What can I do to treat acne scars?
There are many different acne scars. Some are elevated above the skin level whereas others are depressed below the skin levels. Dr. Sapijaszko is knowledgeable in the treatment of all acne scars. The treatments can include one of the following methods alone or in combination:
- Topical Home Preparations
- Chemical Peels and Microdermabrasion
- Laser or IPL Therapies
- Filler Substances
- Surgery (Excision or Grafting)
Topical Home Preparations
Almost all patients with acne scarring can benefit from topical preparations. As with acne treatments, these preparations include vitamin A acid derivatives such as Retin-A®, Tazorac® or Differin®. These preparations can help with new collage production and can be combined with more effective methods like chemical peels, microdermabrasion and Laser or IPL therapies.
Chemical Peels and Microdermabrasion
Chemical peels can be of significant benefit to patients with acne scarring. Superficial (e.g. glycolic acid or salicylic acid) and medium depth (Jessner’s solution, trichloroacetic acid [TCA]) chemical peels can be used to successfully improve acne scarring. Generally, multiple peels in the concentrations above 35% are needed.
Different forms of microdermabrasion can also be used alone or in combinations with other modalities. Some newer forms of microdermabrasion use firm brushes and can also perform infusion of therapeutic substances into the skin.
Laser or IPL Therapy
Laser or IPL therapies can be very successful in the treatment of acne scarring. Almost all kinds of scars can be improved with these modalities. In this category, laser resurfacing, laser MicroPeel as well as fractional laser technologies can significantly improve acne scar contours. IPL as well as vascular lasers can be used to improve collagen and reduce the color of acne scars.
Subcision is a relatively new technique designed to free the tethering fibrous bands that cause rolling scars. Special needle is used to sever the tethering fibrous bands between deep layer of the skin and the deeper structures. Once the entire area to be subcised is infiltrated with local anaesthetic, the needle is inserted at the periphery of the scarred area. Using a gentle sweeping motion (such as seen with car windshield wipers) the fibrous cords can be disrupted. At least three insertion sites are used to allow a triangulated approach to heavily fibrous areas. Subsequently, a compression dressing is applied in order to prevent excessive subcutaneous bleeding.
Subcutaneous or dermal fillers such as autologous fat, collagen (e.g. Evolence or Evolence Breeze), hyaluronic acid derivatives (e.g. Restylane , Perlane, Juvederm , Ovita), and Sculptra can be used to achieve final optimal scar correction. As mentioned above, each acne scar represents its unique challenge and the kind of dermal filler selected has to match.
Surgery (Excision or Grafting)
Surgical excision, either elliptical or grafting is used for deeper boxcar scars. These methods can be very effective for the right scar. In most instances, following punch excision, punch grafting or punch elevation is needed to achieve optimal results. This tissue resurfacing can be achieved through medium to deep chemical peels as well as laser skin resurfacing.
Frequently, combination treatments utilizing a variety of surgical procedures (punch excision, punch elevation, subcision, dermal fillers, punch grafting) are used in combination with a resurfacing modality (chemical peels or laser skin resurfacing). Patients need to be counselled appropriately and understand that scar revision and management takes time and patience. With appropriate selection of surgical and non-surgical modalities, a significant improvement in acne scarring can be achieved while maintaining an excellent safety profile.
If you have further questions or concerns or wish to book a consultation appointment, please call us at 780-424-4440 ext. 2 or email us.
The information provided on this website is for Canadian patients only and is meant for information and education that is based on experience and research.