Acne scarring often has profound effects on self-confidence and can even affect people’s behavior. Fortunately, by using a combination of treatment options, we are able to improve the appearance of most body and facial acne scars.
There are many different types of acne scars. Some are sharply dimpled “ice pick” scars, some are larger and flatter with varying degrees of depression, and others have a “rolling” appearance. Some acne scars are firm and elevated, while others are red or purple. Therefore, it is not surprising that there is no single acne scar treatment or procedure that will give optimal improvement of acne scars. A combination of surgery, laser treatments, and medical procedures can be employed to achieve ideal outcomes.
Non-Surgical Improvement of Acne Scars
Some scars can be treated with topical products, injections, or laser resurfacing treatments to improve texture. Additionally, newer laser resurfacing technologies can also improve the appearance of scarred skin without the longer recovery times associated with traditional laser skin resurfacing. Injection of soft tissue fillers can counteract the effects of acne scarring by filling depressed acne scars. Laser therapy targets the color of scars, reducing discoloration.
Surgical Removal (Excision) of Acne Scars
Treating ice pick type scars typically requires surgical excision as there are no lasers or technology-based approaches which will provide adequate correction of these scars. Removal of ice pick type acne scars is performed in the office with the aid of local anesthetic injections. As the scars are removed, sutures are used to repair the skin, converting the deep ice pick scar to a smoother, less depressed scar. Large numbers of ice pick scars can be removed during a single visit and typically, only 1-2 stitches are required at each surgical site.
Subcision Treatment Method for Acne Scar
The scars that are not deep enough to require removal, but are too deep respond well to laser treatment alone, are treated with a technique called subcision. Subcision is an in-office procedure to release the scar from the underlying skin. This allows the depressed area to become somewhat shallower as the firm attachments holding the scar to the deeper tissues are released. Dr. Biesman often uses collagen-stimulating drugs in combination with this procedure to maximize collagen formation and further improve results. Stitches are not required following subcision. Bruising and swelling may occur following both removal and subcision of acne scars.
Dr. Biesman customizes a combination treatment plan specific to each patient’s type of acne scarring and overall aesthetic goals. We often say this is a marathon and not a sprint! Patients can combine multiple procedures, such as subcision and laser, on the same day for optimal outcomes.