Acne scars can be reduced with a variety of non-invasive cosmetic treatments. These include skin resurfacing techniques (ablative and non-ablative laser treatment and chemical peels), filler injections, and microneedling/collagen induction therapy.
Resurfacing techniques aim to blend acne scars into surrounding skin by smoothing out sharp scar edges and promoting growth of new skin cells and skin remodelling. These treatments are most useful for rolling atrophic scars.
Laser Resurfacing
Laser skin resurfacing removes scarred layers of the face with precision to give the skin a more even tone. The treatment also stimulates the growth of new collagen in the face. This procedure is best for people who have mild to moderate acne scarring and are willing to undergo multiple treatment sessions.
Fractional laser treatment such as Frazel and carbon dioxide lasers use a non-ablative technique to reduce the appearance of superficial scarring. The lasers vaporize columns of tissue, which results in the formation of new skin that is tighter and smoother.
This technique is less invasive than ablative lasers, but it can still result in redness and swelling after the treatment. People with darker skin tones may experience hyperpigmentation after laser resurfacing. This can be minimized by using a bleaching agent before and after the treatment. It is also important to avoid excessive sun exposure after this procedure. The UV rays in sunlight can cause new scars and blotches.
Dermal Fillers
Dermal fillers minimize skin depressions caused by acne scars as well as reduce fine lines and wrinkles. Cosmetic surgeons use safe FDA-approved fillers containing hyaluronic acid, polymethyl methacrylate, poly-L-lactic acid, calcium hydroxylapatite or even the patient’s own body fat. Fillers are temporary and last several months to years – depending on the type of filler used.
Before injecting, a medical professional cleans the area and applies an anesthetic cream to numb it. Then, the surgeon inserts small injections using a thin needle. The patient may experience a slight pinching sensation but should not feel much pain.
When staging combination therapy, a doctor takes into account the types of acne scars and each patient’s tolerance for risk and discomfort. For example, if a patient has significant atrophic scars with wasting, a scarlift procedure such as microsubcision or punch elevation might be performed first and then fillers applied. The lift will help draw the base of the scar toward the surface for improved appearance.
Microneedling
Microneedling is a minimally-invasive skin-rejuvenation technique that involves the use of a device that creates tiny pinpricks in your skin. This stimulates collagen production, resulting in smoother and tighter skin, reduction of fine lines and wrinkles, and improved skin tone and texture.
BUSM’s clinical studies show that microneedling is also effective at decreasing the appearance of acne scars. It is a great option for those looking to minimize their acne scars and achieve smoother, more even skin.
It’s important to note that microneedling does not work well for all types of scarring and is generally better for superficial boxcar scars. It does not improve ice pick or deep rolling atrophic scars, which require more aggressive treatments.
Prior to treatment, it’s best to avoid retinoids and other topical agents that can cause redness or irritation. Your provider will give you specific instructions about how to prepare for your microneedling session. We also recommend taking Zovirax three days before your treatment to prevent an outbreak of cold sores.
Injections
Acne scarring can leave permanent indentations and changes in skin texture. These changes can be minimized by the use of various treatments such as dermal fillers and microneedling.
Dermal fillers can be used to lift depressed acne scars (atrophic scars) and can also stimulate collagen production in the skin. The fillers are injected into the skin with a fine needle. The most popular fillers for acne scars are hyaluronic acid filled products such as Juvederm and Restylane. Other options include polymethyl methacrylate microspheres with collagen (Bellafill) and autologous fat transfer.
Many acne scar patients have dark marks or discoloration which are not acne scars and are called post-inflammatory hyperpigmentation (PIH). The pigmentation can be improved using chemical peels, Cosmelan, and other lightening creams. It is important to protect the skin with sunscreen and avoid sun exposure to prevent further hyperpigmentation.acne scar treatment