Acne Scarring

With the widespread use of highly effective oral medications for severe acne, there are fewer patients who will end up with severe acne scarring.

However, for those who do have residual scarring from their severe acne, various surgical and laser techniques are available.

Permanent

Permanent scarring from past or present inflammatory acne is caused by damage to the collagen layer of the skin (dermis). The normal collagen structure and composition alters to a “scar” abnormal collagen structure and composition. This can lead to depressions (common) or raised areas (less common) leading to a rough and corrugated skin appearance with reduced luminosity.

Successful treatment of permanent scars requires proper assessment of the type of scarring for best result. Options are resurfacing laser treatments (ablative and non-ablative), filler injections, TCA cross (ice pick scars), radiofrequency needling and picosecond laser treatments. Combination treatments are usually required. Multiple treatments may be required based on the severity of scarring, type of scarring and body site (face does better than chest and back)

Non-Permanent

Non-permanent changes: post inflammatory hyperpigmentation which generally occurs in darker skin types and fades spontaneously over many months.

Post inflammatory persistent erythema. Usually recovers but if persists longer than 6 weeks may lead to depressed scars.

Treatment for non-permanent scars: Pigmented scars: compounded fading cream, superficial glycolic peels and picosecond laser (if v persistent).

Red scars: vascular laser (Candela V BeamR) may prevent depressed scars.