Are Acne Scars Permanent?
by Deborah Spalla
Acne, a severe inflammatory response to clogged pores and hair follicles, can be devastating and result in noticeable acne scarring. Contrary to popular belief, it is not restricted to the adolescent population – pregnant women, adult athletes, those in their 50s, all are susceptible to developing acne on their faces, backs, and chests.
While these eruptions are a cause for concern, many individuals who’ve suffered from acne find the scars remaining after treatment are as much, if not more, frustrating than the original acne eruptions because they can last long after acne has become a thing of their past.
Are acne scars permanent? And, if not, what treatments are available to you?
Acne Scars Don’t Have to be Permanent
The permanency of acne scars depends on many factors, including which type of acne you had, the type of scars left behind, how quickly your acne was managed and the cosmetic resources available to you.
Here is some information on acne scarring as well as tips for eliminating the scars as soon as possible.
The more severe the acne scarring the more difficult it is to treat
There are three main types of acne scars, and each of them is categorized by their severity:
- Ice pick scars. These scars are deeper than they are wide.
- Boxcar scars. These scars are wider than they are deep, with defined edges.
- Rolling atrophic scars. These scars can look more lumpy or contoured but smooth out when stretched. They are also the most common type of acne scars. Tthe inflammatory response that causes them can disrupt the collagen and subcutaneous fat layers that create the skin’s typically smooth structure. Rolling atrophic scars are typically the most difficult to eliminate.
In addition to the types of scars you have, how the scars display can complicate matters. For example, some scars also affect skin pigment (pigmentation), injury or irritation causing dilatation of the blood capillaries and reddened skin patches (erythema), slightly raised scarring (hypertrophic) or dramatically raised scarring (keloid).
Acne scars themselves are classified by severity, with Class 1 scars being the easiest to treat and Class 4 being the most difficult. Hybrid scars that combine multiple features – such as pigmentation and erythema – may also be more difficult to treat depending on the severity of the scar’s features.
The good news is that with successful acne treatment and the assistance of a dedicated and experienced dermatologist, most patients will experience tremendous aesthetic benefits from acne scar treatment options.
Options For Treating Acne Scarring
Here are some of the most successful treatments used to treat acne scars, preventing them from becoming permanent.
Living a healthy lifestyle and using a personalized skin care routine
The sooner you get acne under control, the better when it comes to preventing and eliminating scarring. While many of the myths and wives tales around what causes acne in terms of diet or health are proven false, lifestyle habits do matter.
Acne is an inflammatory response and the more we can do to quell that – via sound, expert acne treatment, a daily skin care routine and a healthy lifestyle and diet – the less severe the acne outbreaks will be. Even after acne has cleared up, focusing on an anti-inflammatory diet will minimize the inflammatory response that contributes to more severe scarring, as well as flare-ups, pain and skin irritation.
This treatment, which uses a chemical, high-concentration trichloroacetic acid (TCA) to peel away surface layers of skin, is very successful at treating ice pick scars. Chemical peeling should be performed by a licensed esthetician as a stand-alone therapy and should run its complete course for optimal outcomes. Chemical peeling should take place before any laser surgery for the best outcomes.
Some of the most successful acne scar treatments involve some type of resurfacing procedure such as chemical peels, laser abrasion, and dermabrasion. These treatments are less invasive than surgical options, and they work to remove outer layers of scarred skin, which are then replaced by smoother, healthier skin layers.
The following resurfacing treatments are the most successful on mild rolling atrophic and boxcar scars.
Various energy devices, including CO2 lasers and erbium YAG lasers, are employed to smooth the outer skin contours while tightening up the middle layers of skin. Fractional lasers seem to be more successful than non-fractional laser therapy for acne because it penetrates deeper and does not injure the surface of the skin, which is already sensitive with acne patients.
Invasive and surgical procedures
Finally, the most stubborn acne scars may respond to more invasive procedures. These include:
- Subcision. This process uses a specialized needle that acts like a mini-scalpel. It works best for rolling scars with depressions. The needle removes fibrous scar tissue underneath the skin, so new tissue can grow back and raise the depression for a smoother surface.
- Micrisubcision. Instead of a specialized subcision needle, this process uses a traditional subcutaneous needle that is worked back and forth underneath a rolling depression, making a pocket. This pocket may fill in with new tissue or, more commonly, a filler material is injected into the pocket to raise the depressed area.
- Excision. Many acne scars respond well to excision, which cuts away the scar completely. Larger scars will be healed using a stitch or two. This is only used for more severe scars and may leave a small scar in its wake, but many patients prefer the fewer, smaller flat surgical scars to the more disruptive acne scars.
These invasive procedures can be trickier for those with darker complexions and it’s recommended that it be tried first in a less-visible location (like behind the ear) before being attempted on the face or chest.
There is a wide range of dermal fillers used to smooth out depressions caused by acne scars. Patients should discuss the pros and cons of each one with their doctor. These are injected below the skin to smooth it out. Often, fillers are used to augment other surface or invasive treatments once the treatments have done their work.
Are you worried about permanent acne scarring? Visit us here at Skin Deep and we’ll take a look. Our clinical skin treatment methods are very successful and we’ll work with you and your dermatologist to create a holistic treatment plan that prevents permanent acne scarring.
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