Acne Scar Treatment
Acne Scarring treatment should always be deferred until all active acne has been eradicated and there are no further major outbreaks.
As a cosmetic clinic that regularly sees the psychological effects that acne scarring inflicts on patients, it is disappointing that General Practitioners whom acne sufferers usually first consult, are not allowed to prescribe the drug (Government regulations prevent us from mentioning it by name) which can bring about a permanent cure of acne BEFORE scarring develops.
Your complete guide and quick links to everything you want to know!
What Causes Acne Scarring?
Unfortunately, once Acne Scars develop, there is little chance they can all be completely removed. In most cases, the best we can offer are treatments to reduce the scarring and make it less noticeable. That is why it’s so important to treat acne very early and prevent scarring from occurring in the first place.
Basically, the shape and depth of your acne scars as well as your skin type, will determine which acne scar treatment, or combination of treatments, is best for YOU. As most people have a variety of scar shapes and depths, more than one type of treatment may be necessary to deliver the best possible improvement.
At your Initial Consultation, our doctor will assess your skin and the shapes of your scars and then explain which acne scar treatment, or combination of treatments, is the most appropriate for YOU.
What Determines The Best Acne Scar Treatment?
Essentially, the shape and depth of your scars as well as your skin type will determine which treatment, or combination of treatments, is the most appropriate.
‘Hypertrophic (Raised) Scars’ respond best to surgical excision or Laser Resurfacing. As most acne scar sufferers have a variety of scar types, more than one type of treatment is often necessary.
‘Rolling’ or ‘Valley’ Scars are difficult to remove with any form of skin resurfacing such as Chemical Peeling or Laser Resurfacing. We have find that filling the depressions, sometimes in combination with Subcision, to raise the depressions to the level of the surrounding skin surface are usually the best option for this type of scar.
‘Ice-Pick’ Scars are small, deep pitted scars. Punch excision is usually the best option to remove these unless they are very shallow in which case Laser Resurfacing could be a consideration.
‘Boxcar’ or ‘Crater’ Scars, if very shallow, may improve with Laser Resurfacing, otherwise, surgical excision may be the better option.
At your initial consultation, our doctor will assess both your skin and your scars and then explain which treatment, or combination of treatments, you may consider.
Acne Scar Treatments
Subcision With/Without Filling
Subcision with/without filling of the scars is a special form of treatment that can help particular types of acne scars which are tethered to the skin’s deeper skin layers by fibrous bands of scar tissue.
As depicted in the illustration left, after first numbing the area with a local anaesthetic, a special needle is inserted under the scar and moved from side to side to divide the bands of scar tissue that are tethering the scar.
After division of the tethering bands of scar tissue, the scar is filled under its base. This not only serves to raise the scar up to the level of the surrounding skin surface, it also keeps the divided bands of scar tissue apart and prevents them from re-uniting.
Subcision is performed in the privacy of our Clinic’s own Operating Theatre under Local Anaesthesia only.
Laser Resurfacing
Laser Resurfacing is one of our most frequently requested treatments for Acne Scarring. It delivers its best results with shallow ‘pitted’ and shallow ‘crater’ acne scars. It is only minimally effective on ‘valley’ shaped scars. Laser Resurfacing to small areas of the face can be performed under Local Anaesthesia +/- Mild Sedation.
However, if Cheeks or Full Face need to be resurfaced, this is best done in a Licensed Day Hospital under General Anaesthesia administered by our Specialist Anaesthetist. In either situation, you can go home 1-2 hours after your procedure.
Laser Resurfacing requires 9 days of downtime following which you will return to the Clinic for a check and have a cream prescribed to settle the normal post-operative redness.
At Sydney Cosmetic & Plastic Surgery Clinic, we use the computerised Fraxel ‘Repair’ CO2 Laser for the treatment of Acne Scarring.
Being a Fractional CO2Laser, it removes only microscopic columns of skin and leaves intact skin in between to initiate the healing process, shorten recovery time, and reduce the chances of hypopigmentation (loss of skin colour).
Please note that the ability of the laser to remove acne scars will also depend on their depth because the laser cannot remove scars that extend deeper than the laser can safely reach.
Realistically, you can expect a reduction in the number and depth of the scars and not that every acne scar will magically disappear with laser resurfacing.
PLEASE NOTE: Laser Resurfacing may not be an option for those with brown or Asian skin because of the risk of hyperpigmentation complications.
Surgical Excision
Surgical Excision is an option for acne scars that are either too deep or will not respond to other treatments and are performed under Local Anaesthesia in our Clinic’s own Operating Theatre. However, bear in mind that surgical excision will always leave a surgical scar, so you need to consider which of the two scars – the acne scar or the surgical scar – you would prefer to have.
Skin Needling
Skin Needling also known as Microneedling and Collagen Induction Therapy, is a treatment that stimulates collagen production and in turn improves the appearance of acne scars.
Although widely promoted by Beauty Salons and some Cosmetic Clinics, Skin Needling, in all honesty, is capable of delivering, at best, only minor improvements in the appearance of the acne scarring.
Accordingly, although our Dermal Therapist does perform Skin Needling for Acne Scarring, we prefer to reserve it as an additional treatment option rather than recommend it as a first line of treatment because we have more effective initial treatments to offer.
Microdermabrasion
Microdermabrasion is another widely promoted treatment for acne scars. However, please be aware that being only a very superficial treatment, Microdermabrasion cannot significantly reduce the depth of acne scars. Reported improvements in the appearance of acne scarring after Microdermabrasion could possibly be due to changes in the light-reflective properties of the skin making the scars appear less obvious.
Please note that Microdermabrasion is not the same as Surgical Dermabrasion which, for many years before the introduction of laser resurfacing, was a standard treatment for acne scarring. However, it frequently caused permanent hypopigmentation (loss of skin colour) and for that very reason, Surgical Dermabrasion is rarely used nowadays and has been largely replaced by Laser Resurfacing.