What are Acne Scars?
Acne scars develop as permanent textural changes on the skin as a result from an aberrant response to wound healing at different stages. In simple terms, when the body is repairing the damage at the site of acne, over or under production of a substance (collagen) can give rise to formation of a scar at that particular site.
Acne scars are broadly classified in two categories:– Atrophic Acne Scars
– Hypertrophic Scars
Atrophic Acne Scars:
More common and classified into three sub-types:– Ice Pick Scars- are narrow, deep and extend into the lower layer of the skin forming a v shape.
– Rolling Scars- these are poorly demarcated depression of the skin without deep penetration.
– Boxcar Scars- these are u-shaped, uniform, round or oval shaped and anchored deep or shallow in the structure of the skin.
These are typically pink, raised and firm. The keloidal scars are reddish-purple papules and nodules that proliferate beyond the borders of original wound. They commonly occur on upper and mid back, shoulders and jaw angles.
There are multiple treatment options available to treat this condition. These may include invasive, semi-invasive and non-invasive techniques. However, the treatment will depend on factors including type of scar, skin type and location of the scar. The following are three broad approaches for the management of Acne scars:1. Aesthetic Approach: Includes the use of Chemical peels, Dermal fillers, microdermabrasion.
2. Surgical Approach: Includes Punch techniques, Microneedling, Trichloroacetic acid (TCA) chemical reconstruction of scars, Dermal grafting, Subcision, Fat transfer, scar revision and cryolush.
3. Lasers: Includes Non-Ablative (Non-wounding), Ablative (Wounding) and Fractional resurfacing. Ablative lasers are CO2 and erbium while Non-Ablative examples are 1450nm diode laser, Q-Switch Nd:YAG laser etc. The efficacy of Non-Ablative lasers is considered to be less that the Ablative lasers.
Different treatment methods come with their own downsides. The physician will explain all at the time of consult.