revolutionary technology and see it evolve to serve as my staple treatment for my acne scars patients,” says Michael Gold, M.D., board certified dermatologist and Medical Director at the Gold Skin Care Center in Nashville, Tennessee. “While there are nonsurgical and surgical methods to treating a wide range of superficial to defused acne scars, my go-to-treatment is Sublative due to its exceptional results, minimal downtime and unmatched safety.”
Fractionated lasers can also treat acne scars. These lasers trigger a controlled-wound healing process that galvanizes the skin to build new collagen, which fills in and repairs indented scars. Several treatments may be required.
Another laser, the PicoSure, is FDA approved for the treatment of acne scars. This treatment boosts the density and length of elastin fibers and increases collagen production to help fill in depressed ace scars. Several treatments are needed.
According to Judith Hellman, a New York based dermatologist, “The Fractora device from Inmode Aesthetics uses bipolar radiofrequency energy to reach specific depths in the skin, which is very effective for treating depressed acne scars. There are several tips with various depths and pin density configurations, so we can tailor the treatment to the individual’s needs.”
Microneedling with growth factors can also treat acne scars, Youn says. A microneedling roller or pen delivers tiny pin pricks to stimulate the skin’s natural healing process and stimulate the growth of collagen. Some skin care doctors apply growth factors to the skin as microneedling aids in a more effective delivery of substances that further ramps up collagen production.
Another type of acne scar occurs when there is too much collagen. These are called hypertrophic scars and keloid scars, and they are treated differently than depressed acne scars,
Treatment may include injections of corticosteroids to soften and flatten raised scars. Acne surgery may be needed to remove these scars. Other options may include pulsed dye laser (PDL) to reduce the itch and pain, diminish the color, and flatten a raised scar. Intense pulsed light (IPL) and cryotherapy (freezing the tissue) may also help improve the appearance of raised acne scars. Gels, creams, and tapes that contain silicone reduce the itch and discomfort of both hypertrophic scars and keloid scars. Often, your doctor will suggest a combination of these procedures to get rid of these raised, red scars.
There are more treatments available than ever before to treat acne scars. Talk to your dermatologist or plastic surgeon to determine which is right for you. Most will tell you that treatment should only start once the acne is resolved.