What are the main types of acne scars. How can chemical peels help reduce acne scarring. Which other treatments are effective for acne scar removal. What role does prevention play in managing acne scars.

Understanding Acne Scars: Formation and Classification

Acne scars are a common and frustrating aftermath of acne breakouts. They form when inflammation damages the skin and underlying tissue, leading to abnormal healing processes. The severity and type of scarring depend on various factors, including genetics, skin type, and the intensity of the original acne lesions.

Acne scars are generally classified into two main categories:

• Atrophic scars: These are depressions or indentations in the skin
• Hypertrophic scars and keloids: These are raised scars that extend beyond the original acne spot

Atrophic scars are further divided into three subtypes:

1. Icepick scars: Deep, narrow, pitted scars
2. Boxcar scars: Round or oval depressions with steep vertical sides
3. Rolling scars: Wide depressions with sloping edges

The Importance of Prevention in Acne Scar Management

Prevention is crucial in avoiding the formation of post-acne scars. How can we effectively prevent acne scars? The key lies in early and aggressive treatment of active acne. By reducing the duration and intensity of inflammation, we can significantly decrease the likelihood of scar formation.

Some preventive measures include:

• Prompt and appropriate acne treatment
• Avoiding picking or squeezing acne lesions
• Use of topical retinoids
• Application of silicone gel sheets

Silicone gel, in particular, has proven efficacy in preventing hypertrophic scars and keloids. Its occlusive and hydrating properties help regulate collagen production and reduce excessive scarring.

Chemical Peels: A Versatile Approach to Acne Scar Treatment

Chemical peels are a popular and effective treatment for acne scars, especially for atrophic scars. How do chemical peels work? They involve applying a chemical solution to the skin, which causes controlled damage to the outer layers. This process stimulates skin renewal and collagen production, leading to improved skin texture and reduced scar appearance.

Types of Chemical Peels for Acne Scars

Several types of chemical peels are used in the treatment of acne scars:

1. Glycolic Acid Peels
2. Jessner’s Solution
3. Pyruvic Acid Peels
4. Salicylic Acid Peels
5. Trichloroacetic Acid (TCA) Peels

Glycolic Acid Peels

Glycolic acid, derived from fruit and milk sugars, is an alpha-hydroxy acid (AHA) that effectively treats acne scars. How does glycolic acid benefit the skin? It works by:

• Thinning the stratum corneum
• Promoting epidermolysis
• Dispersing basal layer melanin
• Increasing dermal hyaluronic acid and collagen gene expression

For optimal results, a series of five treatments using 70% glycolic acid, spaced two weeks apart, is often recommended. While generally well-tolerated, glycolic acid peels may cause temporary hyperpigmentation or irritation in some individuals.

Jessner’s Solution

Jessner’s solution is a combination peel containing salicylic acid, resorcinol, and lactic acid in an ethanol base. How does Jessner’s solution work on acne scars? It acts by:

• Disrupting keratin bonds
• Enhancing penetration of other agents
• Promoting corneocyte detachment and desquamation

This versatile peel is well-tolerated by most patients but may cause allergic reactions in rare cases, particularly due to the resorcinol component.

Pyruvic Acid Peels

Pyruvic acid, an alpha-ketoacid, offers multiple benefits for acne scar treatment. What makes pyruvic acid effective? Its properties include:

• Keratolytic effects
• Antimicrobial action
• Sebum regulation
• Stimulation of new collagen and elastic fiber formation

Concentrations between 40% and 70% are typically used for moderate acne scars. However, pyruvic acid can cause significant stinging and burning sensations during application, and proper ventilation is essential due to its irritating vapors.

Salicylic Acid Peels

Salicylic acid, a beta-hydroxy acid (BHA), is highly effective in treating acne scars. How does salicylic acid improve scar appearance? It works by:

• Removing intercellular lipids linked to the cornified envelope
• Exfoliating the skin surface
• Unclogging pores
• Reducing inflammation

A 30% concentration is considered most efficacious for acne scar treatment, often applied in multiple sessions for optimal results.

Advanced Treatments for Acne Scar Removal

While chemical peels offer significant improvements, some acne scars may require more intensive treatments. What advanced options are available for stubborn acne scars?

Laser Resurfacing

Laser treatments have revolutionized acne scar management. How do lasers work on acne scars? They use focused light energy to remove damaged skin layers and stimulate collagen production. Two main types of lasers are used:

• Ablative lasers (CO2 and Erbium YAG): Remove outer skin layers
• Non-ablative lasers: Target deeper skin layers without damaging the surface

Fractional laser technology, which treats only a fraction of the skin at a time, has gained popularity due to its effectiveness and reduced downtime.

Dermal Fillers

Dermal fillers can significantly improve the appearance of atrophic acne scars. How do fillers help with acne scars? They work by:

• Filling in depressed scars
• Stimulating collagen production
• Improving skin texture and volume

Various types of fillers are used, including hyaluronic acid, poly-L-lactic acid, and calcium hydroxylapatite. The choice of filler depends on the scar type, depth, and desired longevity of results.

Microneedling

Microneedling, also known as collagen induction therapy, is an effective minimally invasive treatment for acne scars. How does microneedling improve scar appearance? The procedure involves:

• Creating controlled micro-injuries in the skin
• Stimulating the body’s natural healing process
• Encouraging collagen and elastin production
• Improving skin texture and reducing scar depth

Microneedling can be combined with radiofrequency energy (RF microneedling) for enhanced results, particularly in treating deeper scars.

Combination Therapies for Optimal Results

For many patients, a combination of treatments yields the best outcomes in acne scar removal. How can different therapies be combined effectively? Some successful combinations include:

• Chemical peels followed by microneedling
• Laser resurfacing with dermal fillers
• Subcision (a minor surgical procedure to break up scar tissue) combined with fillers or fat grafting

The specific combination and treatment sequence should be tailored to each patient’s unique scar type, skin condition, and treatment goals.

Topical Treatments and Their Role in Acne Scar Management

While more invasive treatments often yield dramatic results, topical treatments play a crucial role in both preventing and improving acne scars. What topical options are available for acne scar treatment?

Retinoids

Topical retinoids, derived from vitamin A, are essential in acne scar management. How do retinoids benefit acne-prone and scarred skin? They work by:

• Increasing cell turnover
• Stimulating collagen production
• Improving skin texture and tone
• Preventing new acne lesions

Prescription-strength retinoids like tretinoin are most effective, but over-the-counter retinol products can also provide benefits with consistent use.

Vitamin C Serums

Vitamin C is a powerful antioxidant that can help improve the appearance of acne scars. How does vitamin C benefit scarred skin? It acts by:

• Stimulating collagen synthesis
• Protecting against free radical damage
• Brightening skin tone and reducing hyperpigmentation

Look for stable forms of vitamin C, such as L-ascorbic acid or magnesium ascorbyl phosphate, in concentrations of 10-20% for optimal results.

Niacinamide

Niacinamide, a form of vitamin B3, offers multiple benefits for acne-prone and scarred skin. How does niacinamide improve skin health? It works by:

• Reducing inflammation
• Regulating sebum production
• Improving skin barrier function
• Fading hyperpigmentation

Products containing 2-5% niacinamide can be used twice daily for best results.

The Psychological Impact of Acne Scars and Holistic Treatment Approaches

Acne scars can have a significant psychological impact on individuals, affecting self-esteem and quality of life. How can we address the emotional aspects of acne scarring? A holistic approach to treatment should consider:

• Psychological support and counseling
• Patient education on treatment options and realistic expectations
• Addressing any underlying skin conditions or hormonal imbalances
• Lifestyle modifications to support overall skin health

By combining physical treatments with emotional support, patients can achieve not only improved skin appearance but also enhanced self-confidence and well-being.

Emerging Technologies in Acne Scar Treatment

The field of acne scar treatment is constantly evolving, with new technologies and techniques emerging. What are some promising innovations in acne scar removal?

Stem Cell Therapy

Stem cell-based treatments show potential in regenerating damaged skin and improving scar appearance. How might stem cells benefit acne scar patients? They could potentially:

• Promote tissue regeneration
• Modulate inflammation
• Enhance the skin’s natural healing processes

While still in the experimental stages, early studies suggest that stem cell therapies could offer significant advancements in scar treatment.

Nanotechnology in Topical Treatments

Nanotechnology is revolutionizing the delivery of active ingredients in skincare. How can nanoparticles improve acne scar treatments? They may:

• Enhance penetration of active ingredients
• Improve stability of sensitive compounds
• Allow for targeted delivery to specific skin layers

Nanoparticle formulations of retinoids, antioxidants, and other scar-fighting ingredients could potentially offer more effective and less irritating treatment options.

Artificial Intelligence in Treatment Planning

Artificial intelligence (AI) is beginning to play a role in dermatology and scar treatment. How might AI benefit acne scar patients? It could:

• Assist in more accurate scar assessment and classification
• Help predict treatment outcomes based on individual patient factors
• Optimize treatment plans for best results

As AI technology advances, it may become an invaluable tool in personalizing acne scar treatment approaches.

In conclusion, acne scar removal is a complex but increasingly successful field, with a wide range of treatment options available. From chemical peels and laser resurfacing to emerging technologies like stem cell therapy, patients and dermatologists have more tools than ever to address this common concern. By combining effective treatments with preventive measures and addressing the psychological aspects of scarring, individuals can achieve significant improvements in both skin appearance and overall well-being. As research continues and new technologies emerge, the future of acne scar treatment looks brighter than ever, offering hope to millions affected by this condition.

Acne Scars: Pathogenesis, Classification and Treatment

New acquisitions by the literature have showed that prevention is the main step in avoiding the appearance of post-acne scars. Genetic factors and the capacity to respond to trauma are the main factors influencing scar formation [24]. A number of treatments are available to reduce the appearance of scars. First, it is important to reduce as far as possible the duration and intensity of the inflammation, thus stressing the importance of the acne treatment. The use of topical retinoids is useful in the prevention of acne scars but more than any other measure, the use of silicone gel has a proven efficacy in the prevention of scars, especially for hypertrophic scars and keloids.

4.1. Atrophic Scars

4.1.1. Chemical Peels

By chemical peeling we mean the process of applying chemicals to the skin to destroy the outer damaged layers and accelerate the repair process [25].

Chemical peeling is used for the reversal of signs of skin aging and for the treatment of skin lesions as well as scars, particularly acne scars. Dyschromias, wrinkles, and acne scars are the major clinical indications for facial chemical peeling [26, 27].

As regards acne scars, the best results are achieved in macular scars. Icepick and rolling scars cannot disappear completely and need sequential peelings together with homecare treatment with topical retinoids and alpha hydroxy acids [28, 29]. The level of improvement expected is extremely variable in different diseases and patients. For example, ice pick acne scars in a patient with hyperkeratotic skin are only mildly improved even if skin texture is remodeled. On the other hand, a patient with isolated box scars can obtain a significant improvement by application of TCA at 50%–90% on the single scars.

Several hydroxy acids can be used.

(A) Glycolic Acid —

Glycolic acid is an alpha-hydroxy acid, soluble in alcohol, derived from fruit and milk sugars. Glycolic acid acts by thinning the stratum corneum, promoting epidermolysis and dispersing basal layer melanin. It increases dermal hyaluronic acid and collagen gene expression by increasing secretion of IL-6 [30]. The procedure is well tolerated and patient compliance is excellent, but glycolic acid peels are contraindicated in contact dermatitis, pregnancy, and in patients with glycolate hypersensitivity. Side effects, such as temporary hyperpigmentation or irritation, are not very significant [31]. Some studies showed that the level of skin damage with glycolic acid peel increases in a dose- and time-dependent manner. The acid at the higher concentration (70%) created more tissue damage than the acid at the lower concentration (50%) compared to solutions with free acid. An increase in the transmembrane permeability coefficient is observed with a decrease in pH, providing a possible explanation for the effectiveness of glycolic acid in skin treatment [32]. The best results achieved for acne scars regard five sequential sessions of 70% glycolic acid every 2 weeks.

(B) Jessner’s Solution —

Formulated by Dr. Max Jessner, this combination of salicylic acid, resorcinol, and lactic acid in 95% ethanol is an excellent superficial peeling agent. Resorcinol is structurally and chemically similar to phenol. It disrupts the weak hydrogen bonds of keratin and enhances-penetration of other agents [33]. Lactic acid is an alpha hydroxy acid which causes corneocyte detachment and subsequent desquamation of the stratum corneum [34]. As with other superficial peeling agents, Jessner’s peels are well tolerated. General contraindications include active inflammation, dermatitis or infection of the area to be treated, isotretinoin therapy within 6 months of peeling and delayed or abnormal wound healing. Allergic contact dermatitis and systemic allergic reactions to resorcinol are rare and need to be considered as absolute contraindications [35, 36].

(C) Pyruvic Acid —

Pyruvic acid is an alpha-ketoacid and an effective peeling agent [37]. It presents keratolytic, antimicrobial and sebostatic properties as well as the ability to stimulate new collagen production and the formation of elastic fibers [38]. The use of 40%–70% pyruvic acid has been proposed for the treatment of moderate acne scars [39, 40]. Side effects include desquamation, crusting in areas of thinner skin, intense stinging, and a burning sensation during treatment. Pyruvic acid has stinging and irritating vapors for the upper respiratory mucosa, and it is advisable to ensure adequate ventilation during application.

(D) Salicylic Acid —

Salicylic acid is one of the best peeling agents for the treatment of acne scars [41]. It is a beta hydroxy acid agent which removes intercellular lipids that are covalently linked to the cornified envelope surrounding cornified epithelioid cells. The most efficacious concentration for acne scars is 30% in multiple sessions, 3–5 times, every 3-4 weeks [42–44]. The side effects of salicylic acid peeling are mild and transient. These include erythema and dryness. Persistent postinflammatory hyperpigmentation or scarring are very rare and for this reason it is used to treat dark skin [45]. Rapid breathing, tinnitus, hearing loss, dizziness, abdominal cramps, and central nervous system symptoms characterize salicylism or salicylic acid toxicity. This has been observed with 20% salicylic acid applied to 50% of the body surface [46]. Grimes has peeled more than 1,000 patients with the current 20 and 30% marketed ethanol formulations and has observed no cases of salicylism [47].

(E) Trichloroacetic Acid —

The use of trichloroacetic acid (TCA) as a peeling agent was first described by P.G. Unna, a German dermatologist, in 1882. TCA application to the skin causes protein denaturation, the so-called keratocoagulation, resulting in a readily observed white frost [48]. For the purposes of chemical peeling, it is mixed with 100 mL of distilled water to create the desired concentration. The degree of tissue penetration and injury by a TCA solution is dependent on several factors, including percentage of TCA used, anatomic site, and skin preparation. Selection of appropriate TCA-concentrated solutions is critical when performing a peel. TCA in a percentage of 10%–20% results in a very light superficial peel with no penetration below the stratum granulosum; a concentration of 25%–35% produces a light superficial peel with diffusion encompassing the full thickness of the epidermis; 40%–50% can produce injury to the papillary dermis; and finally, greater than 50% results in injury extending to the reticular dermis. Unfortunately the use of TCA concentrations above 35% TCA can produce unpredictable results such as scarring. Consequently, the medium depth chemical peel should only be obtained with the combination of 35% TCA. The use of TCA in concentrations greater than 35%, should be avoided. It can be preferred in some cases of isolated lesions or for treatment of isolated icepick scars (TCA CROSS) [49]. When performed properly, peeling with TCA can be one of the most satisfying procedures in acne scar treatment but it is not indicated for dark skin because of the high risk of hyperpigmentation [50].

(F) TCA Cross —

In our experience the TCA CROSS technique has shown high efficacy in the case of few isolated scars on healthy skin. CROSS stands for chemical reconstruction of skin scars method and involves local serial application of high concentration TCA to skin scars with wooden applicators sized via a number 10 blade to a dull point to approximate the shape of the scar. No local anesthesia or sedation is needed to perform this technique [51]. Unlike the reports found in the literature, in which 90% TCA is suggested, our experiences have shown that a lower TCA concentration (50%) has similar results and much less adverse reactions [52]. TCA is applied for a few seconds until the scar displays a white frosting. Emollients then needs to be prescribed for the following 7 days and high photoprotection is required. The procedure should be repeated at 4-week intervals, and each patient receives a total of three treatments. Our experiences have shown that, compared with other procedures, this technique can avoid scarring and reduce the risk of hypopigmentation by sparing the adjacent normal skin and adnexal structures [53] (Figures and ).

TCA Cross: patient before the treatment.

TCA Cross: patient after the treatment.

4.1.2. Dermabrasion/Microdermabrasion

Dermabrasion and microdermabrasion are facial resurfacing techniques that mechanically ablate damaged skin in order to promote reepithelialisation. Although the act of physical abrasion of the skin is common to both procedures, dermabrasion, and microdermabrasion employ different instruments with a different technical execution [54]. Dermabrasion completely removes the epidermis and penetrates to the level of the papillary or reticular dermis, inducing remodeling of the skin’s structural proteins. Microdermabrasion, a more superficial variation of dermabrasion, only removes the outer layer of the epidermis, accelerating the natural process of exfoliation [55, 56]. Both techniques are particularly effective in the treatment of scars and produce clinically significant improvements in skin appearance. Dermabrasion is performed under local or general anaesthesia. A motorized hand piece rotates a wire brush or a diamond fraise. Several decades ago, the hand piece was made of aluminum oxide or sodium bicarbonate crystals, whereas now diamond tips have replaced these hand pieces to increase accuracy and decrease irritation. There is often a small pinpoint bleeding of the raw wound that subsides with appropriate wound care. Patients with darker skin may experience permanent skin discoloration or blotchiness. As regards the technique of microdermabrasion, a variety of microdermabraders are available. All microdermabraders include a pump that generates a stream of aluminum oxide or salt crystals with a hand piece and vacuum to remove the crystals and exfoliate the skin [57]. Unlike dermabrasion, microdermabrasion can be repeated at short intervals, is painless, does not require anesthesia and is associated with less severe and rare complications, but it also has a lesser effect and does not treat deep scars [58, 59].

It is essential to conduct a thorough investigation of the patient’s pharmacological history to ensure that the patient has not taken isotretinoin in the previous 6–12 months. As noted by some studies [60], the use of tretinoin causes delayed reepithelialization and development of hypertrophic scars.

4.1.3. Laser Treatment

All patients with box-car scars (superficial or deep) or rolling scars are candidates for laser treatment. Different types of laser, including the nonablative and ablative lasers are very useful in treating acne scars. Ablative lasers achieve removal of the damaged scar tissue through melting, evaporation, or vaporization. Carbon dioxide laser and Erbium YAG laser are the most commonly used ablative lasers for the treatment of acne scars. These abrade the surface and also help tighten the collagen fibers beneath. Nonablative lasers do not remove the tissue, but stimulate new collagen formation and cause tightening of the skin resulting in the scar being raised to the surface. Among the nonablative lasers the most commonly used are the NdYAG and Diode lasers [61].

The ablative lasers are technologies with a high selectivity for water. Therefore, their action takes place mainly on the surface but the depth of action is certainly to be correlated to the intensity of the emitted energy and the diameter of the spot used. Among the ablative lasers, Erbium technologies are so selective for water that their action is almost exclusively ablative. CO₂ lasers, which present lower selectivity for water, besides causing ablation are also capable of determining a denaturation in the tissues surrounding the ablation and a thermal stimulus not coagulated for dermal protein. CO₂ lasers have a double effect: they promote the wound healing process and arouse an amplified production of myofibroblasts and matrix proteins such as hyaluronic acid [62].

Clinical and histopathologic studies have previously demonstrated the efficacy of CO₂ laser resurfacing in the improvement of facial atrophic acne scars, with a 50%–80% improvement typically seen. The differences in results reported with apparently similar laser techniques may be due to variations in the types of scar treated. Candidates must present a skin disease with acne off for at least 1 year; they should have stopped taking oral isotretinoin for at least 1 year; they should not have presented skin infections by herpes virus during the six months prior to treatment; they must not have a history of keloids or hypertrophic scarring. Patients with a high skin type phototype are exposed to a higher risk of hyperpigmentation after treatment than patients with low phototype.

All ablative lasers showed high risk of complications and side effects. Adverse reactions to the first generation of ablative lasers can be classified into short-term (bacterial, herpetic or fungal infections) and long-term (persistent erythema, hyperpigmentation, scarring) [63, 64]. In particular, scarring after CO₂ laser therapy may be due to the over treatment of the areas (including excessive energy, density, or both), lack of technical aspects, infection, or idiopathic. It is necessary to take into account these aspects when sensitive areas such as the eyelids, upper neck, and especially the lower neck and chest are treated [65, 66].

Nonablative skin remodeling systems have become increasingly popular for the treatment of facial rhytides and acne scars because they decrease the risk of side effects and the need for postoperative care. Nonablative technology using long-pulse infrared (1.450 nm diode, 1320 and 1064 nm neodymium-doped yttrium aluminum garnet (Nd:YAG), and 1540 nm erbium glass) was developed as a safe alternative to ablative technology for inducing a controlled thermal injury to the dermis, with subsequent neocollagenesis and remodeling of scarred skin [67–72].

Although improvement was noted with these nonablative lasers, the results obtained were not as impressive as the results from those using laser resurfacing [71].

For this reason, a new concept in skin laser therapy, called fractional photothermolysis, has been designed to create microscopic thermal wounds to achieve homogeneous thermal damage at a particular depth within the skin, a method that differs from chemical peeling and laser resurfacing. Prior studies using fractional photothermolysis have demonstrated its effectiveness in the treatment of acne scars [73] with particular attention for dark skin to avoid postinflammatory hyperpigmentation [74].

Newer modalities using the principles of fractional photothermolysis devices (FP) to create patterns of tiny microscopic wounds surrounded by undamaged tissues are new devices that are preferred for these treatments. These devices produce more modest results in many cases than traditional carbon dioxide lasers but have few side effects and short recovery periods [75]. Many fractional lasers are available with different types of source. A great deal of experience with nonablative 1550 nm erbium doped fractional photothermolysis has shown that the system can be widely used for clinical purposes.

An ablative 30 W CO₂ laser device uses ablative fractional resurfacing (AFR) and combines CO₂ ablation with an FP system. By depositing a pixilated pattern of microscopic ablative wounds surrounded by healthy tissue in a manner similar to that of FP [76], AFR combines the increased efficacy of ablative techniques with the safety and reduced downtime associated with FP.

Topographic analysis performed by some authors has shown that the depth of acneiform scars has quantifiable objective improvement ranging from 43% to 80% with a mean level of 66.8% [77]. The different experiences of numerous authors in this field have shown that, by combining ablative technology with FP, AFR treatments constitute a safe and effective treatment modality for acneiform scarring. Compared to conventional ablative CO₂ devices the side effects profile is greatly improved and, as with FP, rapid reepithelization from surrounding undamaged tissue is believed to be responsible for the comparatively rapid recovery and reduced downtime noted with AFR [78–80].

Pigmentation abnormalities following laser treatment is always a concern. Alster and West reported 36% incidence of hyperpigmentation when using conventional CO₂ resurfacing compared to a minority of patients treated with AFR treatments, probably linked to shortened period of recovery and posttreatment erythema [81]. The treatment strategy is linked to establishing the optimal energy, the interval between sessions, and a longer follow-up period to optimize treatment parameters.

4.1.4. Punch Techniques

Atrophic scarring is the more common type of scarring encountered after acne. Autologous and nonautologous tissue augmentation, and the use of punch replacement techniques has added more precision and efficacy to the treatment of these scars [82].

The laser punch-out method is better than even depth resurfacing for improving deep acne scars and can be combined with the shoulder technique or even depth resurfacing according to the type of acne scar [83].

Laser skin resurfacing with the concurrent use of punch excision improves facial acne scarring [84].

4.1.5. Dermal Grafting

Acne scars may be treated surgically using procedures such as dermabrasion and/or simple scar excision, scar punch elevation, or punch grafting [85].

The useful modalities available are dermal punch grafting, excision, and facelifting. The selection of these techniques is dependent on the above classification and the patient’s desire for improvement [86].

Split-thickness or full-thickness grafts “take” on a bed of scar tissue or dermis following the removal of the epidermis. The technique is useful in repairing unstable scars from chronic leg ulcers or X-ray scars. It can also camouflage acne scars, extensive nevi pigmentosus, and tattoos [87, 88]. It is prepackaged dermal graft material that is easy to use, safe, and effective [89].

4.1.6. Tissue Augmenting Agents

Fat transplantation. Fat is easily available and it has low incidence of side effects [90]. The technique consists of two phases: procurement of the graft and placement of the graft. The injection phase with small parcels of fat implanted in multiple tunnels allows the fat graft maximal access to its available bloody supply. The fat injected will normalize the contour excepted where residual scar attachments impede this.

4.

1.7. Other Tissue Augmenting Agents

There are many new and older autologous, nonautologous biologic, and nonbiologic tissue augmentation agents that have been used in the past for atrophic scars, such as autologous collagen, bovine collagen, isolagen, alloderm, hyaluronic acid, fibrel, artecoll, and silicon, but nowadays, because of the high incidence of side effects, the recommended material to use is hyaluronic acid [91].

4.1.8. Needling

Skin needling is a recently proposed technique that involves using a sterile roller comprised of a series of fine, sharp needles to puncture the skin. At first, facial skin must be disinfected, then a topical anesthetic is applied, left for 60 minutes. The skin needling procedure is achieved by rolling a performed tool on the cutaneous areas affected by acne scars (), backward and forward with some pressure in various directions. The needles penetrate about 1.5 to 2 mm into the dermis. As expected, the skin bleeds for a short time, but that soon stops. The skin develops multiple microbruises in the dermis that initiate the complex cascade of growth factors that finally results in collagen production. Histology shows thickening of skin and a dramatic increase in new collagen and elastin fibers. Results generally start to be seen after about 6 weeks but the full effects can take at least three months to occur and, as the deposition of new collagen takes place slowly, the skin texture will continue to improve over a 12 month period. Clinical results vary between patients, but all patients achieve some improvements (Figures and ). The number of treatments required varies depending on the individual collagen response, on the condition of the tissue and on the desired results. Most patients require around 3 treatments approximately 4 weeks apart. Skin needling can be safely performed on all skin colours and types: there is a lower risk of postinflammatory hyperpigmentation than other procedures, such as dermabrasion, chemical peelings, and laser resurfacing. Skin needling is contraindicated in the presence of anticoagulant therapies, active skin infections, collagen injections, and other injectable fillers in the previous six months, personal or familiar history of hypertrophic and keloidal scars [92, 93].

Needling: patient before the treatment.

Needling: patient after the treatment.

4.1.9. Combined Therapy

There is a new combination therapy for the treatment of acne scars. The first therapy consists of peeling with trichloroacetic acid, then followed by subcision, the process by which there is separation of the acne scar from the underlying skin and in the end fractional laser irradiation. The efficacy and safety of this method was investigated for the treatment of acne scars. The duration of this therapy is 12 months. Dot peeling and subcision were performed twice 2-3 months apart and fractional laser irradiation was performed every 3-4 weeks. There were no significant complications at the treatment sites. It would appear that triple combination therapy is a safe and very effective combination treatment modality for a variety of atrophic acne scars [94].

4.2. Hypertrophic Scars

4.2.1. Silicone Gel

Silicone-based products represent one of the most common and effective solutions in preventing and also in the treatment of hypertrophic acne scars. The silicone gel was introduced in the treatment of hypertrophic acne scars to overcome the difficulties in the management of silicone sheets. Indeed, the silicone gel has several advantages: it is transparent, quick drying, nonirritating and does not induce skin maceration, it can be used to treat extensive scars and uneven areas of skin. The mechanism of action is not fully understood but several hypotheses [95] have been advanced: (1) the increase in hydration; (2) the increase in temperature; (3) protection of the scar; (4) increased tension of O2; (5) action on the immune system. There is, currently, only one observational open label study, conducted on 57 patients. In this study, the gel was applied on the scars 2 times daily for 8 weeks with an average improvement in the thickness estimated between 40% and 50% compared to baseline.

As regards the treatment of already formed hypertrophic scars, the gel should be applied in small amounts, twice daily for at least 8 weeks to achieve a satisfactory aesthetic result. Whereas for the purposes of prevention, the same dosage is recommended for at least 12–16 weeks; the treatment should be started as soon as possible after the risk of a patient developing hypertrophic acne scars has been identified.

Treatment with silicone gel can be used in patients of any age and women of childbearing age. Moreover, the silicone gel can be used throughout the year, including summer.

4.2.2. Intralesional Steroid Therapy

Intralesional injection of steroids is one of the most common treatments for keloids and hypertrophic scars. It can be used alone or as part of multiple therapeutic approaches. Corticosteroids may reduce the volume, thickness, and texture of scars, and they can relieve symptoms such as itching and discomfort [96]. The mechanisms of action have not been completely clarified: in addition to their anti-inflammatory properties, it has been suggested that steroids exert a vasoconstrictor and an antimitotic activity. It is believed that steroids arrest pathological collagen production through two distinct mechanisms: the reduction of oxygen and nutrients to the scar with inhibition of the proliferation of keratinocytes and fibroblasts [96]; the stimulation of digestion of collagen deposition through block of a collagenase-inhibitor, the alpha-2-microglobulin [97]. During the injection the syringe needle should be kept upright [24]. It is always preferable for the injections to be preceded by the application of anesthetic creams or be associated with injections of lidocaine [97].

Intralesional steroid therapy may be preceded by a light cryotherapy with liquid nitrogen, 10–15 minutes before injection, to improve the dispersion of the drug in scar tissue and minimize the deposition in the subcutaneous and perilesional tissue [98]. The steroid that is currently most frequently used in the treatment of hypertrophic scars and keloids is triamcinolone acetonide (10–40 mg/mL) [99]. The most common adverse reactions are hypopigmentation, skin atrophy, telangiectasia, and infections [100]. As for injuries to the face, the use of intralesional steroids is recommended for the treatment of individual elements which are particularly bulky and refractory to previous less invasive methods.

4.2.3. Cryotherapy

Cryotherapy with liquid nitrogen can significantly improve the clinical appearance of hypertrophic scars and keloids and also determine their complete regression.

The low temperatures reached during cryotherapy sessions cause a slowing of blood flow and cause the formation of intraluminal thrombus hesitant to anoxia and tissue necrosis [101]. Age and size of the scar are important factors conditioning the outcome of this technique: younger and smaller scars are most responsive to cryotherapy [102]. Compared with intralesional injections of corticosteroids, cryosurgery is significantly more effective than alternative methods for richly vascularized injuries 12 months younger [103]. During each session of cryotherapy the patient is usually subjected to 2-3 cycles, each lasting less than 25 seconds. Cryotherapy can also be used before each cycle of intralesional injections of steroids to reduce the pain of injection therapy and to facilitate the injection of cortisone, generating a small area of edema at the level of the scar tissue to be treated [98]. Possible adverse reactions are represented by hypo- and hyperpigmentation, skin atrophy, and pain [102]. With regard to localized lesions to the face, the possible outcomes of freezing restrict the use of cryotherapy in these areas, especially in cases where the scars are numerous or for dark phenotypes. Therefore, cryotherapy can be taken into consideration especially for scars located on the trunk or for particularly bulky scars on the face.

4.2.4. Pulsed Dye Laser

The use of lasers for hypertrophic scars and keloids was first proposed by Apfelberg et al. [104] and Castro et al. [105] in the 1980s, and since then more lasers with various wavelengths have been introduced. Unfortunately, laser therapy for hypertrophic scars has had only variable success in the past due to the minimal improvement in a high percent of patients [106–108].

On the contrary, the use of pulsed dye laser (PDL) has provided encouraging results in the treatment of hypertrophic/keloidal scars over the past 10 years. Several studies have been conducted to investigate how the PDL works on hypertrophic/keloidal scars. They have revealed that PDL decreases the number and proliferation of fibroblasts and collagen fibers appear looser and less coarse [109]. Moreover, PDL also produces an increase in MMP-I3 (collagenese-3) activity and a decrease in collagen type III deposition [110]. As a consequence, PDL flattens and decreases the volume of hypertrophic scars [111, 112], improves texture [113], and increases elasticity [114], usually after two to three treatments [115]. Additionally, pruritis and pain within the scars are significantly improved [116]. Besides, no recurrence or worsening of PDL-treated scars occurs during the 4-year followup after cessation of treatment [116]. The most common side effect of the PDL is purpura which can last as long as 7–10 days. Blistering can also occur as well as hypo- and hyperpigmentation which is more likely in darker skinned individuals [117]. Therefore, the ideal candidates for PDL are patients with lighter skin types (Fitzpatrick Types I–III) because less melanin is present to compete with hemoglobin laser energy absorption [118, 119].

4.2.5. Surgery

For the correction of large facial scars, W-plasty seems to be optimal [12]. This therapeutic procedure causes a disruption of the scar which makes the lesion less conspicuous. Especially in facial surgery, autologous skin transplants, namely, full thickness skin transplant or composite fat-skin graft, are another valuable alternative for achieving wound closure with minimal tension. The preferred donor sites for skin graft used for facial defects are the retro- and preauricular sites as well as the neck [120].

4.2.6. Other Approaches

Other treatment options for hypertrophic acne scars and keloids that can be taken into account include elastic compression, intralesional injection of 5-fluorouracil, imiquimod, interferon, radiotherapy, and bleomycin. All these approaches, however, are more effective for the treatment of hypertrophic scars not caused by acne and their use is not recommended due to their impracticality (elastic compression), the lack of clinical experience in the literature (5 FU, interferon, radiotherapy, bleomycin) the lack of efficacy (imiquimod), and the high costs (interferon).

15 Best Acne Scar Treatments, According to Dermatologists

When you’re dealing with a stubborn scar after your zit heals, your best bet is acne scar treatment. Post-acne dark spots and hyperpigmentation are, for the most part, out of your control, thanks to your genetics (and oftentimes, the sun). But, that doesn’t mean you’re stuck with them forever. While seeking treatment from a dermatologist will ensure a custom regimen for your skin, over-the-counter acne scar treatments can be just as effective as long as you know where to start.

To help you figure out what causes acne scars and the best acne scar treatments, we tapped Onyeka Obioha, MD, a board-certified dermatologist.

What causes acne scars

“Acne scars are a result of the injury the acne lesion created on the skin,” explains Dr. Obioha. The inflammation from the acne causes a loss of collagen in the skin, which results in scarring that’s characterized by depressions or pits in the skin, she adds. For people with melanin-rich skin, the inflammation can also trigger pigment production, causing post-inflammatory hyperpigmentation, and for those with lighter complexions, it can result in residual redness and red acne scars.

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How to treat acne scars

In order to treat acne scars, Dr. Obioha says you first have to treat any active breakouts and then prevent scarring with “effective skin care.”

Topical retinoids can help control future breakouts, in addition to stimulating collagen production to smooth the surface of your skin, says Dr. Obioha. Additionally, she recommends using antioxidants such as vitamin C to support the overall health and vibrancy of your skin. “Exfoliating AHA/BHA cleansers are also helpful,” she says.

In addition to using these products, Dr. Obioha recommends working with a dermatologist who understands your skin and can create a routine for you to follow that focuses on treating your particular type of scarring. You can also try treatments such as microneedling, laser resurfacing, and chemical peels to get rid of your acne scars, but make sure to speak to a dermatologist or esthetician first.

The best acne scar treatments

Shop below for the most effective acne scar treatments by type.

Best drugstore acne scar treatment

Differin Gel Acne Treatment — $12.00

This is one of the best acne and acne scar treatments you can get your hands on, and you don’t have to worry about spending your entire paycheck on it. This gel helps prevent breakouts before they happen (it gets deep into your pores) and also prevents new acne from forming. Differin also promotes skin cell turnover which is a fancy way of saying it helps remove dead skin, in addition to reducing and preventing your risk of scarring and hyperpigmentation due to being formulated with adapalene, a retinoid-like compound.

Neutrogena Stubborn Marks PM Treatment — $16.00

Add this scar treatment to your evening routine if one of your skin-care goals is to get rid of acne scars for good. The retinol helps exfoliate your skin, which, as a result, helps get rid of post-acne marks, in addition to evening out the texture and tone of your skin.

The best acne scar creams

Topicals Faded Serum for Dark Spots & Discoloration — $36.00

Acne scars won’t stand a chance if you’re using Topicals. We know it has serum in its name, but it looks and feels like a cream (in the best way possible), and most importantly, will reduce acne scars. It features ingredients like tranexamic acid and niacinamide, which help combat dark patches and marks and reduce discoloration. It’s also got azelaic acid, which works wonders by brightening skin and evens out skin texture.

Murad InvisiScar Resurfacing Treatment — $36.00

This resurfacing cream does a little bit of everything, which is probably why it has over 31,000 “hearts” on Sephora’s website. It targets old and new acne scars and is supposed to minimize the scar size, depth, and hyperpigmentation in eight weeks. It’s also great for dark circles under the eyes and evening out the texture of your skin.

Acne scar brightening serums

Eadem Milk Marvel Dark Spot Serum — $68.00

This is my current favorite dark spot serum, and I’m already on my second bottle. What I love about this serum is how gentle it is. It’s scent-free, can be used daily in conjunction with other products like retinol, and it was created with melanin-rich skin in mind.

CeraVe Vitamin C Serum with Hyaluronic Acid — $18.00

One way to prevent and reduce acne scars is by using products that have vitamin C in them. This serum has 10 percent l-ascorbic acid (the purest form of vitamin C) to brighten scars, along with three essential ceramides, hyaluronic acid, and vitamin B5 to provide hydration.

Other products to treat acne scars

SkinMedica AHA/BHA Exfoliating Cleanser — $47. 00

Dr. Obioha says that exfoliating AHA/BHA cleansers are also helpful in preventing and reducing acne scars, hyperpigmentation, and increasing cell turnover. SkinMedia is one of her go-tos, as it removes dead skin cells and impurities from the skin.

Kosa Sport Good Body Skin — $18.00

I’m typically not a fan of body washes but I absolutely love this new body wash from Kosas Sport. It’s gentle, features AHAs and enzymes to exfoliate the skin without leaving it feeling or looking dry, has a light, fresh scent, and helps reduce and prevent body acne and scars.

Why you should wear sunscreen to prevent and reduce acne scars and hyperpigmentation

Creams and serums formulated specifically to target post-inflammatory hyperpigmentation will reduce your acne scars over time, but another simple way to help reduce scars is by wearing two fingers’ worth of sunscreen daily (SPF 30 or higher). Make sure that you reapply about every two hours.

Wearing sunscreen helps reduce hyperpigmentation because UV radiation increases melanin production, which tends to make the appearance of your dark spots worse, and the sunscreen will inhibit this production, Jenny Liu, MD, board-certified dermatologist, told Well+Good previously.

A good spot treatment, an antioxidant-rich serum, sunscreen, and a game plan from your derm will help you get rid of your acne scars in no time!

Want even more beauty intel from our editors? Join Well+Good’s Fine Print Facebook group (and follow us on Instagram) for must-know tips and tricks.

Our editors independently select these products. Making a purchase through our links may earn Well+Good a commission.

How to Find the Right Acne Scar Treatment Procedure for You—With or Without Lasers

Best for: Raised acne scars.

Cost: The cost and amount of treatments needed varies widely depending on the scar.

Surgery

Surgical options for acne scars may seem a little counterintuitive, since surgeries in and of themselves leave scars behind. According to the AAD, these post-operation scars will gradually fade. The AAD also notes that acne scar surgery may involve lifting the scar so that it leaves less of a depression in the skin, or a procedure called subcision, in which the scar tissue that’s pulling the skin down is broken up.

Subcision works particularly well as a precursor to laser treatments as it frees up the skin, so to speak, and allows the laser to work more efficiently over the area, Dr. Vashi says. As with any surgery, there’s always a risk of bleeding or infection, Dr. Johnson says, so, again, be sure that your provider is an experienced, board-certified dermatologist.

Best for: Those who have just a few depressed scars. Some types of surgery can also address raised scars that haven’t responded to other treatments, like injections.

Cost: $200-400 per scar/lesion

Topical silicone treatments

With new or only slightly raised scars, Dr. Vashi says silicone gel sheets, which work to reduce the scar’s size and stiffness have been found, anecdotally, to be effective treatment options. Silicone gels and sheets are also an attractive option because they can be purchased over-the-counter at drugstores or online.

But they take a fair amount of dedication to get results: You’ll need to wear the sheet (basically all day) in the same spot every single day for a while, possibly months, the AAD says. That can cause side effects, including rashes. And, if you’re treating acne scars on your face, you may not want to put up with that. Even if you do, know that silicone treatments aren’t likely to completely treat the scar.

Also, know that topical silicone treatments are most effective if used “while the scar is healing and before it thickens,” Dr. Stevenson says. So if you’ve had a raised scar for a few years and are just now thinking about trying to minimize it, you may not see great results with topical silicone.

Best for: New or only slightly-raised scars.

Cost: $20-40 for a package of eight sheets.

There is no one “right” way to address acne scars.

Just as a reminder, scars are not inherently dangerous or bad for you. They’re usually a normal part of the healing process. And the treatments out there to make them less noticeable are costly and definitely not perfect. So, if they don’t bother you, it’s perfectly fine to keep them around!

But if you do want to try to get rid of them, there are plenty of options out there. And your best course of action will be to talk to your dermatologist about which procedures are best for you.

And, instead of viewing lasers as something to avoid when planning your scar regimen, think of them as the Tony Stark of the Avengers-esque assembly of treatments your dermatologist will prescribe—undoubtedly intense, but they’re going to anchor the rest of the team. (We know you didn’t ask, but dermabrasion is obviously the Hulk.)

When carried out by an experienced derm and taken as just one part of your overall treatment plan, laser treatments don’t have to be scary. But the most important thing is to work with a dermatologist you trust to find a plan that works for you—with or without lasers.

Related:

Acne Scar Removal Beverly Hills

Rooted at the base of each facial hair follicle is an oil gland that produces the appropriate amount of secretion to keep the skin healthy and glowing. When these hair follicle roots become saturated with dirt, dead cells, debris or makeup, the oil builds up, creating a pimple. Sometimes these growths fill with bacteria, making their spread throughout the skin cells even worse. They may mushroom to become pustules, lesions, cysts or nodules.

How do acne scars form?

Many clients struggle with picking at their pimples. This sometimes leaves damaging scars, which are due to an excess of collagen being released by the body to compensate for a wound. Acne scars are quite troublesome because even after the pimples themselves have healed, they still leave a trail that can negatively affect the appearance.

What are some causes of acne?

There are several factors that contribute to acne, including overproduction of the androgen hormone during the teenage years, or a general change in the oil glands’ functioning. There is also the possibility that acne is genetic and is passed on through the generations.

What are the best treatments for acne and acne scar removal?

The Biomed Spa is pleased to offer our Beverly Hills clients a wide selection of procedures that can revitalize the skin and clear up the complexion. We may suggest antibiotics, retinoids or glycolic acid, or may direct a client towards birth control pills, which can regulate hormones. Medications like Isotretinoin may also be prescribed.

In addition, your aesthetician may recommend laser therapy, CO2 laser treatment, dermaplaning, dermabrasion, fraxel laser, Vbeam, microdermabrasion, laser skin resurfacing, dermal fillers, chemical peels and facials, or cortisone injections. These are all excellent acne treatment options. Visit The Biomed Spa for some excellent results from acne scar removal Beverly Hills clients can rely on.

Why should I choose The Biomed Spa for my treatment?

Gorgeous, youthful skin is one of The Biomed Spa’s specializations. We have been helping clients from Beverly Hills and beyond for decades to look and feel their best, providing them with personalized attention and a customized treatment plan that targets their individual skincare needs.

Our integrity demands that we never suggest a treatment that isn’t required, however. We dote on each patient and take as long as is needed to answer all their questions. Our providers believe that knowledge about a certain procedure is empowerment, and we want only well being and confidence for all our clients before they move forward.

How To Get Rid Of Acne Scars

Acne can be frustrating to deal with from the time it starts forming to the time it ends its cycle. The lumps and bumps that form can be painful, hard to conceal, and overall distressing. For many acne sufferers, once the blemishes have run their course, they may leave behind a trail of scars in their wake, which can range in type and severity. Luckily, they don’t have to be permanent—there are a few ways you can get rid of acne scars. With time, patience, and the right skin care routine, you can help address the look of your acne scars and pave the way toward clearer-looking skin. 

What Causes Acne Scars To Form?

Acne forms when a pore plug (blackhead or whitehead) becomes infected with bacteria, creating an inflammatory response that for some skin types and tones can be chronic. Since your fingers might carry bacteria, popping a pimple can push bacteria deeper into the skin and increase the chance of a scar forming. To help reduce the risk of acne scars forming, make sure not to pick at your blemishes. The American Academy of Dermatology (AAD) suggests that acne scars may also look more noticeable with age as collagen levels begin to decrease. The sun’s harmful rays can also darken the appearance of scars and marks, so be sure to apply broad-spectrum SPF 30 or higher prior to heading outdoors to prevent sun damage. 

How To Get Rid Of Acne Scars?

The good news is that there are many corrective options available to address acne scarring. According to the Mayo Clinic, mild acne marks that do not leave any indentations may improve with the use of dark spot correctors and proper sun protection measures. We recommend using the L’Oréal Paris Youth Code Dark Spot Correcting & Illuminating Serum Corrector, which improves the appearance of dark spots and discoloration for a more even, radiant and youthful complexion. You should also look for products containing ingredients like glycolic acid, which works as an exfoliant that helps shed dead skin cells and brighten up your skin. Reach for the L’Oréal Paris Revitalift Derm Intensives 3.5% Glycolic Acid Cleanser which works to gently dissolve dead skin cells and remove excess oil to leave you with hydrated and refreshed looking skin. If you’re in need of a serum, try using the L’Oréal Paris Revitalift Derm Intensives 10% Pure Glycolic Acid Serum. It’s specially blended with aloe to help soothe and hydrate the skin. 

Editor’s Tip: Products with glycolic acid may increase photosensitivity, so be sure to apply a face moisturizer that has SPF 30 or higher in it. We love to layer on the L’Oréal Paris Revitalift Triple Power Day Lotion SPF 30 the morning after using the pure glycolic acid serum. 

If your acne scars are deep and indented, there are other options that may help smooth their appearance. Depending on the type of acne scar, its severity, and how long it has been around, one of the below options (or a combination of them) may work to get rid of your acne scars.

Treatment #1: Dermabrasion

If your acne scars are deep, your dermatologist may recommend a skin-resurfacing procedure known as dermabrasion. According to the Mayo Clinic, dermabrasion utilizes a device that sands the outer layers of skin to reduce the look of facial lines and improve the look of acne scars and other hyperpigmentation. 

Treatment #2: Chemical Peels

Chemical peels are often used to help reduce the look of signs of aging (such as fine lines and wrinkles), certain types of acne, and skin discoloration. During a chemical peel, your dermatologist will apply a chemical solution to the skin, encouraging the top layer of skin to peel away. For an at-home solution, reach for the L’Oréal Paris Revitalift Bright Reveal Brightening Daily Peel Pads, which can be used to resurface dull, uneven skin tones and rough textures. It includes glycolic acid to help brighten and smooth your skin. 

Treatment #3: Laser Resurfacing

Fractional or ablative lasers are commonly used to address the appearance of acne scars. These aggressive lasers can leave the skin swollen and red for a bit of time. Some skin care providers may prefer non-ablative lasers, which are arguably less harsh, to lighten scars. However, while this type of laser doesn’t require downtime, a series of treatments will be necessary for the desired results. 

Editor’s Tip: Make sure to research and seek out laser treatment from a trained professional only. Some laser treatments can be damaging to people with darker skin tones. 

Treatment #4: Fillers

The AAD suggests that dermal fillers may improve the look of depressed acne scars but not icepick scars (deep V-shaped scars, that look like an ice pick made a puncture in the skin). These fillers can be injected into the acne scars to fill them out and soften their crater-like appearance. Note that this is only a temporary solution and would likely need to be done regularly.

Due to the different types and severities of acne scars, it can be challenging to pinpoint the right options that will prove successful for all. We recommend visiting your skin care provider to talk about the side effects and risk factors associated with each option before determining the best plan of action for your acne scars. 

Next: How to Hide Acne Scars with Makeup

7 Treatment Options for Saying Goodbye to Acne Scars: Los Gatos Dermatology: Cosmetic Dermatologists

Acne scars are not fair. First you had to suffer from unsightly blemishes, and now that they’re gone, a permanent scar or multiple scars lie in their place. Not every a pimple leaves a scar, though. The blemishes and cysts that become inflamed, swollen, and reddish are most likely to cause a scar when they go away.

When acne erupts, it damages the surrounding skin. Your body tries to heal this damage by producing collagen. Collagen is a protein that helps support skin structure. Sometimes the body produces too little, and the result is a depressed scar, and sometimes it produces too much, creating a raised scar.

The good news is that you don’t have to live with acne scars. There are numerous options to treat both types of scars. At Los Gatos Dermatology, we offer seven different treatment options to help fade or eliminate your scars. Dr. Bruce Saal recommends the best choice or choices to make your skin look better. Treatment options include:

Prescription medications

Both oral and topical medicines, often in conjunction with other treatments, can help reduce the appearance of some acne scars.

TheraClear™ Acne System

TheraClear Acne System treats acne scars without any oral or topical medication, ointments, or creams. It’s an FDA-approved vacuum and light device treatment that is effective for both reducing acne and acne scars. Multiple treatments are usually needed to achieve your desired result.

Thermage®

Thermage is a radiofrequency laser device that transmits heat to the skin, which promotes collagen production to fill out depressed scars. This treatment helps smooth and tighten your skin without medication, injections, or surgery. It not only diminishes the appearance of acne scars but improves your overall look and tightens loose skin.

CO2 skin resurfacing

This laser treatment fades sun spots, acne scars, and other hyperpigmentation on the skin. It’s an ablative treatment, meaning it removes the outer layer of the acne-scarred skin. It’s a powerful laser that produces remarkable results in terms of giving you an improved overall more youthful look.

But there are several days of downtime, which means your skin won’t look so great for about two weeks after the treatment as it turns red, swells, and peels off. So don’t plan any big social events immediately following the treatment.

Fractional laser treatment

Fractional laser treatments are less intense than an ablative laser treatment. The results aren’t as dramatic, so this treatment is best if you have mild acne scars. The laser uses fractional light energy to treat acne scars and also improve your skin’s overall appearance.

Downtime for fractional laser is minimal, and you will probably need two to three treatments spaced about a month apart.

Juvederm® XC injectable

Juvederm is a popular type of facial filler used for plumping up sunken areas in your face and filling in creases around your mouth. It can also plump up deep, sunken acne scars.

SilkPeel® Dermalinfusion

SilkPeel Dermalinfusion is a skin care treatment similar to microdermabrasion where the top layer of the skin is exfoliated. But with SilkPeel Dermalinfusion, various facial serums are used in conjunction with the buffing away of the top layer of skin to treat specific conditions.

For more information about how to fade your acne scars, call Los Gatos Dermatology in Los Gatos, California, or use the online form to contact us.  

Best Acne Scarring Removal in Honolulu by Dermatology Expert

Adult acne is much more common in Honolulu than you might think, and it can really affect your self-esteem. Complicating matters is the fact that, left untreated or not treated properly, it can cause acne scarring as an unsightly reminder.

If you’re prone to acne breakouts, pay heed and get treatment because acne scarring can have an adverse effect on your social and professional life. In the world of Honolulu cosmetic dermatology, skin specialist Dr. Kory Kitagawa, founder of Kitagawa Dermatology, specializes in acne scar treatment with a variety of effective procedures.

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Acne and Acne Scarring in Honolulu, HI

Acne does not discriminate. Regardless of skin color, skin type, age, or area of your body, acne can hit anyone. Many of the areas are ones that you show to the world every day:

•    Face
•    Neck
•    Shoulders
•    Chest
•    Back

And with the different types of acne that can form – pimples, blackheads, whiteheads, papules, cysts, and nodules – is it any wonder why acne can be so disruptive? However, it’s the potential long-term effects of acne that are even more troublesome – scarring.

Although acne scars develop from any type of acne, the most serious scars form from nodules and cysts because they inflict the most damage to the skin around the affected area. Another common factor in the development of acne scarring is constantly picking at your pimples. If your acne is mostly superficial, it will often heal itself without scar treatment and won’t leave a noticeable mark. Blemishes that go deeper under your skin, on the other hand, usually don’t heal cleanly by themselves, resulting in flawed skin.

Atrophic and Hypertrophic – They’re Not All the Same

Not all acne scars are the same, mostly taking form in two distinct types, atrophic and hypertrophic.

Atrophic scars are ones that form shallow depressions on your skin because of tissue loss from the acne breakout. Atrophic scars show themselves in two different forms: icepick scars and boxcar scars. The former are small noticeable holes or indentations in your skin, as if from being poked with an icepick. Boxcar scars, on the other hand, are deeper round or oval depressions with steep, sharply angled sides. If you’ve had chickenpox, you might recognize the similarities in the scarring.

Hypertrophic, or keloid, scarring is characterized differently. Instead of causing depressions in your skin, the opposite occurs – the scar is a raised collection of tissue that has accrued due to your body’s over-production of collagen to repair the wound your acne has left. Learn more about acne scar removal at WebMD.com.

Acne Scar Removal Treatment

Unfortunately, many people in Honolulu think that acne scars will fade as time passes, and, while it may happen, it’s not something you should expect. The best method of dealing with acne scars is undergoing cosmetic services for treatment designed for acne scar removal.

Laser Skin Resurfacing

Laser skin treatments for acne scars involve beaming a laser light into your skin to remove the scarred upper layers, allowing deeper layers of your skin to come to the surface. This refreshes your skin and rejuvenates your appearance. It’s also a catalyst for your skin’s self-repairing mechanism by stimulating collagen production to restore your vibrant, youthful radiance!

Other Light Therapies

Aside from lasers, other types of light therapy for acne scar treatment are effective because they gently zap your scars with intense beams of light that don’t damage your skin beyond the targeted scar. Light therapy is often used in conjunction with other acne treatments to even better effect.

Soft Tissue Fillers

If you’re like many of our patients, you might be surprised to learn that soft tissue dermal fillers can help fade acne scars. Restylane is an effective family of dermal fillers that can be injected into your scar to temporarily smooth and plump the scarred area.

Excision and Punch Graft

This procedure takes a delicate touch. Your dermatologist will gently excise your acne scars and then stitch them up for healing. After that, a skin graft is taken from a different part of your body, such as your ear, and applied to the excised area so that the natural healing process can take place. This is another treatment often used together with other treatments, such as laser resurfacing, to produce amazing results.

Chemical Peel

A chemical solution is applied to your skin to remove the top layer, allowing the fresh, new layer underneath to come to the surface.

Remove Acne Scars at Kitagawa Dermatology Honolulu

Don’t let acne scarring affect your life. Be sure not to ignore it because there is treatment available to remove acne scars. At Kitagawa Dermatology, we are proud to offer the best acne treatment in Honolulu, Hawaii regardless of how severe they are or where they are located on your body. To learn more, fill out our online contact form or call 808.533.4434 today.

Next, read about injectable fillers.

90,000 Laser treatment of acne scars in the LINLINE clinic

Why choose LINLINE for post-acne laser treatment?

What is post-acne?

What if the skin resembles a lunar landscape?

Acne disease (acne) is often severe. Too much pus is produced and the hair follicle ruptures. As a result of this rupture, various bacteria penetrate into the deep layers of the skin. They injure healthy tissue, and the focus of inflammation spreads deep into the skin.As a result, cysts and fistulas are formed, after which deep scars remain on the skin – post-acne.

How to get rid of post acne?

Post-acne owners know that it is almost impossible to fight them. These scars are very difficult to treat, since they were formed against the background of prolonged inflammation. Often, the patient tries to speed up the healing process of acne (crushes them and injures the skin), but this only exacerbates the formation of deep scars, shaped like lunar craters.

Peculiarities of post-acne treatment

Previously, post-acne scars were practically not amenable to safe correction. Skin after acne requires special treatment: it is susceptible to any injury, susceptible to infections. If a person undergoes Roaccutane therapy, his skin becomes dry and sensitive, and it is very easy to injure such skin.

Methods of post-acne treatment

Such an aggressive technique as chemical peeling is not only painful and traumatic.The acid literally corrodes the skin, leaving behind burns and pigmentation. By solving one problem, you risk getting another. That is why deep chemical peels have long been banned in Europe. This method is still popular only in Russia.

We offer you two safe acne treatment options. Peeling with erbium laser and RecoSMA. Both options are effective. The only difference is in the number of procedures. RecoSMA is painless and safe. To achieve the full result, a course of at least 3 procedures is required.Laser peeling is a less comfortable technique that requires a little rehabilitation (5-7 days).

Laser nanoperforation and RecoSMA

Both laser methods are suitable for treating the effects of acne and differ in the depth of laser exposure (Nanoperforation is a more superficial method, RecoSMA is a deeper one). The choice of method depends on the severity of acne, in some cases – on the type of skin. The method of exposure is chosen by the doctor.

This is the safest and most gentle skin healing technique.It completely restores the affected areas in a short time. Laser treatment gently triggers the skin regeneration process. The body begins to actively produce collagen and elastin. As a result, the scars become less and less noticeable and after a course of procedures disappear completely. The procedure is comfortable and does not require any special anesthesia. The recovery period takes no more than 2-3 days. New healthy skin forms at the site of atrophic scars.

How is the post-acne laser treatment procedure?

Techniques Nanoperforation and RecoSMA, thanks to special laser settings, allow very delicate, point-like destruction of scar tissue.In addition, during the procedure, the fibroblasts are stimulated, which begin to intensively produce new collagen and elastin. Due to this, the scar tissue is “lifted” and the texture and relief of the skin are leveled. The result is visible after the first procedure, the relief is noticeably leveled. But in order to finally eliminate post-acne, several sessions are required.

What happens after the acne laser treatment procedure?

Nanoperforation and RecoSMA work with sufficiently deep layers of the skin, but at the same time it has a very short rehabilitation period – a maximum of 3 days.In addition, unlike other techniques, the doctor fully controls the work of the beam, which means that safety is guaranteed.

When is the result visible after acne laser treatment?

After Nanoperforation and RecoSMA, the first results are visible after a few days and reach their maximum after a few weeks. We start the natural processes of skin renewal, and they do not happen overnight. But during this period, the skin gets better and better day by day.

How RecoSMA works in post-acne treatment

1. RecoSMA gently replaces healthy scar tissue
2. Skin relief is smoothed, raising the “bottom” of the scars to the skin surface
3. Tightens the pores, which prevents further acne from occurring.

Here you can read more about laser nanoperforation and RecoSMA

Laser peeling (erbium laser)

The technique is effective, but unlike nanoperforation, it has a longer recovery period.

Erbium laser peeling evaporates the upper layer of the epidermis. Healthy skin forms at the site of the scars. Unlike other lasers (eg CO2), the penetration depth of the laser beam is completely controlled.This is what makes it possible to guarantee the safety of the procedure.

How laser peeling works in post-acne treatment

During the peeling, a deep renewal of the skin layers takes place. During the recovery period, regeneration of new skin occurs, during which the density and depth of post-acne scars decreases, and the structure of the skin improves.

Here you can read more about laser peeling

The necessary technique and the optimal course of treatment will be prescribed by a specialist in a personal consultation.

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Ekaterina (Chelyabinsk) writes:

I got rid of acne scars in 3 months and 4 nanoperforations.Before that I had been using foundation for 5 years, now I have forgotten about it.

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Laser procedures in LINLINE are painless, effective and safe for the skin. See for yourself on the test procedure.

Laser removal of scars and scars in St. Petersburg

Removing scars on the face and body with a laser will permanently get rid of an aesthetic defect.The technique is suitable for eliminating scars that have appeared for various reasons: traces of acne, surgery, cuts and other mechanical damage.

Fraxel re: store DUA fractional laser is used in our clinic. It is characterized by high efficiency, low rehabilitation period and absolute safety.

Types of scars that can be removed

These include all types of scars:

• Atrophic . With such lesions, the skin sinks inward, dimples and ruts appear.This is due to the fact that as a result of damage to the lining, the connective tissues give a low reaction, and there is a small production of collagen.
• Hypertrophic . Defects arising from the inflammatory process in the wound. In this case, connective tissue is formed in excess, as a result of which a tubercle appears above the main surface of the skin.
• Normotrophic . The least noticeable traces of damage to the skin, which have a lighter shade in comparison with natural skin tone.Unlike other types, they have low sensitivity.
• Keloid . Scars of a pathological nature with an inflammatory process inside. They have a bright color, bring painful sensations, itching and tend to further increase the area of ​​connective tissue – over time, it begins to go beyond the boundaries of the damaged area. Such a scar requires compulsory treatment.

In any case, before carrying out the procedure, a medical examination and consultation is required.

Advantages of the method

• Versatility. Laser correction is the removal or resurfacing of all types of scars, on any skin type.
• Painlessness. In order for the procedure to be completely painless, special anesthetics are used. As a result, the patient does not notice the impact.
• Allows you to remove the entire defect. The laser scar disappears without a trace.

Procedure

Before the procedure, the doctor conducts a consultation and examination.In the absence of contraindications, the session can be carried out on the same day. The defect is removed in one or several visits – it all depends on the size and type of the scar. The doctor treats the site with an antiseptic, anesthetic and directs the laser at the scar.

During the session, the laser beam penetrates to a precisely set depth, ensuring the evaporation of damaged skin cells. This activates recovery processes, collagen production. As a result, healthy and smooth skin is formed at the site of the scar.Scars and stretch marks are removed permanently.

Skin care after the procedure

Sometimes a specialist may recommend wearing a silicone patch on the site of exposure to protect the tissues. For 14 days it is forbidden to sunbathe in the sun, visit the solarium and sauna. Also, as a rule, anti-scar ointments are prescribed. They must be applied throughout the course of treatment and rehabilitation. The recovery period lasts up to two weeks.

Contraindications

Resurfacing of scars and scars with a laser is contraindicated in:

• oncology;
• inflammations and infections in the acute stage;
• pregnancy and lactation;
• mental illnesses.

Laser cosmetology in Es Class Clinics Tula at an affordable price

Wrinkles, stretch marks, pigmentation and the effects of acne are not the best “decorations” for your face. And, of course, as soon as you notice such manifestations in your mirror image, it becomes a natural desire – to quickly remove these skin defects.

It is possible to get rid of wrinkles, acne marks and more thanks to laser cosmetology procedures – laser skin resurfacing and laser perforation in Tula (sometimes it is called “nanoperforation”).

To remove wrinkles, the effects of acne, reduce loose skin or remove enlarged pores, you should use laser face peeling (laser resurfacing). In “Es Class Clinic Tula” one laser resurfacing procedure takes place within half an hour. After that, slight redness may appear on the skin, but they will go away after 2-3 days, because the recovery period after grinding is quite short. Experts recommend applying sunscreen to the areas that have undergone the procedure, this is necessary in order to protect the skin from the aggressive effects of sunlight.

Laser peeling is indicated for use at any age. For young 20-year-old girls, the procedure will help get rid of the effects of acne, acne (acne), improve the complexion and skin structure. In more mature years, it will return youth and freshness to your skin, get rid of wrinkles and pigmentation.

In order to get a rejuvenating effect, you do not need to go under the knife of a plastic surgeon at all. Laser peeling in combination with laser perforation gives an overwhelmingly pleasant result.After all, it becomes noticeable after the first procedure.

In addition to fighting skin defects, laser peeling also has a therapeutic effect, namely, stimulates cell growth and collagen production. Thanks to this, wrinkles are smoothed, skin elasticity and smoothness increase. Plus, scars, scars and age spots are eliminated. These procedures can be performed on the skin of the face, including the area around the eyes, hands, décolleté and neck. Laser removal of age spots, stretch marks, stretch marks in Tula is carried out by professional cosmetologists.

Previously, a dermatocosmetologist will conduct a free consultation with you, warn you about possible contraindications and select an individual course of procedures.

In the department of cosmetology “Es Class Clinic Tula” you can easily restore youth to your skin, remove unpleasant defects and receive complex professional care for your face and body.

90,000 How to get rid of acne marks.How to remove, remove scars from prischis – Laserhouse

• Laserhouse
• How to get rid of acne marks. How to remove, remove scars from prischis – Laserhouse

Our skin exhibits an amazing ability to regenerate. And any minor damage will heal within a week. But only sometimes the result is a small scar or scar. And if a small scar on the body does not bring discomfort, then acne scars on the face do not go unnoticed.Pronounced depressions on the cheeks and forehead greatly spoil the appearance, and therefore it is not surprising that many are ready to resort to the most extreme methods, just to get rid of them.

So how do you get rid of acne marks? Very often, after acne, small dark spots remain on the face. In order to remove such “imprints” of experienced problems, there are several ways, ranging from specialized cosmetics for lightening pigmentation and ending with the so-called “grandmother’s recipes”.

Of the most effective remedies developed to get rid of acne marks, we can name drugs from such brands as Obagi, Zein Obagi, Danne, Skin Tech. These drugs belong to the class of professional, highly effective cosmetics, but at the same time they are great for home use.

To prepare the product yourself, you can find just a lot of recipes on the Internet. It can be various compresses, masks, scrubs and decoctions.Not all of them are effective, but many are able to make the tracks much lighter.

And if there are many methods of struggle from traces of acne in the form of pigmentation, up to home care, then removing scars after acne is much more difficult. Removing a pimple, we disrupt the skin at the cellular level, as a result, in order to restore the normal structure, you need to make no small efforts.

The most effective ways to deal with acne scars are professional beauty treatments.These include: laser face resurfacing, microdermabrasion and injection techniques. The principle of the first two is to remove the upper layers of the skin, which leads to a leveling of the surface and activation of the nutrition of the skin as a whole. Microdermabrasion is carried out according to the principle of micro-resurfacing, and laser resurfacing – according to the principle of “evaporation” of the surface layers of the skin. Both methods lead to the activation of collagen production and contribute not only to the leveling of the skin surface, but also to lighten the pigmentation, which also often remains after acne.Such procedures are carried out in the mode of a cosmetology center under the strict supervision of a cosmetologist. In this case, both resurfacing can be carried out both superficially and deep enough, depending on the depth of the scars and the properties of the patient’s skin.

The effectiveness of each of the methods depends on the correctness of the conduct, the condition of the skin and the desired results. Of course, in order for the skin to look perfect, you need to make a lot of effort, and you also need to combine several methods.But isn’t smooth, even and healthy skin worth it?

Laser acne treatment (MAGIC I®)

Acne (acne or pimples) and blackheads are a very common problem that almost every girl and young man faces. There are many methods and remedies for dealing with acne, but the most effective and less traumatic is laser treatment for acne and post-acne. With the help of a laser, you can remove the primary sources of the spread of acne, including purulent, comedones, disinfect the skin, and normalize the separation of sebum.

The laser is ideal for use in the development of inflammatory processes on the skin, while the laser beam acts as an antiseptic, and as a result of thermal exposure, microbes and pathogenic bacteria are removed. And also with increased fat content and the formation of a significant amount of comedones.

Laser therapy fights rashes in adolescence and allows you to get rid of post-acne even in adulthood. Scars and uneven skin surface occurs due to keratinization of the superficial epidermis, so cells cannot restore elasticity.Under the influence of the laser, regeneration occurs and recovery processes are launched, which is why the affected skin is actively smoothed.

The laser has a bactericidal effect and has a point effect precisely on the source of infection (propion bacteria acne). Plus, the laser beam corrects the activity of the sebaceous glands, restoring their normal functioning and thereby reducing inflammation. The penetration depth of the laser beam is up to 4 mm, such a depth of exposure cannot be achieved using medicinal creams and ointments.

It is very difficult, as you already understood, to get rid of severe acne (acne) at home and with folk and medical remedies, especially if it is quite difficult. Acne and post-acne laser treatments are a great alternative and possibly one of the most effective treatments for acne and post-acne.

The duration and frequency of laser treatment for acne and post-acne depends on the stage of the disease and the area of ​​skin lesions. On average, you need 5-8 procedures with an interval of 10-15 days.

Benefits of laser acne acne treatment:

The main advantage of laser acne treatment is painlessness and excellent tolerability of the procedure, in contrast to mechanical cleaning and peeling, which for many adolescents is a key aspect when choosing a method for treating acne acne (post-acne).

Additional advantages of laser treatment include: a positive result can be seen already after the first manipulation, the integrity of the skin is not disturbed, therefore, practically no new inflammatory processes arise, the ability to remove old scars and scars, can be used on any part of the skin, both on the face and on the body, there are no consequences, that is, long-term rehabilitation.

The price for laser treatment of acne acne and the consequences of post-acne in the MC “Doctor Laser” is the lowest and most democratic in Moscow.

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Laser treatment of scars and scars in Novosibirsk | reviews, sign up, price

Types of scars:

1. Atrophic.

   Recessed, below the level of the surrounding skin. As a rule, atrophic scars are formed where there were abscesses, there were necrosis of the skin, if the wound was not professionally treated, its edges were not sutured.

2. Hypertrophic.

   A raised scar that protrudes above the skin surface. This type of scar usually occurs immediately after injury or surgery. Since its main task is to hold the edges of the wound, not to allow it to disperse, the scar is the rougher and more pronounced, the more the skin was injured. Gradually, the skin adapts, stretches, and the stress on it decreases. And, accordingly, the scar tissue becomes softer, settles, and dissolves.Further, the scar becomes atrophic or normotrophic (physiological).

3. Normotrophic (physiological).

   This type of scar forms as a result of the skin’s normal reaction to injury. During the healing process, the normotrophic scar becomes less and less noticeable, looks like a thin light strip and does not protrude above the skin surface.

4. Keloid.

   Such a scar appears quite rarely, as a result of an atypical reaction of the skin and other tissues to injury.The main feature of this type of scar is that it cannot be removed by a simple mechanical means: if you start to act on it, it can increase significantly. Keloid scars are treated by injecting hormones directly into the scar and by compression – a special silicone-gel plate is applied to it.

It is far from always possible to completely get rid of scars on the skin, but laser exposure can make them as invisible as possible.

The procedure is practically painless and absolutely safe.The laser does not damage the surrounding tissue by targeting the scar tissue.

The procedure takes several minutes. To completely remove the scar, an average of 5 to 8 procedures are required. The rehabilitation period is short: usually one, maximum two weeks after the laser exposure, not the slightest trace of the procedure remains on the skin.

90,000 Removal of scars, scars. Laser cosmetology. Wellness Town

Treatment of post-acne with laser technique

The consequences of acne disease (acne), manifested in the form of focal seals of the skin, scars, pigment and vascular spots, enlargement of skin pores, the appearance of a vascular pattern, in dermatology are usually combined under the term post-acne.

If diffuse redness and age spots can be easily dealt with, then a change in the relief of the skin, due to the formation of scar tissue, hyper and hypotrophic scars, is one of the most difficult problems in cosmetology.

At the present time, the most effective methods of “leveling” the skin relief is the use of fractional lasers. Due to their ability to diffusely and selectively “evaporate and simulate” the skin, with competent work, it is possible to work with both scar tissue (hyper and hypotrophic scars) and excess skin flap.

Laser removal of neoplasms (papillomas, warts, moles)

It is the most justified and optimal in terms of efficiency and safety. The laser beam is sterile, bactericidal and non-contact, which speeds up the healing process and does not lead, in turn, to the formation of scars and scars.

Benign neoplasms:

-nevi (moles)
-xanthellasms (caused by excessive amounts of cholesterol in the body)
-shirts
– papillomas
-ateroma
-lipomas
– fibromas
– acuminate warts
-hyperkeratosis
– cysts (miliums)
– corns

The laser method of removing neoplasms is recommended in the case of a benign process. It is widely used for the surgical treatment of genital warts, papillomas, nevi, warts, atheroma, lipomas and others.

How the laser removal procedure works

Before the operation, the doctor applies an anesthetic gel to the operation site or injects an anesthetic. After that, with the help of a laser, the neoplasm is evaporated and removed. The laser acts only on damaged tissue areas in layers and does not touch the neighboring ones. In addition, there is no bleeding with this method, since the laser immediately coagulates (seals) the vessels.

Treatment of keloid scars, scars and stretch marks

To get rid of light streaks of scar tissue on the skin of the abdomen, thighs and other areas of the body,
we recommend laser removal. This procedure is more effective than wraps and chemical
peels, and is absolutely safe. Fractional laser allows you to successfully correct stretch marks on the chest,
and also remove keloid scars, the treatment of which is difficult when located in areas with sensitive skin.

Features

Among the features of SmartXide DOT, which performs laser resurfacing of scars and stretch marks, as well as other procedures, the following can be distinguished:

• – Fine tuning capability.
  Laser scar removal equipment allows for easy
  regulate the depth of penetration of the beam into the skin, the duration of the radiation with great precision
  (from 0.2 to 20 ms) and the density of the epidermis coverage (from 5 to 100% of the skin).
• – Fine tuning ensures that the optimal parameters are selected and laser resurfacing of stretch marks or scars will be as effective as possible.
• – The delicacy of the procedure. In most cases, up to 20% of the skin area is exposed and removal of scars, stretch marks and other defects is very easy. -In general, no anesthesia is required.
• – Using the scanning system. In the SmartXide DOT laser machine, with the help of which
  resurfacing and removal of stretch marks, scars is carried out, a scanning system is used, thanks to
  which the beam is not fed monolithically, but divided into several separate columns. These laser beams
  affect micro-zones of the skin and do not affect neighboring areas. During laser resurfacing
  scars, stretch marks and other defects, local tissue coagulation occurs, after which the unaffected
  the rays of the cells begin to divide intensively. Also, resurfacing and laser removal of scars activates
  cell metabolism, redox reactions and collagen synthesis.

Removal of age spots

Pigmented spots are grayish brown or black flat spots localized
usually on the face and hands, i.e.e. in areas not protected from sunlight.
In most cases, they are observed in people over 40 years old, but they also occur at a younger age.

What are the advantages of laser removal of age spots:

• – Efficiency. The visible result after the procedure for removing the formations is achieved in 2-3 sessions.
  The laser acts on the skin at the cellular level, ensuring the preservation of the achieved results for a long time.