Apr
We’ve all had a pimple or two. Sometimes at the most inconvenient times. More than 40 million Americans get acne in some form or another every year. But for some, the memories of acne – namely acne scars remain. Removing acne scars could be one of the most difficult skincare challenges you can face. So much so that if you’re researching acne treatment near me, this is the article for you. At Eternal Dermatology, we’re committed to bringing out the best in your skin with the right acne scar treatment.
Acne develops when the pores on our face, back, and chest become clogged with excess oil, dirt, hair, and bacteria. The results are blackheads, whiteheads, pimples, pustules, cysts, and other forms of acne. Many cases of acne are hormone-related, happening primarily during puberty. Stress, air pollution, some skin products, and even menopause can cause acne.
Some acne, specifically cystic acne, papules, and pustules, get more prominent, causing severe inflammation. Sometimes, the inflammation impacts the dermal layer of your skin, where nerves, hair follicles, collagen, and other essential skin components reside. Ruptured pimples can leak into this once healthy layer. The body also reacts to heal the surrounding tissue. However, this process is imperfect, and the body cannot repair the skin precisely like it was before.
The result is a hard, fibrous-like healing process, which we know as acne scars. Acne scars look bright red or pink at first. Then over time, the scars fade to look a bit lighter or darker than your regular skin color. Some people are more prone to acne than others. If inflammatory acne goes untreated, or the acne is continuously picked or popped, scars will form. About 1 in 3 people with acne will form acne scars.
Do you know that there are different types of acne scars? Based on the body’s reaction to the inflammation, indifferent shapes of scars can form. The types of scars include:
These scars happen when the body does not produce enough collagen. These are flat, thin scars and can sometimes cause form round, depressed scars. Atrophic scars are known as crater scars, leaving dents where your pimples tormented you once before.
These scars are the opposite of atrophic scars. Instead, the body produces too much collagen. The wounds appear raised, thick, lumpy, and tender to the touch.
Ice pick scars sound a bit morbid, but that’s because they look as if the skin was pricked with an ice pick. These scars form a deep, narrow ‘V’ and appear like tiny holes, specifically on the face and back areas.
Sometimes, your acne scars can look like broad depressions with sharp, defined edges. Upon closer inspection, these can look like a square or box, hence the name boxcar scars. Boxcar scars could appear on the cheeks and back.
Rolling acne scars look similar to boxcar scars. These are also broad depressions but have a sloping edge instead. Rolling acne scars tend to cluster together and cover a large surface area like the entire side of the face.
If you’ve struggled with acne before and you’ve taken steps to clear it up, your skin should return to its former smoothness. However, if there are visible signs of scars, you should see a dermatologist immediately for two reasons. First, we must properly diagnose your acne scarring, so you get the best available treatment. Secondly, there aren’t many over-the-counter solutions that can clear up your scars for good. You’ll need specific treatment to deal with the specific type of scarring.
When you visit your doctor, the first step would be to examine the acne scars to know the exact type of scars affecting your skin. Dermatologists will classify the scars as depressed (icepick, boxcar, rolling scars) or raised (keloid scars). The doctor will also ask questions about your previous acne treatment and current medication before proceeding with a treatment regimen. There are several ways to treat acne scars, and your dermatologist will use one (or more) of the following:
Your doctor will want to start things off with some prescription-grade medication. Some topical options can improve the appearance of scars. For instance, you may get a prescription retinoid to use as part of your daily skincare routine.
Retinoids are derivatives of vitamin A. Retinoids help to speed up skin cell regeneration and cell turnover. These qualities make it perfect for fighting acne as it reduces discoloration and fades acne scars. Retinoids come in different strengths and are present in many over-the-counter acne treatments. However, you’ll need a prescription retinoid to work on those scars. Retinoids make the skin sensitive to the sun, so make sure to apply sunscreen in the morning and throughout the day as many times as you need.
Acids are also great options for your acne scars. Of course, not just any acids. We’re talking about alpha hydroxy acids or AHAs and beta hydroxy acids or BHAs. AHAs, like retinoids, are present in many over-the-counter acne treatments. Your dermatologist can prescribe a topical treatment with a higher concentration of AHAs to help your skin. These are great for removing dead skin, which can reduce the appearance of acne scars. Some common AHAs include lactic acid, citric acid, and glycolic acid. BHAs also exfoliate your skin and can reduce the signs of scarring. The most common BHA is salicylic acid which your doctor can provide in prescription strength.
These prescription medications are great for atrophic scars and mild cases of scarring. However, most cases need deeper, in-office treatment.
Chemical peels are a short procedure where a dermatologist or certified esthetician applies a chemical solution to your face. The solution contains specific acids capable of removing dead skin cells from the layers of your skin. Chemical peels consist of mainly alpha hydroxy acids (AHAs) like glycolic acid, mandelic acid, citric, and lactic acids. Some contain beta hydroxy acids like salicylic acid.
Over a couple weeks following the chemical peel, the skin begins to slough off, revealing fresh, new skin underneath. You can see how this is a perfect solution for acne scars. Chemical peels are classified by the part of the skin it impacts:
Based on the severity of your acne scars, your dermatologist will use a medium peel, specifically trichloroacetic acid (TCA), over several sessions to clear your acne scars. A study of non-energy-based techniques for clearing scars showed a 70% reduction in scars for those using chemical peels. Chemical peels are among the most effective, non-invasive procedures that can help clear up your acne scars. Some peels are not suitable for darker skin types, as they may cause burning and dark skin discoloration. Be sure to see a chemical peel expert with experience in the use of advanced peels in all skin types.
Some scars, like hypertrophic scarring, can benefit from steroid medication. Corticosteroids are popular for reducing inflammation and are often used to reduce painful acne cysts. However, dermatologists have seen promising results with acne scars.
Over several sessions lasting a few weeks, your dermatologist will inject the steroid directly into the keloid scar. Over time, the scar shrinks or flattens. Steroids have been proven effective against mild to severe scars.
The skin can heal itself, and sometimes it needs a little push. RF microneedling does just that. Your dermatologist will have a handheld wand with 48 (or more) tiny needles at the tip. These needles puncture the skin at varying depths to promote new collagen growth. The device helps break up scar tissue and clumps of collagen. The skin responds by building fresh new collagen in the affected area.
The ‘RF’ in the name stands for radiofrequency. In addition to the needles puncturing your skin, the device sends RF waves to gently heat the dermis, further stimulating collagen production. The session lasts about 30 to 60 minutes, and your dermatologist will use a topical anesthetic for pain management. Like chemical peels and other treatment options, you’ll begin to see the effects of the treatment in 4 to 6 weeks. RF microneedling is excellent for atrophic scars and has a success rate of up to 60%.
Dermal fillers rose to popularity for their ability to plump up the skin and reduce the signs of superficial wrinkles. Add acne scar treatment to the list. Dermal fillers are injectables made up of gel-like compounds of hyaluronic acid. When placed in specific parts of the face, dermal fillers plump and smooth the skin.
Your dermatologist will set up a quick procedure that you can do during your lunch hour. The dermatologist will inject the fillers in the problem areas. Sometimes, a mild topical anesthetic can help with pain at the injection site. You will need continued sessions of fillers over the months to see the maximum effects. Dermal fillers aren’t as effective on tiny atrophic scars, so your dermatologist may pair the procedure with a surface chemical peel.
Laser resurfacing is one of the most effective ways of reducing acne scars. When you search for an “acne scar treatment near me” or “laser treatment for acne scars,” chances are you’ll come across clinics that provide laser therapies. Laser therapies are specifically effective against ice pick scars, box scars, crater scars, and rolling scars. Advancements in laser technology make them effective against hypertrophic scars too.
Laser therapy works via a device that can send out targeted beams of light at specific wavelengths. These beams of light break up the scar tissue to encourage new collagen development. The result is significantly reduced acne scars and smooth, beautiful skin. Lasers have a high success rate with reducing the signs of acne scars. However, you should only visit a board-certified dermatologist trained in proper use.
When doctors first used lasers, they used a Continuous Wave CO2 laser. This evolved to pulsed and scanned CO2 lasers, then the popular Erbium YAG (Er: YAG) laser. These are ablative lasers, meaning they destroy the tissue at the epidermis and even the dermis levels. Today, many dermatologists and surgeons use non-ablative laser treatment. Non-ablative lasers target the tissue at the dermis without damaging the epidermis.
Non-ablative lasers are much safer and are popular for their faster recovery. Laser treatment is not for everyone. Some people have sensitive skin that would provide an unwanted reaction to the laser. Even without sensitive skin, laser therapy patients will experience redness and swelling after their sessions. Make sure to follow the doctor’s instructions for the best recovery possible.
Most in-office procedures have high success and satisfaction rates. But sometimes, the scarring can be so severe that surgery is the best option. Surgery works for deep icepick scars, boxcar scars, and keloid scars. Punch excision is a common surgical procedure used to treat scars of all kinds. Your dermatologist uses a sharp, cookie-cutter-like punch tool to cut or “punch” around the scar. The resulting incision is closed with tiny stitches. When the incision heals, the result is a blemish that’s significantly lighter, smaller and less noticeable than the one before. Punch excision requires precision and should only be performed by a trained dermatologist. This procedure may not be the best for keloid scarring as well as these types of scars tend to reoccur.
Subcision is another common in-office surgical procedure for acne scars. The dermatologist inserts a small needle under the scar to dislodge it from the underlying tissue. The skin reacts by producing more collagen to fill the space, reducing the appearance of your car. Subcision happens over several sessions and shows promising results on crater scars, box scars, and ice pick scars. The treatment may not work for keloid scarring. Keloid scarring can benefit from a combination of cryotherapy (freezing) and steroid injections.
You can take some simple steps to reduce the chances of your acne becoming acne scars. It goes without saying that you should keep your hands off your acne. Acne can be temporary with the right treatment, but popping pimples can make it a permanent problem. Picking scars left from acne can also cause long-term scarring. Treat your acne immediately with dermatologist-recommended medication and be gentle with your skin. The more inflammation, the higher the chances of scars. If you have large pimples, see a doctor immediately for treatment as these are the ones prone to scarring (and over-the-counter treatment may not work). Even with these precautions, you may not be able to prevent all scarring, but we have a range of advanced treatments should it reach that point.
Find your local cosmetic dermatology speciailist if acne scarring has impacted the quality of your life. At Eternal Dermatology, we understand how stressful and emotionally draining acne scars can be. They can prevent you from being your best self! We want you to restore the confidence you once had before your acne, and we can do that with a range of treatment options. By following the sessions of the chosen treatment, you’ll see significant improvement in your skin.
We’re conveniently located in Fulton, MD, and serve Columbia, Silver Springs, Howard County, Baltimore, Washington DC and surrounding areas.
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Get your acne scars under control today.