Acne is the most common skin condition in the United States, according to the American Academy of Dermatology. Its severity can range from mild pimples during adolescence to severe outbreaks that last into adulthood and leave scars. At the same time, dermatologists have a range of treatments, from topical ointments to laser resurfacing. Treatment for scarring must be individualized, according to the academy, because the scars often have complex characteristics.
Punch Excision
In a punch excision, the doctor cuts out the scar with a punch biopsy tool. Approximately 1.5 mm to 3.5 mm of skin and scar tissue are removed, leaving a small hole that's either sutured or fitted with a skin graft. As the area heals, another scar often forms. But this scar is far less noticeable and can fade with time, unlike the original acne scar.
Punch Elevation
Punch elevation is another form of acne scar excision. The Patient's Guide to Acne Scars describes this procedure as similar to a punch excision, because it uses the same punch biopsy tool. But instead of removing all of the scar tissue, the doctor elevates the base of the scar and attaches it to the surrounding skin. This provides a more even texture after the incision has healed.
Uses of Each Method
The punch excision is typically reserved for icepick scars, which look like small puncture wounds. The punch elevation is used for boxcar scars, advises the Patient's Guide to Acne Scars. Boxcar scars look like large angular pores. Because of their size, simply removing the scar tissue may leave a depression or pit. Elevating the scar tissue provides a smoother appearance.
Follow-up
Acne scar excisions are often used in conjunction with other cosmetic treatments. Dermabrasion, microdermabrasion, chemical peel or laser resurfacing can be administered to help eliminate the scars left after a punch excision or punch elevation. These procedures all remove the surface layer of the skin, stimulating the production of new epithelial cells that are similar in tone and texture with the rest of the skin.
Considerations
As with any other type of surgical procedure, you'll experience some downtime, according to the Academy of Dermatology. Wounds take time to heal, and your doctor can better explain what to expect. You'll usually need to deal with some bandaging and caring for incision sites. Follow your doctor's orders for best results.
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