Acne scarring is especially problematic for people who have gone to great lengths or who have waited a long time to find a treatment for acne itself. Dermatologists will often recommend more than one type of treatment for depressed or indented acne scars, and individual treatment plans are based on the type and severity of depressed scars as well as the skin type of the patient.
Scar Types
According to Dermaxime.com, depressed scars are caused by a loss of tissue during the healing of acne and give the skin an uneven appearance. Depressed scars are not all the same, and therefore, treatment for depressed scars will depend on what types of scarring have occurred. Indent scars may be ice pick scars, which are deeper but narrower and given the skin a more jagged appearance. Box scar scars are indented scars with clearly defined edges that look similar to chickenpox scars. Rolling scars give the skin's surface an uneven or rolling appearance.
Punch Procedures
A dermatologist may perform outpatient surgery to improve the appearance of skin by removing or reducing acne scars. A punch excision involves using a small, round tool similar to a cookie cutter to remove the scar completely. Following punch excision, the doctor either places a stitch that will leave a smaller, less noticeable scar or will use a punch graft or punch elevation technique. With a punch graft, the doctor replaces the small area of skin lost during the scar removal with a graft of the person's own skin. During punch elevation, the underlying skin is elevated to the level of the outside skin so that the skin will heal and have a more even appearance.
Subcutaneous Incision
Subcutaneous incision can be done to even out the skin's surface and is especially effective with rolling scars where there is no clearly defined outline to the scar. According to SkinCarePhysicians.com, during a subcutaneous incision, the doctor inserts a surgical probe under the skin and uses it to separate the underlying scar tissue from the rest of the skin. This elevates the skin and flattens the previously scarred surface.
Fillers
A dermatologist may use fillers to smooth fill acne scars and smooth the skin. Treatment with fillers is often temporary, so treatment usually needs to be repeated. There is no downtime when using fillers as an acne scar treatment. The doctor injects a solution of collagen or collagen substitute into the area of the scar. This solution then plumps up the scarred area and promotes new collagen production as well.
Laser Resurfacing
Laser resurfacing is sometimes used alone or as part of a comprehensive treatment plan for treating indented acne scars. With laser resurfacing, a laser is used to remove outer layers of skin. When the new skin forms, it is often smoother and scarring is reduced. The skin continues to improve over the year following laser resurfacing treatment.
Other Treatments
Chemical peels or dermabrasion are sometimes used to treat acne scarring. During a chemical peel, an acid is used to remove the top layer of skin, allowing new skin to form in its place. According to SkinCarePhysicians.com, dermabrasion has been replaced for the most part by laser resurfacing, but some dermatologists still recommend this method for treating acne scars. Dermabrasion involves using a hand-held device containing a small, sharp blade is used to remove the top layers of skin. Patients undergoing dermabrasion are often either sedated or put under anesthesia.
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