Acne scar punch techniques are among the more commonly used procedures for pitted or depressed acne scarring. The scar is cut from the skin during punch surgery, so the results obtained are permanent. The idea behind all the punch techniques is to leave smaller, less noticeable scarring than what is already presented, which then fades more easily. These techniques may be used along with other treatments as part of a comprehensive program. All techniques may involve healing time, depending on the size of the procedure and how much aftercare, such as ointments and dressing changes, is needed.
Punch Excision
All of the acne scar punch techniques begin with a punch excision. During this procedure, a biopsy tool is used to remove the scar. According to "Punch and Grafting Techniques for Acne Scars" in "The Patient's Guide: Acne Scars," the size of the biopsy tool depends on the size of the scar, typically between 1.5 mm and 3.5 mm. The area is prepped and local anesthesia is applied. The biopsy tool, which is like a tiny cookie cutter, is then used to cut out the scar itself. The resulting small wound may be sutured together with a stitch.
Punch Grafting
Grafting may be done following punch excision instead of a suture. The skin graft is harvested from a donor site elsewhere on the patient's body. The tiny skin graft is then sewn into place in the wound created during punch excision. For larger punch excisions, this leaves a smoother surface than simply placing a stitch.
Punch Elevation
For deeper scars, punch elevation may be used instead of grafting. According to "Depressed Acne Scars: Effective Treatment Available" on the American Academy of Dermatology's AcneNet, during a punch elevation, the bit of scar tissue that was removed during the punch excision is elevated to the level of the surrounding skin and reattached. The idea behind this is that elevating the scar and reattaching it gives the skin a smoother appearance without the risk of discoloration associated with grafting.
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