Scars are growths--usually of fibrous tissue--that replace damaged skin. While their appearance often improves in half a year to 18 months, according to the American Academy of Dermatology, or AAD, they never completely heal. Nor can any treatment completely get rid of a scar, notes AAD. There are treatments available, however, that can minimize discoloration and shrink scars considerably. Appropriate treatment depends on the type of scar and other individual considerations.
Depressed Acne Scars
The three types of depressed acne scars are known as rolling, icepick and boxcar scars. Several procedures treat these types of markings on the skin.
The injection of fillers levels out depressions. Human or bovine collagen is a common filler, explains AAD, and while treatment provides immediate results, it usually is not permanent. Your own fat is another filler option, as is hyaluronic acid. Polymethylmethacrylate, or PMMA, is the only permanent filler, according to AAD's Skin Care Physicians site.
Some cosmetic procedures destroy scarred skin, allowing new skin to grow. While this leaves permanent markings, they are typically less noticable than the original scars. For depressed acne scars, these procedures include laser skin resurfacing, chemical peels, dermabrasion and microdermabrasion. Lasers, acid compounds, and rotating blades are the tools used, respectively.
Surgery also treats depressed acne scars. Various techniques are employed to cut out existing scars and leave flatter, smaller scars in their place. Sometimes, scarred skin can be elevated to be more even with surrounding skin; at other times, skin grafts are performed.
Keloid and Hypertrophic Acne Scars
There are two types of elevated acne scars. Keloids are thick, dark scars that spread beyond the boundaries of the injury, and are prone to recurrence after treatment, says New York Presbyterian Hospital, or NYPH. Hypertrophic scars are similar, but are confined to the boundaries of the injury.
Pressure therapy with bandages or pressure-inducing implements may help to shrink raised acne scars. This tactic must be employed almost completely around the clock for at least several months.
Raised scars may be destroyed with laser surgery or cryosurgery. The former is also useful for treating the discoloration of scars. The latter uses liquid nitrogen or other freezing agent to cause scar tissue to fall off.
Interferon or corticosteroids, injected into scar tissue, can help to shrink and soften acne scars. These are called "intralesional injections." Treatments are generally administered once every week or two over the course of several weeks.
Surgery also is used to remove raised scars. Skin grafts are sometimes performed after removal of large acne scars, notes NYPH. Because keloids are prone to growing back, additional treatments are usually necessary following surgery. These may include corticosteroid injections, pressure therapy or radiation therapy, explains Skin Care Physicians.
Additional Treatments
There are supplemental acne scar treatments, and others still are being tested for efficacy. Elevated acne scars may sometimes be improved with massage, used similarly to pressure therapy. Application of gels made with silicone may reduce some keloids, states AAD. Injections of 5-Fluorouraci can help to reduce hypertrophic scars, and occasionally keloids, according to Skin Care Physicians, which also mentions that a cream medication called Imiquimod has sometimes worked after surgery to prevent keloid recurrence. Radiation therapy, used on its own, is a possible treatment for keloids less than five months old, explains Skin Care Physicians.
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