BENGALURU: We have all had acne of varying degrees of severity at some point in our lives, and while it’s frustrating, the struggle with acne isn’t one that lasts long. However, when we see the enduring imprint that acne has left behind, that is — acne scars, it instantly dawns upon us that a new battle has begun just when one has ended.
Acne scars, unlike acne marks (hyperpigmentation), cause significant damage to the epidermis and dermal collagen. Acne scars can be hypertrophic (raised) or atrophic (depressed) which include box scars, rolling scars, and ice-pick scars. While topical creams and ointments are ineffective in the treatment of acne scars, there are several therapeutic options that can be used alone or in combination to greatly reduce its appearance.
Procedures like chemical peels, such as salicylic acid peels, Jessner’s peels, and TCA peels, have keratolytic, antibacterial, and sebum-controlling capabilities and can help with acne scars by stimulating new collagen production. Microdermabrasion is a process that utilises a spray of aluminium oxide crystals to remove damaged skin in a controlled and painless manner all while encouraging the regeneration of new collagen, alleviating mild scars.
Dermatologists perform micro-needling for acne scars using medical-grade derma rollers, which are made up of a sterile roller with several fine needles that create many microchannels in the skin, sparking a sophisticated cascade of growth factors that inevitably leads to collagen formation. Combining this with platelet-rich plasma therapy can help to enhance and speed up the healing and regeneration process.
Additionally, hyaluronic acid can be injected into scars to augment and improve their appearance, albeit this is a more temporary solution that would need to be repeated.
Facial resurfacing with the latest fractional CO2 lasers is one of the most recent and effective modalities. Fractional lasers only treat a ‘fraction’ of the skin at a time. It fractionates or pixelates the laser beam into numerous little columns of light that penetrate the skin and enable the formation of new skin cells and remodels collagen. This novel laser treatment ensures that surrounding healthy skin is left unaffected. Ablative Laser procedures need numbing of the skin beforehand and can result in a few days of downtime, although they are remarkably efficient.
Each morphological scar type requires a different treatment strategy, and while one scar type may respond well to one treatment method, another scar type may not. As a result, you must consult with your dermatologist who will start you on the right combination of treatment modalities and recommend the appropriate number of sessions required for you.
Acne scar treatment, while difficult, can enhance an individual’s self-esteem and generate a wave of confidence. Thus, healing these scars can be a gratifying experience for both the individual and the dermatologist.
(The writer is a head dermatologist at DermaZeal Clinic)