Acne scarring

After we have cleared a patient’s acne, the next questions are always about how to help with acne scarring.  In this post we’ll talk about types of acne scars and what treatments Dr Rosenberger recommends.

Before jumping in, first things first.  How can we reduce acne scarring in the first place.  DON’T PICK.  I know, this is easier said than done, but it is really important.  The more you pick, the more scars and discoloration you will have.  No matter how bad a pimple looks on a given day, a scar for the rest of your life is worse!  

True acne scars are either raised or indented.  More commonly patients struggle with post inflammatory hyperpigmentation, which is the temporary discoloration left behind by any kind of injury or irritation to the skin.  This is generally not permanent and resolves on its own in 3-6 months. 

As always, we’ll start with the simplest and least expensive options first.  Treating scars generally involves stimulating growth of collagen to fill in the old marks.  There are lots of ways to do that.

1. Use RetinA or some type of prescription strength retinoid.  Retinoids help shed old skin to grow a healthy new layer of skin.  They also help strengthen and grow new collagen to fill in those old scars.
2. Wear sunscreen and stay out of tanning beds.  One of the number one things that break down collagen is sunlight, so getting a tan will not help scars.  In fact, it makes them worse.  Sunlight often also accentuates and stimulates the temporary discoloration from acne lesions.
3. Microneedling.   This procedure that we offer in the office uses a device to poke lots of microscopic holes in the skin.  This controlled injury can break up scar tissue and stimulate growth of collagen. Depending on the depth of the scars, multiple treatments can be required. 
4. Subcision.  This is an old-fashioned technique that involves using a needle or other device to break up the scars.  Dr Rosenberger often combines subcision with filler on more persistent and deep acne scars. This should only be done by a trained dermatologist or plastic surgeon.
5. Laser Genesis.  This procedure that we offer in the office uses laser light to gently heat up the deeper layers of the skin to stimulate collagen growth.  This is a no downtime, low-risk procedure. 
6. Other Laser procedures that we do not offer in the office can more aggressively treat acne scarring.  These procedures offer faster improvement but are more costly and require extensive downtime.

Things to consider when choosing a treatment.

1. Downtime.  In my experience, the last thing my patients want is to look worse, even for a few weeks.  That is why the procedures we offer are no downtime procedures.
2. Not making any more scars!  In my opinion there is no sense treating acne scars unless the active acne is being treated aggressively and under control.
3. Patience.  Treating acne scars takes a long time.  Realistically, 6 months or more to grow enough healthy tissue to fill in the scars.  Generally, there is no quick fix.

If you are struggling with acne, get it under control as quickly as possible to avoid future scarring and DON’T PICK!  

If you know someone who is struggling with acne and acne scarring, send them this article!

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