In order to know how to get rid of acne scars, it’s first necessary to understand how acne scars occur in the first place. It must come as no surprise to acne sufferers that all scarring begins as a pimple that has become infected or inflamed. This happens when the pores become clogged or congested with bacteria, oil, sebum and dead skin cells.
Accumulation of debris and infected material can cause the pore to swell and rupture, spilling its contents into the skin and surrounding area, causing infected lesions to spread. In most cases the lesions are superficial and the skin can recover without developing into an acne scar.
If the damage to the pore is extensive, however, the skin can develop indentations due to the loss of dermal tissue. These are known as pitted scars or “atrophic scars.”
To make matters worse, these indentations are often accompanied by texture irregularities. Ironically, texture issues and the general disfigurement caused by acne scarring occur during the healing process. As the body attempts to repair the tiny ruptures it lays down new collagen fibers. But this mending process is imperfect, and the patched up skin is never as smooth as before.
Different types of acne scars
In addition to atrophic acne scars it’s possible to develop skin discolouration known as PIH or post inflammatory hyperpigmentation. How to get rid of acne scars and the different types are described below:
Ice pick scars
Ice pick scars present as small, hollow depressions on the skin’s surface. These typically occur on the cheeks and surrounding areas. Since ice pick scars tend to sit quite deeply they can be challenging to eliminate entirely. Medical treatment for ice pick scars typically entails taking a multi-disciplinary approach, incorporating modalities such as scar revision surgery, laser facial resurfacing treatment, chemical peels, skin needling and medical skincare products.
Unlike the ice pick variety, boxcar scars tend to be more superficial with well-defined edges. Typically located on the cheeks, jawline and temples, boxcar scars are easier for clinicians to treat because of their shallow positioning. The treatment protocol for boxcar scars can involve a combination of laser facial resurfacing treatment, chemical peels, skin needling, dermal fillers and medical skincare products.
Rolling scars can be deep, shallow or both. Their characteristic wavy or “rolling” appearance is attributed to their sloping edges. These types of scars are tethered to deeper dermal structures. As with the others, treating rolling acne scarring involves a multi-step approach, often requiring several visits. Scar revision surgery may be recommended as the first course of action to release the tethers. Next, additional fine-tuning of the remaining shallow depressions can be done with laser facial resurfacing treatment, chemical peels, skin needling, dermal fillers and medical skincare.
Pigmented or Post Inflammatory Hyperpigmentation (PIH) Scars
The most common type of acne scar results from overproduction of melanin. Individuals with all complexions can develop hyperpigmentation – which can be brown or red – but those with darker skin tend to be affected the most. That’s because during the natural healing process the body produces melanin. Those with darker complexions have a tendency to over-produce it, resulting in stubborn red or dark spots known as PIH. The most effective treatment for PIH is light therapy, chemical peels, skin needling and medical skincare products.
Types of acne scar treatments
Laser facial resurfacing treatment
This modality uses amplified light energy to carefully strip the top layers of the epidermis in a controlled manner. The objective is to resurface scar tissue by encouraging healthy new cells to come to the surface and replace damaged tissue.
This treatment is suitable for rolling, boxcar, ice-pick and pigmented scars. There can be up to one week of downtime with laser and patients should plan accordingly. Several sessions may be required for deeper scars and this modality may not be suitable for individuals with darker skin.
Scar Revision Surgery
The goal of scar revision is to create a less pronounced scarring, improving texture and smoothness of the skin. There are several techniques that can be used. Acne scar revision excises deeply pitted scars and sutures together the open edges of skin. Another lesser known method is called Subcision. This involves using a special needle to release the scar tissue or “tethers” that are pulling on the skin. As the fibers are released, new collagen creates a smoother appearance. This treatment is effective for all atrophic scars – rolling, ice pick and boxcar.
These are composed of TCA and other pharmaceutical-grade acids that deliver a controlled resurfacing to the skin. A series of chemical peels can help improve the appearance of post inflammatory hyperpigmentation, as well as smooth shallow pitted scars. Depending on the strength of the peel, the downtime from a chemical peel can last anywhere from 1-7 days.
Skin needling is also called derma-rolling, Collagen Induction Therapy (CIT), micro-needling and Percutaneous Collagen Induction (PCI) just to name a few. This treatment involves inserting microscopic needles into the epidermis with the goal of triggering collagen formation in the skin. As healthy new skin cells and collagen travel to the skin’s surface, both pigmented and shallow acne scars are minimised. The downtime is only a few days and all skin types can benefit from this treatment.
Have you heard about the unique Bloomea acne scar treatment offered at Restoration Clinic in Perth? Give us a call at (08) 9025 3218 or contact us by email to learn more about it and the other acne scar treatments that may be suitable for you.