What are pockmarks and how do they form. How can you prevent pockmarks from developing. What are the best treatments for existing pockmark scars. Are there any at-home remedies that can help improve the appearance of pockmarks. When should you see a dermatologist about pockmark scars.

Understanding Pockmarks: Causes and Types

Pockmarks are indented scars on the skin caused by a sudden loss of collagen due to inflammation. While conditions like chickenpox can cause pockmarks, acne is the most common culprit. These scars, also known as pitted acne scars, can vary in size and appearance.

There are three main types of pockmarks:

• Ice pick scars: Small, narrow, and deep, resembling holes made by a toothpick
• Boxcar scars: Broad, sunken depressions with well-defined edges
• Rolling scars: Similar to boxcar scars, but smoother and shallower, giving the skin surface an uneven, “rolling” appearance

All pockmark scars result from collagen damage caused by inflammation. Cystic acne, in particular, poses a high risk of developing into pockmarks and pitted scars.

Preventing Pockmarks: Early Intervention is Key

The best way to prevent pitted scarring is through early intervention. This means addressing the underlying problem, such as acne, as soon as possible. If over-the-counter treatments aren’t effective, it’s crucial to consult a board-certified dermatologist promptly.

Why is early treatment so important? Delay in addressing the issue is perhaps the largest contributing factor to the development of scars. By seeking professional help early on, you can significantly reduce the risk of permanent scarring.

Additional Prevention Tips

1. Avoid picking, scratching, or squeezing spots on your face
2. Protect your skin from sun damage by using sunscreen daily
3. Maintain a consistent skincare routine
4. Manage stress and maintain a healthy diet

Remember, picking at acne can force debris deeper into the skin, spreading infection and worsening inflammation and scarring. Sun protection is equally important, as UV radiation can trigger collagen breakdown, similar to inflammation.

Are Pockmarks Permanent?

Pitted scars are, by definition, permanent. However, this doesn’t mean you’re without options. While complete resolution is rare, there are numerous treatments available that can significantly improve the appearance of indented scarring.

It’s important to note that the effectiveness of treatments can vary depending on the severity and type of scarring. In many cases, a combination of treatments may yield the best results.

Topical Treatments for Pockmarks

For very shallow indented scars, topical treatments might offer some improvement. However, it’s important to manage expectations, as these treatments are generally more effective for prevention and mild scarring.

Retinoids

Retinoids, such as retinol and tretinoin, are among the most effective topical treatments for pockmarks. These vitamin A derivatives stimulate collagen production, which can help improve the appearance of shallow scars over time.

Alpha Hydroxy Acids (AHAs)

AHAs, like glycolic acid and lactic acid, can help exfoliate the skin and promote cell turnover. While they may not directly fill in deep pockmarks, they can improve overall skin texture and appearance.

Vitamin C

Vitamin C is a potent antioxidant that can help boost collagen production and protect the skin from further damage. While it may not dramatically improve deep pockmarks, it can contribute to overall skin health and appearance.

Professional Treatments for Pockmarks

For more significant improvements, professional treatments performed by a dermatologist are typically necessary. These treatments can range from minimally invasive procedures to more intensive options, depending on the severity of the scarring.

Chemical Peels

Chemical peels involve applying a solution to the skin that causes controlled exfoliation. This can help improve skin texture and reduce the appearance of shallow scars. Multiple treatments may be necessary for optimal results.

Microneedling

Microneedling uses tiny needles to create controlled micro-injuries in the skin, stimulating collagen production. This can help improve the appearance of pockmarks over time. Some practitioners combine microneedling with radiofrequency for enhanced results.

Laser Treatments

Various laser treatments can be effective for pockmark scars. These include:

• Fractional laser resurfacing
• CO2 laser treatments
• Erbium YAG lasers

Laser treatments work by removing the top layer of skin and stimulating collagen production in deeper layers. The choice of laser depends on the type and severity of scarring.

Dermal Fillers

For deeper pockmarks, dermal fillers can provide immediate improvement by literally “filling in” the indented areas. While not permanent, results can last several months to a year or more, depending on the type of filler used.

Combining Treatments for Optimal Results

In many cases, a combination of treatments may yield the best results for pockmark scars. For example, a dermatologist might recommend a series of chemical peels followed by microneedling, or laser treatments combined with topical retinoids for ongoing maintenance.

The optimal treatment plan will depend on various factors, including:

• The type and severity of scarring
• Skin type and tone
• Budget and time constraints
• Individual response to treatments

A board-certified dermatologist can assess your specific situation and recommend the most appropriate combination of treatments for your needs.

When to See a Dermatologist

If you’re concerned about pockmarks or any type of acne scarring, it’s advisable to consult a dermatologist. Early intervention is crucial, so don’t wait for scars to become severe before seeking help.

Consider seeing a dermatologist if:

• You have persistent acne that isn’t responding to over-the-counter treatments
• You notice the formation of deep or cystic acne
• You’re developing scars from healed acne
• Existing scars are causing you physical or emotional distress

A dermatologist can provide a comprehensive evaluation of your skin and recommend the most appropriate treatments to prevent further scarring and improve existing pockmarks.

Living with Pockmarks: Skincare and Makeup Tips

While seeking professional treatments, there are steps you can take to care for your skin and minimize the appearance of pockmarks in your daily life:

Skincare Routine

Maintain a consistent skincare routine that includes:

• Gentle cleansing to avoid irritating the skin
• Regular exfoliation to promote cell turnover
• Hydration to keep the skin plump and healthy
• Sun protection to prevent further damage

Makeup Techniques

While makeup can’t eliminate pockmarks, certain techniques can help minimize their appearance:

• Use a pore-filling primer before applying foundation
• Opt for a full-coverage foundation
• Apply concealer with a patting motion rather than rubbing
• Set makeup with a finely-milled powder

Remember, it’s important to remove makeup thoroughly at the end of each day to prevent clogged pores and potential acne breakouts.

The Psychological Impact of Pockmarks

It’s important to acknowledge that pockmarks can have a significant psychological impact. Many individuals with visible scarring experience decreased self-esteem and confidence. If you’re struggling with the emotional effects of pockmarks, consider the following:

• Seek support from friends, family, or a mental health professional
• Join support groups for individuals dealing with skin concerns
• Focus on self-care and overall well-being
• Remember that your worth is not determined by your appearance

While treating the physical aspects of pockmarks is important, addressing the emotional impact is equally crucial for overall well-being.

Dealing with pockmarks can be challenging, but with the right approach and professional guidance, significant improvements are possible. Remember that everyone’s skin is unique, and what works for one person may not work for another. Be patient with your skin’s healing process, and don’t hesitate to seek professional help when needed. With advances in dermatological treatments and a comprehensive approach to skincare, you can work towards achieving smoother, healthier-looking skin.

How to Get Rid of Pockmarks and Acne Scars on Your Face in 2021

Sometimes, the aftermath of a skin issue can be as frustrating as the issue itself—and that’s especially true for anyone who has ever dealt with pockmarks. Ugh. If you’ve had a past acne breakout and now have indented acne scars or divots to show for it, you’re probably already familiar with this skincare saga. And if you’re not, welp, this is still relevant to you, because any inflammatory pimple has the potential to leave you with a pockmark.

So whether you’re someone who already has pockmarks and are looking to improve them, or you’re just someone who wants to avoid them in the future, we’ve gotchu covered with help from Rachel Maiman, MD, cosmetic and general dermatologist at Marmur Medical. Keep reading to find out exactly what pockmarks are, how to prevent them, and the best treatment options to try. And since early intervention is key, you better get to scrollin’ already.

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What is the meaning of pockmarks?

According to Dr. Maiman, the term “pockmark” describes a hallow, indented scar on the skin that’s caused by a sudden loss of collagen as a result of inflammation. While conditions like chickenpox are sometimes the culprit, acne is the most common cause for pockmarks, which is why they’re also referred to as pitted acne scars.

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Now, take a look at your skin. You might notice that your pockmarks vary in size and appearance. That, my friend, is because there are multiple kinds of pitted acne scars. Yay! We love skin! Here’s the breakdown, according to dr. Maiman:

Three main types of pockmarks

• ice pick scars (small, narrow, and deep, like a toothpick made the hole)
• boxcar scars (broad, sunken depressions with well-defined edges)
• rolling scars (similar to boxcar scars, but smoother and shallower, making the skin surface look uneven and “rolling”)

All pockmark scars are caused by collagen damage from inflammation (cystic acne will always run the risk of resulting in pockmarks and pitted scars, FWIW), which brings us to. ..

How do you prevent pockmarks?

Dr. Maiman says the absolute best way to prevent pitted scarring is early intervention—i.e., treat the problem that’s causing it, like acne. So if you’re drugstore topicals aren’t working, it’s truly critical to seek out the evaluation of a board-certified dermatologist to get help. “The reason this is so important is that delay in treatment is perhaps the largest contributing factor to the development of scars,” Dr. Maiman says.

Now that you’re hopefully getting your butt to the dermatologist, stop yourself from picking, scratching, or squeezing spots on your face in the meantime. Dr. Maiman stresses that this is never a good idea, no matter what, but especially for inflammatory lesions that manifest as cysts and nodules. “Picking at your acne can force debris deeper into the dermis, spreading an infection to other tissue and worsening inflammation and scarring.”

And lastly, stay out of the sun and wear sunscreen (you knew it was coming). Diligent sun protection is important, people! Dr. Maiman says the same way that inflammation triggers collagen breakdown, so, too, does UV radiation.

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Are pockmarks permanent or can you get rid of them?

Pitted scars are, by definition, scars, so they’re permanent. These types of scars can rarely be resolved entirely, which is why it’s so critical to prevent scarring before it occurs. That said, you’ve got plenty of options for improving indented scarring with some pretty impressive results. Here’s how:

How do you fill in pitted acne scars?

If you’ve got very shallow indented scars, topical treatments might help a bit, but in-office treatments with a dermatologist are most effective for pockmarks. And, as Dr. Maiman points out, sometimes a combination of treatments will give you the best results. Below, all the best treatment options, both at-home and in-office.

At-home treatments for pockmarks:

• Retinol: Your best bet, according to Dr. Maiman, is to choose active ingredients known to stimulate collagen production, like retinol, to reverse the collagen deficiency that creates the appearance of those scars.
• Alpha hydroxy acids: Other effective collagen-stimulating ingredients found over the counter are alpha-hydroxy acids (aka AHAs), such as glycolic acid, which helps exfoliate skin to churn out fresher, brighter, plumper skin.
• Vitamin C: Dr. Maiman says vitamin C is also a great addition to your daily routine, since it helps boost collagen production to help smooth scars over time.
• Dermarolling: At-home dermarolling is never going to be the best option (you should be seeing a derm for that). But, Dr. Maiman says it can be somewhat effective at home once a week, if you use a simple handheld roller that contains 0.25-millimeter needles. The only caveat? You can’t be breaking out. Otherwise, dermarolling can worsen both inflammatory acne and its scarring, making this whole situation worse.

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ORA Microneedle Face Roller System 0.25mm

In-office treatments for pockmarks:

• Prescription retinoids: A step up from your OTC retinol would be a prescription retinoid, which could give you even better results.
• Microneedling with radiofrequency: One of Dr. Maiman’s favorite treatment methods for indented scarring, microneedling superficially “injures” your skin to stimulate a repair response in your body that increases collagen production and improves scar appearance. When combined with radiofrequency, it becomes a bit more aggressive, with energy being released deeper within the skin to trigger a bigger inflammatory and collagen response (which is good).
• Laser: Fractionated non-ablative and ablative resurfacing lasers are also excellent options. These types of lasers create micro-columns of destruction in your skin in order to encourage new collagen growth. Yup, these tend to hurt a bit, but they’re a tried-and-true treatment for pockmarks.
• Chemical peels: Although Dr. Maiman argues chemical peels are less effective than device-based treatments, they can still be helpful for exposing fresh, healthy tissue and stimulating the production of new collagen to make pitted scars look less pronounced.
• Surgical scar revision: Don’t like your scar? Your doctor can essentially remake it with a procedure that involves actually excising the scar and suturing the opposing, normal skin together (though this is best for one-off pockmarks, instead of full-face indents).
• Subcision: With this procedure, Dr. Maimain says your doctor can break up the cord of scar tissue that’s tethering the skin down and making a depression in the skin.
• Others: Dermabrasion, dermal filler injections—the list goes on. Your doctor will be able to figure out which treatment would be the best for your specific case. The point here is that you have plen-ty of options for treating your pockmarks, K?

The takeaway:

The best way to prevent pockmarks is by getting a dermatologist involved early on in your skin journey. A delay in professional treatment = scars. Simple as that. And the same goes for those who already have pockmarks. As Dr. Maiman explains it, your skin’s ability to produce new collagen wanes as you age, which only makes it more difficult to respond to collagen-stimulating treatments, topical or otherwise. The sooner you can see a dermatologist for treatment, the better your results will be. End of story.

Brooke Shunatona
Brooke Shunatona is a contributing writer for Cosmopolitan.com.

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How To Get Rid Of Pitted Acne Scars (3 Best Treatments)

As if acne breakouts weren’t bad enough, when they finally clear, you may be left with little indented marks on your skin instead. These pitted acne scars are tricky to treat but there are a variety of treatments that can help. This article will help to explain just how to get rid of pitted acne scars.

 

What Are Pitted Acne Scars?

Pitted acne scars, otherwise known as atrophic acne scars, are the indented marks left behind on your skin after a fairly severe acne breakout.

There are three main types of pitted acne scars: icepick, boxcar, and rolling.

The difference between the three types of pitted acne scars are generally down to their depth and width. For example:

• Icepick scars are deeper than they are wide.
• Boxcar scars are wider than they are deep.
• Rolling scars are the shallowest and the widest type of pitted acne scars and leave a ‘ripple effect’ on your skin.

If you’re interested in a more detailed explanation of the biology behind pitted acne scars, check out: Acne Scars vs Acne Marks.

 

What Causes Pitted Acne Scars?

Pitted acne scars are usually caused by severe inflammatory acne, especially if spots have been picked or squeezed.

When an acne pimple is healing, it goes through the same processes as any other wound. In order for your skin to heal itself, it needs to create new collagen and tissue.

Certain enzymes regulate the amount of collagen that your skin produces during this process. If these enzymes are unbalanced, it can lead to too little or too much collagen being produced.

If too much collagen is produced when an acne pimple is healing, it causes a raised, or hypertrophic, acne scar.

When too little collagen is produced as the acne pimple heals, it causes a pitted, or atrophic, acne scar.

The majority of acne scars (80-90%) are atrophic.

 

How To Get Rid Of Pitted Acne Scars

The first step in how to get rid of pitted acne scars is to prevent them from forming in the first place. If active acne is not treated, then new scars will continue to form.

The most effective way to prevent or reduce acne scarring is to treat inflammatory acne as early as possible and avoid picking at spots and pimples.

 

Retinoids

Retinoids are derivatives of vitamin A that increase skin cell turnover (your skin’s natural exfoliation process). They are also able to boost collagen production and treat the fine lines and wrinkles caused by sun damage.

Research suggests that retinoids, such as tretinoin and adapalene, are able to block an important inflammatory pathway that is associated with acne and acne scarring ^[1]. This means that they can treat active acne and prevent pitted acne scars from forming.

Some forms of retinoid are also able to help get rid of pitted acne scars after they’ve already formed. For example, 0.1% tazarotene gel was as effective as microneedling at improving the appearance of pitted acne scars ^[2] and multiple studies have found 0.3% adapalene gel can improve pitted acne scars after 24-weeks of use ^[3][1].

 

Retinoids + Glycolic Acid

Glycolic acid is an alpha-hydroxy acid that acts as a chemical exfoliant by loosening the top layer of skin and removing dead skin cells. It can also help boost collagen production which means it can help to get rid of pitted acne scars.

Retinoids and glycolic acid can complement each other’s effects when combined together. Retinoids increase the rate that new skin cells are brought to the surface of the skin and glycolic acid helps them to shed faster. In addition, both ingredients can boost collagen production.

One research study found that the combination of 0.025% retinoic acid and 12% glycolic acid improved pitted acne scars after 12-weeks of use ^[4]. Other research concluded that 0.1% retinaldehyde combined with 6% glycolic acid improved pitted acne scars as well as treating active acne and discoloration (PIE & PIH) ^[5].

 

Microneedling

Microneedling is a treatment that uses tiny needles to puncture your skin, allowing topical ingredients to penetrate into your dermis, initiating a wound-healing response, and boosting collagen production.

Research suggests that microneedling can improve pitted acne scars by 50-75% ^[6].

While there are a number of microneedling devices available for home use, it’s much safer for your skin to have a professional perform the treatment. This is mainly due to the fact that they have devices with sterile, single-use attachments which reduces the risk of infections and skin damage.

 

Laser Treatments

Laser treatments use focused beams of light to target light-absorbing molecules within your skin including melanin (the substance that gives your skin its color) and hemoglobin (the substance that makes your blood red).

The light energy from the laser is transferred to heat and causes damage to the melanin or hemoglobin which helps to reduce pigmentation and redness. The damage also initiates a wound healing response, causing your skin to produce more collagen.

There are various different types of laser that can help to get rid of pitted acne scars. Some also help treat other skin conditions that often accompany pitted acne scars, such as PIH, PIE, and active acne.

Vascular lasers (e.g. PDL) that target hemoglobin are useful if you still have active acne as well as pitted acne scars and can also help with PIE acne marks.

Non-ablative fractional lasers (e.g. Fraxel) mainly target water but are also absorbed to some extent by melanin and hemoglobin. They are a great option for improving overall skin texture, pitted acne scars, PIH, and sometimes PIE. However, they aren’t suitable if you’re still having active acne breakouts as they can make this worse.

Fractional lasers may be better at treating some types of pitted acne scars over others, with less improvement in icepick scars than in boxcar and rolling scars ^[7].

 

Other Products That May Get Rid Of Pitted Acne Scars

Although there is little research to support their effectiveness at getting rid of pitted acne scars, a number of skincare ingredients have plenty of research to back up their ability to boost collagen production.

Examples include:

 

Other Tips For How To Get Rid Of Pitted Acne Scars

1. Wear Sunscreen Every Day – The UV radiation from the sun destroys the collagen in your skin and leads to premature skin aging. In order to get rid of pitted acne scars, you need to increase the amount of collagen within your skin, and preventing unnecessary collagen loss is the best place to start!
2. No Picking/Squeezing! – The more you squeeze and pick at spots, the more inflamed your skin becomes, and the more likely the spot is to scar than if left alone to heal on its own.
3. Moisturize – Dehydrated skin exaggerates any textural irregularities on your skin, including pitted acne scars, wrinkles, and pores. Increasing your skin hydration can make your skin appear plumper and instantly improve the appearance of wrinkles and pitted acne scars.
4. Exfoliate – If you have a lot of dead skin cells sitting on the surface of your skin it can leave your skin looking dull and tired and, like dehydrated skin, can exaggerate the appearance of pitted acne scars. Exfoliation helps to remove this layer of dead skin and reveal brighter and smoother skin.
5. Patience Is Key! – It takes approximately three months for your skin to produce new collagen which means that this is the earliest that you may be able to see results. It will usually take longer than this to see significant results (most studies took at least six months).

 

Summary

Pitted acne scars are the indented marks left on your skin after a bad acne break out. They are caused when your skin doesn’t produce enough collagen when the acne pimple is healing.

There are a number of ways how to get rid of pitted acne scars including topical treatments such as retinoids and glycolic acid, and professional treatments including microneedling and laser treatments.

Most treatments are going to take at least six months to see any substantial improvements but you may notice some subtle results after three months.

 

References

1. Tan, J., Tanghetti, E., Baldwin, H., Stein Gold, L. & Lain, E. (2019). ‘The role of topical retinoids in prevention and treatment of atrophic acne scarring: Understanding the importance of early effective treatment’, J Drugs Dermatol., 18(3), 255-260. Available at: https://www. ncbi.nlm.nih.gov/pubmed/30909329
2. Afra, T., Ramzi, M., Narang, T. et al. (2018). ‘Topical Tazarotene gel 0.1%, as a novel treatment approach for atrophic postacne scars: A randomized active-controlled clinical trial’, JAMA Facial Plast Surg., 21(2), 125-132. Available at: https://jamanetwork.com/journals/jamafacialplasticsurgery/article-abstract/2714234
3. Loss, M., Leung, S., Chien, A. et al. (2018). ‘Adapalene 0.3% gel shows efficacy for the treatment of atrophic scars’, Dermatol Ther., 8(2), 245-257. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002315/
4. Chandrashekar, B., Ashwini, K., Vasanth, V. & Navale, S. (2015). ‘Retinoic acid and glycolic acid combination in the treatment of acne scars’, Indian Dermatol Online J., 6(2), 84-88. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375771/
5. Dreno, B., Katsambas, A., Pelfini, C. et al. (2007). ‘Combined 0.1% retinaldehyde/ 6% glycolic acid cream in prophylaxis and treatment of acne scarring’, Dermatology, 214(3), 260-267. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17377389/
6. Dogra, S., Yadav, S. & Sarangal, R. (2014). ‘Microneedling for acne scars in Asian skin type: an effective low cost treatment modality’, J Cosmet Dermatol., 13(3), 180-187. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25196684/
7. Sardana, K., Manjihi, M., Garg, V. & Sagar, V. (2014). ‘Which type of atrophic acne scar (ice-pick, boxcar, or rolling) responds to nonablative fractional laser therapy’, Dermatol Surg., 40(3), 288-300. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24447255/

Laura is a skincare addict and sunscreen enthusiast with more than 10 years of experience working in healthcare and over 5 years of experience working as a nurse. She has experience in plastic and reconstructive surgery, dermatology, and aesthetics and has received training in laser treatments. Laura is currently working in healthcare education and writes for ScienceBecomesHer in her spare time. Read More.

Top 7 Treatments To Remove Deep-Pitted Or Atrophic Scars

Are you having persistent breakouts? Do you notice that acne scars that are deep indent your skin and simply refuse to fade? Well, do not lose hope just yet. Fortunately, thanks to revolutionary innovations in dermatology, advanced treatment options are now available that can help to reduce severe scarring and restore smoother-looking skin. Read on to know the best treatment options to remove or minimise the appearance of deep scars visibly!

What Are Deep-Pitted Acne Scars?

Deep pitted acne scars, also known as atrophic scars, are usually the result of severe acne. They generally appear due to the loss of tissue during cell regeneration that eventually leaves behind a skin that has a pitted appearance. They look sunken and depressed with indentations or holes compared to the surrounding skin and are usually challenging to treat. Since they adversely affect the skin texture, they become a significant aesthetic concern for people who have acne-prone skin. If you have severe acne here are some signs and symptoms of deep-pitted scars you may observe.

Must Read: How To Treat Acne Scars?

How To Identify Deep Scars?

Here are the common characteristics of deep scars:

• Tissue Depth Or Depression: Flat, thin scars have an indentation that extends vertically to the deep dermis layer of skin or subcutaneous tissue.
• Loss Of Tissue/Skin Volume: These round to oval depressions have sharply demarcated edges and a width of 1.5 to 4 mm. Fibrotic indentations result in shadowing and a pitted appearance.
• Discolouration Of Skin: Acne may result in post-inflammatory hyperpigmentation. Some acne scars may vary in colour from pink, tan, skin-coloured to dark brown.
• Undulating Appearance: Often, these scars have a horizontal orientation with sharp margins or depressed tracks. Skin appears uneven due to the loss of critical rebuilding tissue without collagen.

Must Read: How To Get Rid Of Acne Scar On Your Face?

Do Pitted Scars Go Away?

No, most deep-pitted scars do not go away on their own or heal with time. However, many advanced procedures are now available to minimise them safely and effectively. Please read the next section to know more about them.

Professional Removal Treatments For Deep-Pitted Scars

Here are some popular professional solutions available at various skin clinics for treating deep-pitted scars.

• Laser Skin Resurfacing: Top dermatologists use fractionated erbium YAG laser, a USFDA-approved laser technology to create micro-injuries and treat deep-pitted scars by stimulating new collagen production. They target the scarred tissue by focusing a laser beam of precise wavelength with a handheld device. This non-invasive treatment is quick and painless with topical anaesthesia. It requires about six to eight sessions or as recommended by your dermatologist to rejuvenate the appearance and texture of your skin dramatically and make deep scars less noticeable.
  Must Watch:
  
• Chemical Peels: This advanced aesthetic procedure helps in the controlled exfoliation of the top layers to reduce scarring and reveal clear skin from underneath. Chemical peels use plant-based extracts along with AHAs and BHAs to effectively remove dead cells and encourage collagen production around deep scars, giving smoother skin and more even appearance. Dermatologists decide and administer the concentration of peels depending on the severity of scarring. Doctors generally recommend them only for treating superficial scars. However, nowadays, they may suggest them as a combination treatment for deep-pitted scars along with other modalities.
• MNRF: Micro-needling Radiofrequency or MNRF is a revolutionary dermatological procedure that uses radiofrequency energy to tighten the skin and make depressed scars less noticeable. The process stimulates both collagen and elastin production to remodel the skin. The heat energy generated during the treatment stimulates the cells in the connective tissues beneath the scarred surface and enables deep scar revision. The procedure gives impressive results with minimal or no side-effects. There is also almost nil downtime associated with this modality.
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• Fillers: Your dermatologist may recommend fillers to treat deep-pitted scars. These fillers fill the scarred tissues and lift them to the level of the surrounding skin. They contain substances such as hyaluronic acid to add volume to the depressed scars with minimal discomfort. Hyaluronic acid fillers are USFDA-approved for safety but offer temporary results that last for nine months to two years. Subsequently, the body enzymes may gradually digest them. The filler treatment has no downtime and provides quick results.
• Surgical Removal: It is an invasive approach to remove severe scars. The surgical procedure helps in resurfacing scarred tissue and makes them less noticeable. After the scar excision, the doctors suture the skin, which may leave a smaller and less prominent scar than the original one. This is also called punch excision. The new scar is likely to fade over time, giving a smoother-looking appearance.
• Microdermabrasion: This treatment is a less intensive form of exfoliation which removes dead cells from the outermost skin layer and reduces small scars. Dermatologists spray ultra-fine crystals through a tube to scrub the skin and use vacuum suction to remove them instantly during the procedure. It requires multiple sessions to show visible improvement in skin texture.
• Dermaroller: Dermatologists recommend this treatment for minimising deep scars by encouraging your skin to produce more collagen. Your doctor may use a handheld, sterile needle-studded roller to puncture the scarred tissue gently. As the skin heals, it naturally produces more collagen and fills up the indentations. Most individuals notice results after nine months to a year though it may require repeated sessions as recommended by your skin specialist.

Must Read: What Is The Cost Of Laser Scar Removal?

Do Scar Removal Creams Help To Heal Deep-Pitted Scars?

Many OTC scar removal creams are available without a prescription, but they fail to reduce the appearance of deep pitted scars. Since scars are a result of tissue damage, topical ointments and gels cannot heal them or reduce any discomfort associated with them.

What Results Can You Expect?

The advanced treatments performed by dermatologists help in reducing the depth, size and visibility of scars. They help in improving the texture of the scarred tissue and giving you blemish-free skin.

However, the results may vary depending on the severity of the scars, skin type, the modality of treatment selected, the technology available and the expertise of the dermatologist performing the procedure.

Now you know all about treatments for deep-pitted scars. Go ahead and consult an experienced dermatologist at your nearest Oliva Skin & Hair Clinic to find out a suitable procedure for you and make an informed decision.

How to Get Rid of Pitted Acne Scars (At Home)

Getting rid of pitted acne scars is one of the biggest challenges in dermatology. Unlike superficial scarring and skin discoloration, atrophic acne scars are usually permanent if left untreated. Fortunately, there is hope for those people looking to reduce the appearance of severe scarring.  Read on for more information about what options you have in dealing with this type of acne aftereffects.

What Are Pitted Acne Scars?

Acne scars are divided into two categories: atrophic and hypertrophic.

• Atrophic Scars (Pitted Acne Scars) – Atrophic scars are usually the result of severe acne, or even chickenpox. They are indented scarring that heals below the normal layer of skin tissue. They occur when the skin is unable to regenerate tissue, ultimately leaving behind a pitted appearance.
• Hypertrophic Scars – Unlike atrophic scars, hypertropbic scars develop as a result of an overproduction of collagen. 

Types of Pitted Acne Scars

The three types of pitted acne scars are: rolling, boxcar and ice pick

Pitted acne scars (atrophic scarring) consist of three different types:

1. Rolling Scars: Rollings scars are known for the wavy indentations that scroll across the skin. These scars occur when fibers of tissue form between the upper layers of skin and the tissue located below the surface. As the tissue continues to grow, it pulls on the top layers of skin. This continual stretching then creates the rolling appearance.
2. Boxcar Scars: Distinguished by their oval appearance, these depressions are typically marked by their width and uneven characteristics. Boxcar scars are caused by skin inflammation that lowers the collagen levels of the skin. Without collagen, critical rebuilding tissue is lost and the scars begin to take shape.
3. Ice Park Scars: One of the most common and difficult to treat of the permanent acne scars, ice pick scars are marked by the resemblance the scar has to a skinny and lengthy ice pick. This type of scarring happens when cysts or infections take hold on the skin. The scar begins to make its appearance as the tissue of the skin is not able to regenerate.

What Causes Pitted Acne Scars?

Pitted acne scars are caused by severe acne. As the most common type of acne scarring, they are a result of the inability to regenerate tissue.

Severe acne flare-ups that continue over time will increase the chances that this scarring takes hold.

Thus, the best way to prevent acne scarring is to actually prevent acne from occurring in the first place.

How to Get Rid of Pitted Acne Scars (At Home)

Here’s how you can get rid of your pitted acne scars at home

Although there are no miracle cures when attempting to get rid of pitted acne scars, there are a number of steps that you can take to help the fight against severe scarring.

1. Cleansing

The best thing that you can do for your face is to adopt a regular cleansing routine. Drugstore facial cleansers that formulated for the face will be the best line of defense in the fight against acne.

2. Exfoliation

Although many people neglect the exfoliating process, this treatment can pay big dividends when looking to prevent acne scars from forming. By working to reduce the chances of acne flare-up, acne scarring will also be reduced. The most effective exfoliating products contain either alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs).

While both types of acid groups are effective at peeling away dead layers of skin, their unique properties make them suited for different types of skin.

• Oil-soluble BHAs, also known as salicylic acid, are better for oily and acne prone skin.
• Conversely, water-soluble AHAs, also known as glycolic or lactic acids, are better suited for use on skin that is not prone to acne because of its ability to smooth out skin tone.

3. Vitamin C Serums

Ava Shamban, MD, a Beverly Hills dermatologist and founder of SKINxFIVE, recommends using a vitamin C serum for acne scars to help brighten the appearance of discoloration. “Vitamin C, especially combined with other antioxidants, will stimulate collagen to help lift up depressed acne scars,” she says.

4.

Topical Retinoids

Topical retinoids such as tazarotene have been proven to be an effective treatment in the battle to minimize the appearance of deep acne scars. As a derivative of vitamin A, the antioxidant properties in topical retinoids heal damaged skin and promote the production of new skin cells. They are also an exceptional preventative measure to guard against new breakouts.

4. Microneedling/Dermarolling

This innovative process uses hundreds or thousands of tiny needles rolled and inserted into the skin through the use of a specially designed rolling mechanism. According to Healthline, the device promotes the production of both elastin and collagen to stimulate scar relief. Although this process may seem intimidating to beginners, the procedure is actually considered to be minimally invasive while carrying very few risks and side effects. For more severe scarring issues, longers needles should be used in order to provide the most effective penetration and results.

5. Wear Sunscreen

There is a myriad of uses for practicing good sunscreen habits. In addition to guarding against signs of aging, regular sunscreen use can also help to minimize the appearance of existing acne scars. Without the use of sunscreen, even the smallest healing wounds or scars can appear noticeably darker in color when exposed to the sun’s harmful UV rays. Be sure to make the regular use of a board-spectrum sunscreen of at least 30 SPF or higher part of your normal skincare routine. Check out our list of best sunscreens to prevent tanning.

Best Products for Pitted Acne Scars

1. Prosper Beauty Dermaroll

Prosper Beauty Dermaroll is an excellent option and great first step in getting rid of pitted acne scars. Follow the directions on the box for best results.

• How to use:For best results use light pressure, gently roll over skin in horizontal, vertical, and diagonal directions. Pass each area of the skin 2-3 times per direction. Do not roll over the same section more than 10 times.
• How it works on pitted acne scars: Microneedling facilitates exfoliation, improves skin’s appearance with a luminous look and gives skin a smoother feel.
• What you can expect: Because everyone’s skin is unique and scars may be different depths, it’s hard to say exactly. Generally, you should see improvement within 4-6 weeks. For best results, follow up with a vitamin C serum.

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2. Mad Hippie Vitamin C Serum

Vitamin C serum is a holy grail in the skincare industry. Vitamin C is potent antioxidant that helps reduce skin inflammation, hyper-pigmentation pigmentation, and promotes healthy collagen production.

• How to use: The powerful antioxidant properties of vitamin C make it a natural option for the treatment of deep scarring issues. Overtime, this potent product will help to improve the skin’s appearance and overall tone. Apply twice daily (after cleansing and before moisturizing).
• How Vitamin C helps pitted acne scars: Vitamin C, especially combined with other antioxidants, will stimulate collagen to help lift up depressed acne scars (according to Ava Shamban, MD).
• What you can expect: The formula boasts a unique combination of L-ascorbic acid, vitamin E, ferulic acid, hyaluronic acid, and konjac root. Together, the ingredients work to deliver protection from free radicals while helping the appearance of pitted acne scars. You should see improvement within 4-6 weeks (or longer depending on skin appearance).

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3. Paula’s Choice SKIN PERFECTING 8% AHA Gel

Paula’s Choice 8% AHA gel is well known in the skincare industry – and for good reason. It is an ideal exfoliant for those dealing with hyperpigmentation or skin texture concerns.

• How it use: This leave-on exfoliant will not treat scars but will work to keep acne from forming in the first place. Apply at night after cleansing your skin, and before moisturizing. Leave on, do NOT wash off.
• How AHA helps pitted acne scars: AHAs help pitted acne scars by exfoliating away dead skin cells and helping improve celluar turnover. In addition to helping acne scars, they also help prevent existing acne (ultimately preventing new scars from forming). 
• What you can expect: The concentrated eight percent AHA formula uses glycolic acid to slough away dead layers of skin. Additional benefits include the minimization of fine lines and wrinkles and a brighter complexion.
• Ideal for: Those who do not have any existing acne or breakouts

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4. Paula’s Choice SKIN PERFECTING 2% BHA Liquid Exfoliant

This product is ideal if you’re still suffering from acne and trying to get it under control. By controlling your acne, you lessen the chance of new scars from developing.

• How to use: This product can be used after cleansing and before moisturizing. Apply a dime size amount to a cotton ball and apply all over your skin. DO NOT wash off. Follow with your favorite moisturizer. 
• How BHA helps pitted acne scars: Specially formulated for acne prone skin, this popular product unclogs pores in an effort to prevent acne from developing. By preventing acne, you also prevent pitted acne scars from developing.
• What you can expect: Although it will not directly reduce scarring, this leave-on exfoliant is a good preventative measure to take to keep acne at bay. Combined with the dermaroller and Vitamin C serum above, you’ve got yourself a solid plan to finally combating your pitted acne scars.
• Ideal for: Those with oily and acne prone skin.

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Professional Treatment for Pitted Acne Scars

For more severe scarring, you should consult with a professional

For most, professionals are the best choice when dealing with pitted acne scars.

1. Chemical Peels

One of the most commonly practiced ways to treat atrophic acne scars is through the use of chemical peels for acne scars. In this procedure, a layer of chemicals is applied to the face and then stripped off. As the mixture is peeled off, dead skin cells are removed and fresh layers of skin are left in its place. This regeneration has proved extremely useful in the fight to decrease the appearance of pitted acne scars.

Chemical peels vary widely in the ingredients used and the strength of the formulation. The most superficial peels will have you back to work in under an hour while stronger peels might even require sedation. This variety makes chemical peels an extremely versatile treatment choice.

2. Fillers

Fillers are a proven treatment when dealing specifically with the scars left behind by rolling atrophic acne. These soft-tissue fillers work by raising the level of the indented scarring to reach the normal layer of the skin, creating a smoother and evener appearance on the surface. The fillers provide immediate results while continuing to improve the plumpness of the skin tissue in an effort to minimize the visible appearance of the scarring.

3. Skin Needling

Also known as microneedling, this process uses a tool with hundreds of small needles to create microscopic punctures on the surface of the skin. These tiny wounds stimulate the production of new collagen. Studies show that by amping up collagen production, skin becomes more elastic and acne scars are minimized.

4. Punch Excision

Studies report that punch excision is very effective in getting rid of acne scars. This treatment uses a small scalpel to punch holes in the skin, cutting out the existing scar tissue. The wound is then closed with stitches and left to heal. Skin is usually taken from behind the ear if a skin graft is needed to close the wound. Although this procedure creates a new scar, it is less obtrusive than the acne scar that had been in its place. Punch excision is an especially popular procedure in the treatment of ice pick scars.  

5. Subcision

A subcision is used to describe the process in which a doctor inserts a small needle under the scar tissue in order to loosen the area surrounding the scar.
By doing so, a new wound is created that complements the existing layer of skin. This process then minimizes the appearance of the old scar. Although this procedure can be used as a standalone treatment, it is often combined with other options such as chemical peels and microneedling to provide a more comprehensive treatment regimen.

6. Retin-A (Tretinoin)

As one of the most potent of the group of medications known as topical retinoids, Retin A is a prescription drug used to treat a wide variety of acne and resulting scarring issues. Also known as tretinoin, Retin A can treat existing acne by speeding up the rate of cell turnover and decreasing the buildup of irritants in the pores.

According to Jama facial plastic surgery, topical retinoids are effective as micro-needling for acne scars. Although the drug will not do much to fade severe atrophic acne scars, it can treat the effects of post-inflammatory hyperpigmentation. By working to promote new cell growth, Retin A can also make the skin more toned and smoother in appearance.

When to See a Dermatologist

When over the counter options are not working, it is time to call in the professionals. A dermatologist will determine the most effective treatment protocol. 

Take Before and After Pictures

Although it can be uncomfortable to take before pictures, this process is an important part of the documentation. These pictures will help you to understand what is working and what is not. The pictures also provide useful data to the dermatologist overseeing your treatment.

FAQ:

How long does it take for pitted acne scars to fade?

Some scars can take longer to fade than other types of scarring, making it difficult to pinpoint a general time frame. Severe acne scars will never fade away without the help of professional treatments.

Does collagen boosting cream work for pitted acne scars?

Studies show that collagen boosting creams can improve pitted acne scars. However, consult a professional to transform the appearance of severe acne scars.

Can home remedies help with pitted acne scars?

Home remedies may be successful in fading basic discoloration caused by scars. However, natural remedies do not have the strength needed to lift and rejuvenate the skin.

Do acne scar creams work for pitted acne scars?

Some users will find success with specially formulated acne scar creams if the products contain the right ingredients. The best ingredients to look for include vitamin C or other retinoids. These products combined with the microneedling process can improve the appearance of pitted acne scars.

Ice Pick Scar Treatments

Ice pick scars are acne scars that have a sunken or pitted appearance. These scars leave the skin looking like it was punctured by a tiny ice pick. Although acne is most common among teenagers, it affects people of all ages.

The Appearance

When pores on your skin become clogged, a common skin condition called acne erupts. Ice pick scars are left after acne is cured.

Visually, ice pick scars can appear like tiny craters over the cheeks. They are narrow deep scars and less than two millimeters wide, and they look as if a sharp object like an ice pick has punctured a hole in your skin. 

The Causes

Across the globe, acne is one of the most common skin disorders treated by dermatologists. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children.

Skin and the tissue beneath it are damaged by outbreaks of acne because the breakouts penetrate the skin deeply. Your body tries to repair the damage by producing collagen. When too little collagen is produced, ice pick scars develop and leave behind noticeable pits or depressions in the skin.

As acne begins to heal, certain people are more prone to developing ice pick scars. In addition to genetics playing a role, the risk of getting acne scars increases if you have inflammatory acne, if you delay treatment, or if you pick/squeeze/pop acne.

The American Academy of Dermatology suggests several skincare habits that will decrease your risk of getting acne scars:  

• Don’t scrub your skin
• Don’t pick, pop, or squeeze acne
• Don’t use abrasive or astringent cleansers
• Avoid repeatedly touching your face throughout the day
• Avoid the sun and stay away from tanning beds
• Don’t wear hats or tight headbands
• Don’t wait to consult a dermatologist

The Treatment

Products containing benzoyl peroxide and salicylic acid are effective treatments for ice pick acne scars. You can also now purchase the topical retinoid, like Differin®, over the counter at a pharmacy and use it as directed.‌

Successful medical procedures used for treating ice pick scars include the chemical reconstruction of skin scars (CROSS) using high concentrations of trichloroacetic acid. Here, the chemical is placed on each ice pick acne scar using a toothpick.

Other treatment methods include laser treatments, fillers, punch excision, punch grafting, and chemical peels. These treatments can be performed by dermatologists or dermatologic surgeons.

Early treatment. Early treatment can prevent psychological stress that often accompanies ice pick scars. Catching acne early can clear skin and prevent acne from getting worse. You may need to make prevention part of your daily ritual to prevent acne outbreaks, but that may be a better option than dealing with the stress of permanent acne scars.

Acne is often dismissed as a transitory condition prevalent in adolescents, that will go away on its own. Treatment of ice pick scars is often delayed, particularly in male individuals, even though early intervention can mean the difference between a permanent scar and a more treatable one.

Emotional effects. If you have ice pick scars from acne, be aware that the skin condition can affect more than just your appearance. Over time, acne can take a toll on your well-being and emotional health. Dealing with ice pick acne scars can cause low self-esteem, anger, frustration, anxiety, and poor self-image. Often, there are feelings of loneliness and depression that lead to a decreased quality of life.

Ice pick scars are particularly stressful because they often occur on the cheeks of the face and are characterized by narrow pitted shapes in the skin. These shapes are often more noticeable to the naked eye and are not covered up well with makeup.

Expected Result. With time and persistence, most treatments can reduce the size and visibility of acne scars. Many scars fade and become barely noticeable. This is not the case with most ice pick scars. Due to the depression in the skin, treatments that help other acne scars fade or diminish over time are not as helpful.

a Guide to All Your Options

• You can get rid of acne scars with topical creams like retinoids or with medical procedures like corticosteroids or laser therapy.
• Vitamin A derivative creams are helpful for acne scarring because they promote new skin cell growth. 
• A highly effective medical treatment is micro-needling, which uses small needles to puncture the skin and promote collagen growth. 
• This article was medically reviewed by Debra Jaliman, MD, a board-certified dermatologist with a private practice in New York City.
• This story is part of Insider’s guide on How to get clear skin.

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Acne is a very common skin problem, one that affects 50 million people, including teens and adults, in the United States annually, according to the American Academy of Dermatology (AAD).

Even if you no longer get breakouts, you may still have some scarring left behind from acne. This scarring can be unsightly and bothersome, so here are some of your options for reducing or even eliminating it.

Types of scars

The type of treatment your dermatologist will recommend will depend in part on the type of scar you have. You can have raised acne scars or depressed acne scars.  

Raised scars, or hypertrophic scars, are exactly what they sound like: thick or lumpy scars that sit on top of the skin.

Meanwhile, depressed scars, or atrophic scars, cause an indentation in the skin.

Here are the types of acne scarring and what they look like:

Yuqing Liu/Insider

You can also have red patches or discolored skin where acne lesions used to be. Although it might not be scarring in the traditional sense, many people also refer to this left-behind discoloration, or pigment alteration, as scarring. 

There are many options for treating all of these types of scarring, and some methods can help with more than one issue.  

“The (altered) pigment is easier to treat than actual scars,” says Ivy Lee, MD, a dermatologist in private practice in Pasadena, California.

Topical remedies

If you’re just trying to get rid of the redness that remains from your experience with acne, your doctor may start by suggesting an over-the-counter topical cream, like a vitamin A derivative cream such as Differin. It’s a mild retinoid that promotes cell turnover, meaning that it can help boost your skin’s ability to shed dead and damaged cells and replace them with new ones. It can also lighten the darker pigment, says Ivy.

You could also try a stronger over-the-counter remedy like alpha hydroxy or beta hydroxy cream to address the discoloration and promote cell turnover. But be forewarned: it may be effective, but it may also be irritating to your skin, says Ivy.

If the over-the-counter creams aren’t quite effective enough, your doctor can prescribe a stronger version of a vitamin A cream to help improve your skin. These prescription-strength retinoids can address both atrophic scars and discoloration, says Ivy. Many people respond very well to them.

“Very rarely do I need to resort to chemical peels or micro-needling or lasers,” she says.

Medical procedures

Topical therapy might be effective enough for eradicating your acne scars. But if you have more severe scarring, you may want to turn to medical treatments. Here are some of your options: 

• Fillers, which can fill in those deeper depressions left behind by acne with collagen or fat. “The downside is that they tend to be expensive and require touch-up for maintenance,” says Ivy.
•  Micro-needling, which involves using small needles to puncture the skin and breaks down collagen bundles in the top layer of skin. These tiny injuries actually stimulate new collagen growth, which improves the skin.
• Laser therapy to remove scarred tissue from the surface of the skin. There are a few different kinds, but one commonly used version uses a pulsed dye laser (PDL) to reduce redness and flatten scars.
• Other resurfacing procedures, such as dermabrasion or chemical peels. These work by removing layers of skin, which encourages new cell growth that can reduce the appearance of scars. 
• Corticosteroid injections are effective for raised scars. “Corticosteroid injections can help flatten hypertrophic scars which can occur on the chest and back,” says Ivy. 
• Surgery can also be used to cut out scars in extreme cases. 

If you’re wondering what to try first, turn to micro-needling for deep scars. Ivy refers to micro-needling as her “workhorse tool” since it’s safe, and it requires minimal downtime — perhaps 24-36 hours after the procedure, compared with up to a week for laser therapy or even longer for surgery.

Research shows that micro-needling is effective for reducing deep scarring, but the American Academy of Dermatology warns that micro-needling should not be used on raised, or hypertrophic, scars.  

“Micro-needling is wonderful,” says Ivy. “It shrinks and tightens those scars and evens out the texture. It increases smoothness. It can also address the discoloration we see with acne, as well.”

Home remedies

Some people like to try home remedies to address their acne scars. Some commonly used products include:

• Milk peels: Lactic acid can provide a gentle exfoliating effect on your skin and reduce some of that left-behind redness. “It’s pretty mild and incredibly safe, so there’s minimal harm, but I think there’s also minimal benefit,” says Ivy. 
• Dermaroller. A derma-roller is a mini wheel covered with tiny needles that prick the face. This is the at-home version of your dermatologist’s micro-needling tool. You can get good results, but the office-based rollers will stimulate further into the skin and produce better results, notes Ivy.

Tempted by remedies that you have seen online? Not so fast, says Ivy. “Baking soda and coconut oil are not helpful for acne scars so you can set those aside for cooking,” she says.

The bottom line

If you’re unhappy with your skin’s appearance, thanks to acne scars or discoloration, talk to your dermatologist about the best way to improve your skin’s appearance without causing any unnecessary irritation. 

Related articles from our Health Reference library:

Effective Treatments of Atrophic Acne Scars

J Clin Aesthet Dermatol. 2015 May; 8(5): 33–40.

Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Corresponding author.This article has been cited by other articles in PMC.

Abstract

Atrophic scarring is often an unfortunate and permanent complication of acne vulgaris. It has high prevalence, significant impact on quality of life, and therapeutic challenge for dermatologists. The treatment of atrophic acne scars varies depending on the types of acne scars and the limitations of the treatment modalities in their ability to improve scars. Therefore, many options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, laser treatment, punch techniques, fat transplantation, other tissue augmenting agents, needling, subcision, and combined therapy. Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application. In order to optimally treat a patient’s scar, we need to consider which treatment offers the most satisfactory result. There are also promising procedures in the future, such as stem cell therapy. In this article, the authors review the different treatment options of atrophic acne scars. This may be useful for selecting the best therapeutic strategy, whether it be single or combined therapy, in the treatment of atrophic acne scars while reducing or avoiding the side effects and complications.

Acne is a common condition that affects up to 80 percent of the adolescent population to some degree or another.^1–8 It is caused and characterized by multiple factors including Propionibacterium acnes activity, increased sebum production, androgenic stimulation, follicular hypercornification, lymphocyte, macrophage and neutrophil inflammatory response, and cytokine activation.^8–11 Inflammatory acne lesions can result in permanent scars.⁹ Scarring occurs early in acne and may affect some 95 percent of patients with this disease, relating to both its severity and delay before treatment.⁶ Acne scars can be classified into three different types : atrophic, hypertrophic, or keloidal. Atrophic acne scars are the most common type.^1,3,12 The pathogenesis of atrophic acne scarring is most likely related to inflammatory mediators and enzymatic degradation of collagen fibers and subcutaneous fat.¹ The most basic and practical system divides atrophic acne scars into three main types: ice pick, rolling, and boxcar scars. ^13–15 A number of treatments are available to reduce the appearance of scars. Treatment of acne scars must be individually directed for each patient depending on the types of scars present.

CHEMICAL PEELS

Chemical peeling is the process of applying chemicals to the skin to destroy the outer damaged layers,^9,16,17 thus accelerating the normal process of exfoliation.^9,16 Different agents have different depths of penetration, and therefore, chemical peels can be divided into four different groups based on the histologic level of necrosis that they cause. The classification of peeling agents are listed in .^18,19

TABLE 1

Classification of peeling agents

DEPTH OF PENETRATION	HISTOLOGIC LEVEL	PEELING AGENTS
Very superficial	Destruction of the stratum corneum without creating a wound below the stratum granulosum	Glycolic acid, 30% to 50%, applied briefly (1 to 2 minutes) Jessner solution, applied in 1 to 3 coats TCA 10%, applied in 1 coat
Superficial	Destruction of part or all of the epidermis, anywhere from the stratum granulosum to the basal cell layer	Glycolic acid, 50% to 70%, applied for a variable time (2 to 20 minutes) Jessner solution, applied in 4 to 10 coats TCA, 10% to 30%
Medium depth	Destruction of the epidermis and part or all of the papillary dermis	Glycolic acid 70%, applied for a variable time (3 to 30 minutes) TCA, 35% to 50% Augmented TCA (CO2 plus TCA 35%; Jessner solution plus TCA 35%; glycolic acid 70% plus TCA 35%)
Deep	Destruction of the epidermis and papillary dermis, extending into the reticular dermis

Glycolic acid. Glycolic acid is the most commonly used alpha hydroxyl acid as a peeling agent.^16,20,21 It can be used as a daily skin care product in low concentrations of 5 to 15 percent. Greater concentrations of 30 to 70 percent are used for chemical peels.¹⁶ The higher the concentration, the deeper the peel they produce. Glycolic acid acts by thinning the stratum corneum, promoting epidermolysis, and dispersing basal layer melanin. Glycolic acids are systemically safe and nontoxic and produce superficial peels capable of significant effects, but with few complications. They are also well-tolerated by patients. The best results achieved for acne scars include five sequential sessions of 70% glycolic acid every two weeks.⁹

The advantages of glycolic acid are very mild erythema, mild desquamation, and short postoperative period. The disadvantages are penetration often not uniform, mandatory neutralization, and high risk of overpeel if time of application is too long or the skin is inflamed.²²

Trichloroacetic acid (TCA). TCA can be used in different concentrations; 10% to 20% TCA is used for superficial peels, whereas 35% is used as a medium-depth peel. Concentrations higher than 35% are not recommended because the results are less predictable and the potential for scarring is higher.^9,20 The application of TCA to the skin causes epidermal cellular necrosis and necrosis of collagen in the papillary to upper reticular dermis, depending on the concentration of TCA.^10,23,24

TCA application to the skin causes protein denaturation, the so-called keratocoagulation, resulting in a readily observed white frost.⁹ The degree of the frosting correlates with the depth of solution penetration. Level 1 is speckled white frosting with mild erythema and corresponds to superficial penetration.^16,20 This should heal after 2 to 4 days of light flaking. Level 2 is characterized by an even white-coated frost with background erythema. This degree of frosting is usually desirable for medium-depth peels, a full-thickness epidermal peel that heals after about five days. Level 3 is solid white opaque frost with little or no background erythema,^16,18,20 the peel has extended to the papillary dermis, and this takes up to seven days to heal.¹⁶

The advantages of TCA are low cost, uniformity of application, and the fact that penetration can be easily evaluated by the color of frost. The disadvantages include stinging and burning sensation during the application, high concentrations not recommended in skin types V to VI, and potential for hypo/hyperpigmentation.²²

Jessner’s solution. Jessner’s solution is used for light peels alone or in preparation for a TCA peel.¹⁶ The preparation is made from salicylic acid, 14g; resorcinol, 14g; lactic acid (85%), 14g; and ethanol to l00mL.^9,16,21 The Jessner’s solution was found effective in destroying the epidermal barrier by breaking up individual epidermal cells.¹⁸

The depth of the peel depends on the number of coats of solution applied. A very superficial Jessner’s peel results in faint erythema, which may be associated with a light powdery-looking whitening of the skin surface. Level 1 created with 1 to 3 coats of Jessner’s solution is very superficial and only causes mild flaking of the skin for 1 or 2 days or none at all. A level 2 peel is created with the application of more than 4 to 10 coats of the solution. There is increased erythema and some pinpoints of true white frosting. There is mild-to-moderate burning and stinging, which lasts for 15 to 30 minutes. In the next 1 to 3 days, a mild red-brown discoloration develops, and the skin feels tight. Exfoliation then follows for 2 to 4 days, with moderate flaking. Further coats of Jessner solution create a level 3 peel, where there is prominent erythema and increased areas of frosting associated with a moderate amount of stinging. At this level, exfoliation usually lasts 8 to 10 days, and there might be actual peeling apart from the dry flaking of the skin.

Different patients may require different number of coats to achieve the same level of peel. This is because penetration of the solution depends on a number of factors, including the preparation of the skin, the thickness of the corneum, and the sensitivity of the skin. The advantages of Jessner’s solution are that the peel is very superficial and safe and rarely goes deeper than one would expect.

Disadvantages include erythema and discoloration.¹⁶

Pyruvic acid. Pyruvic acid is an alpha-ketoacid and an effective peeling agent. It presents keratolytic, antimicrobial, and sebostatic properties as well as the ability to stimulate new collagen production and the formation of elastic fibers. The use of 40 to 70% pyruvic acid has been proposed for the treatment of moderate acne scars.⁹

The advantages of pyruvic acid are homogeneous penetration with uniform erythema, mild desquamation, short postoperative period, and the ability to be used in all skin types. Disadvantages include intense stinging and burning sensation, mandatory neutralization, and pungent and irritating vapors for the upper respiratory mucosa.²²

Salicylic acid. Salicylic acid is one of the best peeling agents for the treatment of acne scars.⁹ It is a beta hydroxyl acid agent,^9,20,21 which removes intercellular lipids that are covalently linked to the cornified envelope surrounding keratinized cells.^9,21 The most efficacious concentration for acne scars is 30% in multiple sessions, 3 to 5 times, every 3 to 4 weeks. The side effects of salicylic acid peeling are mild and transient. These include erythema and dryness. Persistent postinflammatory hyperpigmentation or scarring are very rare.⁹

The advantages of salicylic acid are established safety profile in all skin types, formation of white precipitate to verify if application is homogeneous, and an anesthetic effect that is useful in combination peelings. The disadvantage of salicylic acid is intense stinging and burning sensation.²²

CROSS technique/dot peeling. Using a high strength of the peeling agent TCA, the CROSS technique (chemical reconstruction of skin scars)^7,10,23 has been found to be useful as a simple office procedure. It is best suited to treat ice pick or small boxcar scars.³

The CROSS technique entails stretching the skin and using a fine wooden toothpick to apply 65 to 100 percent TCA to the bottom of the ice pick scar, which leads to destruction of the epithelial tract. This is followed by collagenization in the healing phase and filling up of the depressed ice pick scar. It causes momentary, mild, tolerable burning on application, and no anesthesia is required. Collagen formation may take 2 to 3 weeks and can continue up to 4 to 6 weeks. On average, about 25 percent improvement of scars takes place with one session. The procedure may be repeated two or three times at intervals of 2 to 4 weeks.¹⁷ The advantage of the CROSS technique is that since the adjacent normal tissue and adnexal structures are spared, healing is more rapid with a lower complication rate.^17,25,26

Deep peels (phenol). Deep peels may also be an option, but are more rarely used because of the downtime required for healing and the potential for complications and adverse events.¹² Deep peeling solutions penetrate the skin to the midreticular dermis and create maximal effect for production of new collagen. The solutions for deep peeling are composed of a combination of croton oil and phenol in various concentrations. Phenol peels have been the agent traditionally used, but may cause cardiac arrhythmia so patients require cardiac monitoring during the procedure.^14,27

Deep peels can improve atrophic acne scars, but require sedation and cardiovascular monitoring, are not recommended in skin types IV to VI, can cause cardiotoxicity, and can cause hypo/hyperpigmentation.²²

DERMABRASION/MICRODERMABRASION

Dermabrasion was the first major advance treatment of acne scarring.^6,28 Dermabrasion and microdermabrasion are facial resurfacing techniques that mechanically ablate damaged skin in order to promote re-epithelialization. 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.⁹ Dermabrasion completely removes the epidermis and penetrates to the level of the papillary or reticular dermis,^6,9,28 inducing remodeling of the skin’s structural proteins. Microdermabrasion, a more superficial variation of dermabrasion, only removes the outer layer of the epidermis,^9,29 accelerating the natural process of exfoliation. Both techniques are particularly effective in the treatment of scars and produce clinically significant improvements in skin appearance. Unlike dermabrasion, microdermabrasion can be repeated at short intervals, is painless, does not require anesthesia, and is associated with less severe and rare complications,²⁹ but it also has a lesser effect and does not treat deep scars.⁹ In addition, dermabrasion does not improve ice pick or deep boxcar scars optimally.^2,12

LASER TREATMENT

Laser resurfacing is an effective treatment that is easier to use than other modalities.³⁰ Different types of laser, including nonablative and ablative lasers, are very useful in treating acne scars, except for deep ice pick scars.¹

Ablative lasers.
Carbon dioxide (CO₂) laser. CO₂ laser resurfacing vaporizes tissue at a depth of 20 to 60um and zones of thermal necrosis ranging another 20 to 50um.³¹ Energy at 10.600nm wavelength is absorbed by both intracellular and extracellular water, causing rapid heating and vaporization of tissue.^32–34 Dermal heating below the zone of ablation induces a wound-healing response,^32,35 which causes collagen remodeling and heat-mediated tissue contraction. Re-epithelialization generally takes 5 to 10 days, and erythema may persist for months.³² Side effects may include dyschromia (hyper- or hypopigmentation),^9,32,36 infection,^37,38 lines of demarcation between treated and untreated areas,³² and scarring.^36–38

Erbium: yttrium-aluminum-garnet (Er:YAG). Er:YAG emits a wavelength of 2940nm,^39,40 is 10 times more selective for water than CO₂ laser due to its shorter wavelength, and reduces residual thermal damage.^31,34,41 Er:YAG at 5J/cm vaporizes tissue at a depth of 20 to 25um with an additional 5 to l0μm zone of thermal necrosis.³¹ The main difference is that energy from the Er:YAG laser more closely approximates the absorption peak of water (3,000nm), so virtually all the energy is absorbed in the epidermis and superficial papillary dermis. Thus, it has a more superficial ablation profile and a smaller zone of thermal damage beneath the ablated layer,³² leading to shorter healing times and a lower rate of side effects.^10,33,42 Re-epithelialization takes 4 to 7 days with En:YAG.³¹

Plasma skin resurfacing. A new technology utilizes a nonlaser device to generate plasma, a cloud of electrons, from nitrogen atoms, and a spark of radiofrequency.³⁴ This technology uses pulses of ionized nitrogen gas to deliver heat energy directly to the skin.^32,33,43 The epidermis initially is left intact, only later to shed as healing is completed.³⁴ Roughly 10 days after treatment, fibroblasts depositing new collagen and elastin fibers can be seen. Side effects are rare and can include temporary hyperpigmentation, erythema, edema, epidermal de-epithelialization, infection, and scarring.³²

Nonablative lasers. Nonablative skin remodeling systems have become increasingly popular for the treatment of acne scars because they decrease the risk of side effects and the need for postoperative care.^9,44 These nonablative lasers are designed to spare the epidermis and stimulate the dermis to produce new collagen.⁴⁵

Neodymium:yttrium-aluminum-garnet (Nd: YAG) laser. The Nd:YAG laser is used on patients with darker or more sensitive skin. These lasers cool the surface of the epithelium while also penetrating the deeper layers of the skin with infrared wavelengths. These wavelengths target the underlying water and collagen without disrupting the epidermal layer.⁴² Thermal damage serves as the stimulus for inflammatory mediator release, fibroblast activation, neocollagenesis, and dermal remodeling.⁴⁶ The Nd:YAG laser requires more sessions (3-5 treatments per month for several months), but a patient can expect to see a 40- to 50-percent improvement in the quality of their scarring.⁴² The results are long lasting and continue well beyond the last treatment, indicating ongoing collagen remodeling after completion of the laser treatment sessions.⁴⁷ This treatment offers significant advantages to patients in terms of its minimal recovery period and minimal risk of infectious and pigmentary complications.^47,48

Diode laser. The 1450nm diode laser in the infrared spectrum targets the water in the upper dermis, remodels the skin’s underlying collagen, and promotes formation of new collagen.⁸ An increase in collagen synthesis and deposition was noted until six months after treatment with this laser.³⁴ Side effects are usually minimal and can include postoperative erythema, edema, and hyperpigmentation.^8,40

Fractional photothermolysis (FP). Although improvement was noted with nonablative lasers, the results obtained were not as impressive as the results from those using ablative laser. For this reason, a new concept in skin laser therapy,^9,49 called FP, has been designed to create microscopic thermal wounds to achieve homogeneous thermal damage at a particular depth within the skin.^50–52 Fractional photothermolysis system selectively damages the dermal tissue to induce a wound-healing response that affects the stimulation of prolonged neocollagenesis without damage to the epidermis in order to overcome the problems associated with laser resurfacing, dermabrasion, and chemical peeling.⁵³ Efficacy of treatment for patients with diverse morphology of scars was noted, ranging from ice pick to boxcar and rolling scars.⁵⁴ Treated zones are completely healed within 24 hours compared with two weeks for ablative laser resurfacing.⁵⁵

The benefits of this system are less downtime and side effects compared to the conventional ablative laser and an increased efficacy of tissue regeneration compared to the nonablative methods.^56,57

Pinpoint irradiation technique. Pinpoint irradiation technique accompanied by needling is as effective as FP in the treatment of atrophic acne scars.^53,58 It often induces microscopic thermal wounds to achieve skin rejuvenation treatment for ice pick acne scars. In pinpointed irradiation, no complications could be seen as those with ordinary laser resurfacing and the downtime is shortened to 3 to 6 days. All irradiated points on the face were small dry macules of ablated epithelium, which could be gently removed with a topical antibiotic cream after a day. The color of the treated scar area was back to pink or normal within 2 to 4 days. Also, postoperative hyperpigmentation did not occur;⁵⁸ this could be because there was no overlapped irradiation, no massive damage, and the time interval between each shot was relatively long.⁵³

RADIOFREQUENCY (RF)

Radiofrequency is nonionizing electromagnetic radiation with a frequency range between 3 and 300GHz. With the fractional bipolar RF device, the RF current flows through the skin between the electrode-pin rows. It generates fractional deep dermal heating in the region of the electrode matrix to induce skin injury and then elicits a wound healing response, stimulating the remodeling of dermal collagen. More recently, fractional bipolar RF, based on the principle of “sublative rejuvenation,” which causes low epidermal disruption with high dermal remodeling, has been introduced to improve the efficacy and reduce the side effects of FP. The fractional bipolar RF device was also able to improve acne scars significantly.⁵⁹

PUNCH TECHNIQUES

Punch excision. Punch or elliptical excision to the subcutaneous level is preferred for ice pick scars^1,12,14,60 and also deep boxcar scars.² Punch excision removes a pitted scar with a straight-walled disposable or hair transplant punch that is slightly larger than the scar being addressed.^6,28 The goal is to trade a larger, deeper scar for a smaller, linear closure that will hopefully be less noticeable and possibly fade with time.¹⁰ Although excisional procedures are an effective one-time treatment, a major disadvantage is that only the scars that are treated have a chance of improving. It does little for the surrounding textural irregularity or discoloration that is frequently seen in a field of acne scars.³

Punch elevation. Punch elevation combines the techniques of punch excision and grafting without the risk of skin color or texture mismatch.^2,12 This limits its use to shallow and deep boxcar scars.² After the scar has been isolated from the surrounding skin, it is elevated enough to be slightly raised against the bordering tissue.^6,28 Retraction of the grafted tissue occurs during the healing phase, resulting in a leveled surface.^2,12

Punch replacement grafting. This is probably the best of these techniques for sharp-walled or deep ice pick scars. It is quite a painstaking technique as often 20 or more replacement grafts are required in a single session, but it is usually worthwhile as it will often yield the best results for difficult sharply defined scars. The scar is discarded and is replaced with a slightly larger full-thickness skin graft, usually from the postauricular area. Some of the grafts will heal in the same level of skin surface and some will be elevated.^6,28

FAT TRANSPLANTATION

Fat is close to the ideal augmentation material in that it is cheap, readily available, and incapable of being rejected or causing allergic or other adverse tissue reactions.^9,28,61 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 blood supply. Most acne-scarred patients achieve maximum results about three months after the procedure.^6,28

OTHER TISSUE AUGMENTING AGENTS

There are many new and older autologous, nonautologous biologic, and nonbiologic tissue augmentation agents that may be used for atrophic scar contour correction.^6,9 Soft-tissue fillers are effective in treating patients with rolling acne scars.¹ Fillers for acne scarring can be utilized in two ways. First, fillers can be injected directly under individual scars for immediate improvement. Second, volumizing fillers, such as poly-L lactic acid (PLLA) or calcium hydroxylapatite, can be delivered to areas where laxity of skin or deep tissue atrophy is accentuating the appearance of acne scars.^1,3 Injectable PLLA is a biocompatible, biodegradable, synthetic polymer hypothesized to elicit the endogenous production of fibroblasts and, subsequently, collagen.⁵

There are many tissue augmentation agents that have been used in the past, but nowadays, because of the high incidence of side effects, the recommended material to use is hyaluronic acid.⁹ Hyaluronic acid derivatives potentially offer improved longevity of correction and reduced risk of immunogenicity and hypersensitivity.⁶² There are also indications that native hyaluronic acid promotes cell proliferation and extracellular matrix synthesis and modulates the diameter of the collagen fibers.⁶³

NEEDLING

Skin needling also called collagen induction therapy^1,61 or needle dermabrasion is the technique of rolling a device comprising a barrel studded with hundreds of needles, which create thousands of micropunctures in the skin to the level of the papillary to mid-dermis.^1,26 With this technique, the rolling is usually continued until bruising occurs, which initiates the complex cascade of growth factors that finally results in collagen production.^4,9,26 Results generally start to be seen after about six 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.⁹ The optimal scars to treat with skin needling are the same as fractional laser resurfacing—rolling acne scars and superficial boxcar scars.^1,4

Compared to other resurfacing procedures, this technique has many advantages. First, it is purposed to be safe in all skin types and to carry the lowest risk of postinflammatory hyperpigmentation when compared to laser resurfacing, chemical peels, or dermabrasion.^1,9 Second, the treatment does not result in a line of demarcation between treated and untreated skin. Third, the recovery period of 2 to 3 days is significantly shorter than other resurfacing procedures. Finally, needling is much less expensive to incorporate into a practice compared with a fractional laser or dermabrasion.¹

SUBCISION (SUBCUTANEOUS INCISIONLESS SURGERY)

Subcision is a procedure in which a needle is inserted under the skin and passed in multiple directions. Subcision is best utilized for rolling acne scars^3,60,64 that have normal quality of skin at the base of each scar; it is less effective for treating boxcar and ice pick scars.³ The mechanisms of scar improvement are releasing fibrotic strands underlying scars, organization of blood in the induced dermal pocket, and connective tissue formation in the area.^28,61,64

The advantages of this innovative method include the following: easy to apply, inexpensive, short down-time, applicable for various skin types (I–IV), no significant complications, and remarkable and persistent improvement in short time without injury to the skin surface. The disadvantages include pain at the time of subcision in some cases, bruising, transient discoloration, hemorrhagic papule and pustule, hypertrophic scar, necessity of frequent suctioning sessions, and recurrence.⁶⁴

COMBINED THERAPY

There is a new combination therapy for the treatment of acne scars. The first therapy consists of peeling with TCA, followed by subcision, the process by which there is separation of the acne scar from the underlying skin, and finally 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 to 3 months apart and fractional laser irradiation was performed every 3 to 4 weeks. There were no significant complications at the treatment sites.⁹ It would appear that triple combination therapy is a safe and very effective combination treatment modality for a variety of atrophic acne scars.^9,55

The current study could be added to recent research welcoming the relative new comer platelet-rich plasma (PRP) to the dermatologic field. PRP is an autologous concentration of human platelets contained in a small volume of plasma. It provides further evidence of the potential benefits that the use of PRP offers as an adjuvant to CO₂ laser in the treatment of atrophic acne scars. The superiority of the combination was clearly evident in several aspects, including the rapidity and degree of improvement of the acne scars, fewer side effects, and shorter downtime.⁶³

STEM CELL THERAPY

Epidermal substitute is made by adding epidermal cells to a scaffold to form a composite skin with some biological activity. Cells in these substitutes have a relatively weak ability to proliferate and self-renew, which affects the outcome of repair. However, the seed cells of the dermal substitute are mainly fibroblasts. Although fibroblasts are easy to obtain and grow relatively quick, their function is simple and they do not encourage the development of skin appendages. This problem might be resolved effectively if the dermal substitute is used to cover the wound with a population of epidermal stem cells.⁶⁵

The traditional concept of stem cell therapy comprises the isolation of stem cells from patients, propagation and differentiation in vitro, and subsequent re-injection of autologous cells into the patient. An alternative approach that could be easier includes local activation and recruitment of endogenous stem cells to the site of defect for new tissue regeneration. This may occur in response to certain agents that can promote the proliferation and differentiation of stem cells.⁶⁶ The mechanisms for stem cell delivery to improve wound healing are intravenous or subcutaneous injection, but the mechanism through this is currently still not clearly understood.⁶⁷

The role of epidermal stem cells in contributing to homeostatic maintenance of the skin and wound repair has been well acknowledged for many years.⁶⁸ Stem cell therapy has emerged as a promising new approach in almost every medical problem.⁶⁶ Stem cells found in our body are undifferentiated or nonspecific cells without having any tissue-specific structure that have the potential to become other, more specialized types of cells.⁶⁷ Stem cells demonstrate two defining features, namely self-renewal and multipotency, and are instrumental for renewal, regeneration, and repair.⁶⁵ Stem cells have the ability to renew themselves as well as differentiate into specialized cell types.⁶⁷

CONCLUSION

A variety of effective treatments of atrophic acne scars have been developed. Each of these procedure has a different role in treating acne scars, with some modalities being better suited for certain scar types than others. Individual scars can vary widely in type and depth, with different treatment approaches that can be seen in . If multiple procedures were combined, then many types of scars and fine textural irregularities would likely be improved to a degree that could not be obtained by each procedure alone. The varying morphology of acne scars, especially when multiple types of scars are found in the same patient, suggests the need for combination therapy to provide the most effective treatment. Stem cell therapy might have the potential as a promising therapy for atrophic acne scars in the future.

TABLE 2

Procedures to select by lesion type of scars

TREATMENT	ICE PICK SCARS	ROLLING SCARS	BOXCAR SCARS
Chemical peels
TCA	++	–	++
CROSS technique	++	–	++
Dermabrasion/microdermabrasion	+	–	+
Laser
Ablative and nonablative laser	–	++	++
Fractional photothermolysis	++	++	++
Punch techniques
Punch excision	++	–	+
Punch elevation	–	–	++
Punch replacement grafting	++	–	–
Tissue augmenting agents	+	++	+
Needling	–	++	++
Subcision	+	++	+

ACKNOWLEDGMENT

This work was supported by a grant from the China National Natural Science Foundation (81000700 and 81171518) science project from traditional Chinese medicine Bureau of Jiangsu Province (LZ11084) and Jiangsu National Natural Science Foundation (BK2012877) and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

Footnotes

DISCLOSURE:The authors report no relevant conflicts of interest.

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May 1, 2021

May 1, 2021

Cosmo

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How to remove acne pits? There is no one answer.First, determine the type of acne marks, and we will help you figure out the procedures that will get rid of them.

There are only three types of acne scars: atrophic, hypertrophic, and hyperpigmentation.

Hyperpigmentation

Small red, brown, often purple spots after acne.

Cause of occurrence – skin injury. If it’s simpler – squeezing out pimples. As a protection, the skin intensively produces melanin, a pigment that protects skin cells from damage by the sun’s rays.

Often, hyperpigmentation disappears on its own after 25-28 days (on average, this is the period of cell renewal). If dark spots remain after acne, you can fight them with brightening serums, masks, peels, acids and even homemade masks.
But with atrophic and hypertrophic scars, no serum will help.

Here only salon procedures will solve the problem.

Hypertrophic scars after acne

Convex acne scars, tubercles with a small diameter, often have a red or purple tint.Often itchy.

Hypertrophic scars are formed at the site of acne with excess collagen. They are often the result of popping acne. The skin, protecting itself from traumatic actions, begins to produce a lot of building proteins. As a result, bumps form on the surface. They are also called keloid scars.

How to get rid of them? Most often, cortisol injections directly into the affected area help. Acne peels, mesotherapy, and laser acne treatments can also help.

Atrophic scars

Acne pits, depressed scars that are rectangular, chipped and rounded.

This is the most common type of acne scar. They occur after acne due to a lack of collagen. The skin does not have enough building material for recovery, so small crater formations appear in the place of disappeared blackheads.

If you have acne pits, it is important to get rid of them when you are young, as the skin continues to lose collagen over time.Therefore, atrophic scars become even more noticeable than in youth.

How to remove acne pits

There are four types of treatments that will help remove acne pits:

• laser procedures;
• mesotherapy;
• chemical peels;
• dermabrasion.

Laser treatments

• Laser removal of acne scars is used for severe forms of atrophic scars.

Depending on the degree of skin lesion, the dermatologist can prescribe one of two types of procedures: neodymium and erbium laser peeling.

Neodymium Laser

The neodymium laser acts pointwise at a given depth exclusively on scar tissue. Thanks to the influence of the beam and heat, collagenesis, the process of producing collagen and elastane, is activated. After several procedures, the skin surface is leveled, and scars and irregularities gradually disappear.Bonus – the effect of skin rejuvenation.

Suitable in cases where pits appear pointwise.

Erbium Laser

During the procedure, a directed action of a beam of light is made on a thin layer of the epidermis. In place of the scarred surface, new cells are formed. After several procedures, the skin microrelief is leveled, the pits after acne disappear. The procedure helps to activate cell regeneration, form new skin tissue, and enhance lymphatic drainage.Bonus – the laser eliminates shallow age wrinkles, makes the skin more elastic and taut.

Suitable for large areas of skin with pits after acne.

Chemical peeling

• The procedure helps to get rid of all types of post-acne, including deep pits.

Will take longer than laser treatment. In addition, the procedure is not suitable for everyone – in each case it is important to consult a dermatologist.

The beautician uses chemical peels with a high concentration of acids. They dissolve the top layer of the skin. Unlike the previous case, there is a long recovery period. The procedure also requires certain skin care before and after the peel. You will need strong sunscreens.

After peeling, dead skin cells exfoliate or peel off the face with films – it all depends on the type of peeling chosen and the concentration of acids.

Mesotherapy

• Helps with shallow pits after acne, but will not work with extensive skin lesions.

This is a less traumatic procedure for the treatment of post acne. During the procedure, the cosmetologist peels the skin with acidic agents, then a preparation based on hyaluronic acid, peptides, vitamins A or C is injected under the skin. 4 to 10 procedures.

Mesotherapy is carried out no more than once a week, has no recovery period, there are practically no side effects.Immediately after the procedure, slight swelling and small hematomas at the injection sites are possible.

Dermabrasion

• Helps with atrophic scars of varying severity.

Skin resurfacing takes place during the procedure. This is a mechanical treatment of the face with a special device with a rotating round nozzle. In the case of dermabrasion, the upper stratum corneum is removed using a beam of light. Thanks to the procedure, the synthesis of cells is accelerated, the production of its own collagen is activated, due to which the microrelief of the skin is leveled.After a recovery period (it may take more than a week), the skin becomes firmer, smoother, small pits after acne disappear after the first procedure, deeper ones become less noticeable. Bonus – smoothing out fine wrinkles.

The procedure is painful, so the beautician treats the skin with an anesthetic cream or ointment. Pain medications may also be needed during the recovery period. In addition, due to the traumatic nature of the procedure, the skin from which the upper stratum corneum was removed needs rehabilitation.A dermatologist can prescribe special care.

90,000 Fovea on the face what to do. How to get rid of pits after pustules

Bumpiness of the skin appears as a result of improper care of it during inflammatory manifestations. The main source of pits is acne.

What causes pits on the face?

Acne does not always leave such consequences – with proper treatment and the independent release of acne contents, the skin is restored without consequences.Bumps appear when:

• squeezing out acne, which entails tissue injury;
• furunculosis;
• infectious process;
• Poor skin hygiene during a rash.

If you have a thin outer layer of the epidermis on your face, then you run the risk of getting pits, even if you follow all the rules of treatment. In this case, you will have to immediately carry out procedures aimed at eliminating this defect.

How to get rid of pits on the face?

If they have appeared very recently, then you can try to get rid of the tuberosity with home remedies.

The following products are used for this:

• cocoa butter: the product is applied to the pits and rubbed in with massaging movements for several minutes. As a result of the procedures, the elasticity of the skin increases, which contributes to its smoothing;
• coffee: from coffee grounds (about 1 tsp coffee per cup) and 1 tbsp. l. vegetable oil peeling is being prepared. It is distributed evenly over the face and left for 5 minutes, after which it is washed off. The regularity of the procedure is once a week.Coffee will accelerate tissue regeneration and metabolic processes inside them, as well as remove hardened cells of the upper layer of the skin;
• Tomatoes: Chop a large tomato in a blender and spread the pulp over the face. Soak for 20 minutes, rinse. This remedy tones the skin;
• oatmeal: Scrub requires 5 tbsp. l. flour or flakes crushed in a blender. This is poured in half a glass of kefir, mixed and applied to the face. It is washed off after 15 minutes. The procedure is carried out 2 times a week.

After that it is advisable to moisturize the skin well with special creams.

But if these funds do not help or the situation is severely neglected, it is necessary to contact a dermatologist and cosmetologist. The doctor will advise on medications that have a stronger effect, and in the beauty salon you will find the most optimal cosmetic procedure that can even out even very deep and old pits.

Acne and pimples themselves cause a lot of worries about the aesthetics of appearance, but the traces that sometimes remain after them can even cause serious psychological complexes.

Moreover, pits and scars do not always appear only when the abscesses are squeezed out.


It is enough to form a large pimple or locate several nearby to leave a noticeable mark on the skin after them.

• All information on the site is for informational purposes only and DOES NOT ARE a guide to action!
  
• Only a DOCTOR can deliver an EXACT DIAGNOSIS to you !
  
• We earnestly ask you NOT to self-medicate, but to make an appointment with a specialist
  !
• Health to you and your loved ones!

How to remove acne pits on the face, if it has not been possible to protect the skin from their appearance?


Reasons for the appearance of

At the last stage of its existence, the contents of matured eels come out, freeing the duct of the sebaceous gland.

In its place, a small hole remains (a hole after a pimple), which is gradually tightened, overgrown with connective tissue.

This process is called skin regeneration. It happens rather slowly.

If the wound after a pimple is large, then the previous appearance of the skin may not be achieved.

But not every pimple leaves a mark on the skin.


This usually happens when:


• hygiene rules were not followed;
• bacterial infection joined;
• the pimple was squeezed out, and ineptly;

90,049 pimples covered significant areas;

• the skin is very thin and sensitive.

The most difficult recovery occurs after the breakthrough of an internal pimple.

Then there is damage to the deeper layers of the skin.


Photo: Self-removal of a pimple can cause scar formation

In this case, pits or scars cannot be avoided.

Types of scars after acne

Acne scars are of two types:


• hypertrophic
  – if the connective tissue at the site of the pimple-damaged skin has formed in excess, in this case it protrudes above the surface in the form of a dense nodule, in our understanding, this is a scar, that is, a scar;
• atrophic
  – if the connective tissue does not completely cover the hole formed after the pimple, we call such scars as pits.

Atrophic scars (pits) are also of different types, determined even by eye:


• rounded
  – these are arcuate pits, resembling a wave, depressions of different sizes, their edges are smooth;
• rectangular
  – a depression in the skin with straight edges, often remains after unsuccessful squeezing of acne;
• chipped
  – Conical depressions, the walls of which converge in the middle, the most difficult to treat.

If a hole remains on the skin after squeezing out the pimple, do not entertain vain illusions, it will not disappear on its own.

Every type of atrophic scar needs to be treated.


How exactly depends not only on the variety, but also on the size.

Photos: before and after

How to remove

Quickly getting rid of pits after acne will not work.

It will take time for any of your actions to have a positive result. Get ready to fight hard for an even skin texture.

Shallow pits after acne

Shallow atrophic scars can be removed at home. The meaning of all actions should be reduced to renewing the skin.

They accelerate the exfoliation of the upper layer of the epidermis and stimulate the regeneration process.

This component not only mechanically removes dead cells of the epidermis, but also saturates the skin with useful substances, improves metabolic processes in its cells.

Photo: if the hole is shallow, then masks and scrubs will help to cope with the problem

Clay masks with regular use also give noticeable results.


• Green or black clay should be preferred.
• Typically, a small amount of powder is diluted with water to a creamy consistency and applied to the skin for 15 minutes.

It is good to add a couple of drops of tea tree oil to creams or other skin care products.

It also stimulates cell regeneration.

Deep

If after a pimple there is a deep fossa, then you cannot cope with this problem on your own.


Unfortunately, the cosmetologist does not always help, but modern cosmetic procedures sometimes work miracles.

So the likelihood that the footprints will become at least not very noticeable is high.

Photo: modern cosmetic procedures will help to cope with deep scars

In this matter, the main thing is to listen to the recommendations of specialists.

There are many different procedures for smoothing skin relief on the face (we will talk about them below), but not all of them are suitable for every person.

Video: “What to do if you have oily problem skin”

Ways to delete

Depending on the depth and size, the pits can be removed from the skin surface or made less visible.


For this purpose, both medicinal preparations and special cosmetic procedures are used.

How to treat atrophic scars?

Medication

The pharmaceutical industry produces certain creams and ointments that are specifically designed to combat scars and scars.

They can also be used for pits on the face.

The advantages of these tools are that you can use them at home at a convenient time. And the price in comparison with cosmetic procedures is much lower.

But these medicines also have disadvantages.


The main one is the duration of use, for some funds – up to six months.However, the result is not guaranteed. That is, the fossa may become less noticeable, or it may be smoothed out completely, but how it will be in reality is not known in advance.

However, with newly formed atrophic scars, you can try to apply:


Photo: Contractubex effectively removes fresh scars and acne spots

• Quotlan
  is a cream of Russian production, registered as a remedy, that is, it has fewer contraindications and side effects in comparison with medicines.It can be used as a universal remedy for all skin problems, including traces of them. It has bactericidal, analgesic and regenerating properties. Ideally, its application should be started from the moment of the formation of an acne, which threatens to leave traces of its stay on the skin (it is better if it is an area with thinner skin – on the cheeks, chin, forehead).
• – the gel is specially designed to prevent the formation and fight against various types of scars and scars, including atrophic ones.It has fibrinolytic (dissolves blood clots), keratolytic (softens the stratum corneum of the skin), anti-inflammatory properties, stimulates regeneration.It can also be used at the stage of abscess breakthrough. For a more effective effect, it is recommended to pre-steam the area of ​​application or, after applying the gel, close this area with a plaster.
• Mederma
  – gel, also used to eliminate the consequences. More effective for fresh scars. It helps to even out the skin tone with scar formations.The gel is not recommended to be applied to unhealed wounds.
• Kelofibrase
  is a cream with anti-scar activity. Improves microcirculation of blood at the site of application and maintains the water balance of cells in this area. It is based on urea, a powerful natural ingredient with a moisturizing and antimicrobial effect.

If the pits on the skin are old (formed more than a year ago), then the use of these funds can give an effect only as part of a complex effect.

Seek advice from a dermatologist or beautician.

Cosmetic

Cosmetic procedures, in contrast to the use of gels, give a faster and more visual result.

Photo: laser skin resurfacing procedure

Apply to eliminate acne pits.


• Laser resurfacing.
  The upper layer of the epidermis is removed with. After that, it takes time for its recovery (from 2 weeks), but the pits are noticeably smoothed out.The method has good reviews. Sometimes one procedure is enough, but in difficult cases it may be necessary to repeat it.
• Dermabrasion.
  This is a mechanical method of removing the top layer of the skin using special brushes and other tools. It is carried out under local anesthesia, since the process is painful.

Photo: acid peeling exfoliates dead skin cells

• Chemical.
  The action is similar to the previous methods, only it is carried out due to chemicals, acids, which corrode and exfoliate the stratum corneum of the skin.It will help with shallow rounded pits.
• Collagen Injection
  – make the skin at the injection site smooth and elastic. This method is suitable for the most severe cases, but the result is temporary (although it can be quite long). Collagen injected into the area of ​​the fossa does not eliminate it, but only makes it invisible.

Photo: collagen will make the pit after acne invisible

• Own adipose tissue transplant
  patients at the site of atrophic scar formation.The effect of this procedure lasts up to 1.5 years. After that, it will have to be repeated.
• Surgical method.
  Use for deep pits if other treatments have proven ineffective. The edges of the fossa are incised and it heals again.
• Chemical reconstruction
  with trichloroacetic acid. The method is still in the early stages of approbation. It consists in the treatment of atrophic scars with a highly concentrated solution of this acid. Studies have shown high efficiency in rectangular pits, but this technique has not yet become widespread.

Traditional methods

Traditional methods of treatment are able to get rid of shallow pits with a minimum investment of both time and money. Here are some recipes.

• Liniment Vishnevsky, and alcohol (vodka) are taken in equal amounts and mixed. The mixture is applied to the face for 40 minutes daily. The course of treatment is at least a month.
• Grate ripe tomato without peel. Apply daily to face, rubbing in lightly. Leave it on for 20 minutes and wash off.

Photo: badyaga will get rid of spots after acne

• Badiagi mask has an exfoliating and absorbing effect. Dilute the powder as directed, add a little lemon juice and a few drops of tea tree oil. This remedy will also help with post-stains, as well as fine wrinkles.
• Apply a little lavender oil to a cotton pad and apply to the problem area for a quarter of an hour. Repeat every other day.
• Beat the fat sour cream in a blender with the same amount of lemon pulp.Apply the resulting mass for 15 minutes. It is enough to do every other day.

Photo: cucumber mask evens skin tone

• Finely grated fresh cucumber, apply to skin for 15 minutes daily.
• Powdered sandalwood is mixed with rose water, applied to the face and left overnight.
• Apply cocoa butter daily to problem areas by gently rubbing it into the skin or using your fingertips.
• Dilute 1: 3 apple cider vinegar with water. Freeze in cubes and wipe problem areas with one daily.

Postpone scar treatment if there is inflammation on the face.


In this case, the recipes given can be harmful.

Questions and Answers

What products can be used on the face

In principle, all of the above means are used just on the face.


• After all, it is here that all skin irregularities are accessible to the eyes of others.And the problems arise most of all in this part of the body, because rarely a woman has not squeezed out an unsuccessfully appeared pimple.
• Products with salicylic acid in the composition fight well with skin irregularities. This component promotes faster exfoliation and renewal of the stratum corneum.
• But we must not forget about moisturizing the skin, without this it will be difficult for the regeneration processes to proceed. Use special products and drink at least 2 liters of water per day. It is also important for the normal functioning of skin cells and their repair.

How to get rid of a scar on the nose

Nose pits and scars are not uncommon. Internal acne often appears here, leaving behind unsightly marks.

How to get rid of them?


First, do not forget about proper nasal skin care. It is quite thin here, but it is highly susceptible to pollution, which must be disposed of in a timely manner. Along the way, you can smooth out the unevenness of the relief.

Photo: sea salt scrub will make the skin surface smoother

This double-acting product is a sea salt scrub.

• Take fine sea salt or grind it yourself.
• Mix with honey and rub this mixture gently into the skin of the nose in a circular motion.
• Leave it on for 10-15 minutes, let the skin absorb the nutrients from the ingredients.
• Rinse off and apply moisturizer.

With all the effectiveness of such a scrub, you do not need to use it more than 2 times a week.


On the rest of the days, use other products that exfoliate the top layer, enhance blood microcirculation, and stimulate regeneration.

If the fossa is very deep (this often happens on the wings of the nose), then do not waste time and consult a beautician.

The procedure chosen by him will help to get rid of the defect faster.

Getting rid of pimples left after acne is quite difficult.


It is much easier to prevent their appearance.

This is not always possible, but in most cases, timely and correctly carried out acne treatment will not allow a scar to form in its place.

Video: “Acne Treatment”

Acne is a fairly common occurrence that occurs especially often during adolescence.

If timely treatment is not carried out, then spots may form after acne. They are quite difficult to treat, but if you follow certain rules and use highly effective medicines, you can easily get rid of dimples on the skin.

Quite often occur when hygiene rules are not followed or a bacterial infection develops.Most often, this pathological condition is observed in owners of thin and sensitive skin. If pimples cover large areas or are ineptly squeezed out, then this leads to scarring.

Scars can be hypertrophic and atrophic. Hypertrophic nodules are characterized by an excessive amount of connective tissue formation at the site of a pimple. In this case, the scar is presented in the form of a nodule. If the connective tissue does not completely cover the hole, then this also leads to the appearance of a scar in the form of a fossa.

Atrophic scars are divided into several types. They can be:

1. Rectangular. The depressions in the skin have straight edges. The reason for the appearance of such a scar is squeezing out the pimple.
2. Rounded. The pimples after the pimple have an arched shape that resembles waves. The edges of the scar are smooth. The size of the grooves can be varied.
3. Chipped. The depressions are tapered. The walls converge in the middle.

If a fossa remains on the patient’s skin after squeezing out the pimple, then it must be treated without fail.Scars do not go away on their own.

Traditional medicine


In the fight against acne, traditional medicine is often used, which is characterized by high efficiency. Medicines are characterized by ease of preparation and low cost, therefore they enjoy a high level of popularity.

Cosmetologists in the treatment of scars recommend using tomato. To prepare the drug, you need to take overripe tomatoes and knead their pulp.The resulting gruel is applied to the face. It is necessary to keep the cosmetic product for half an hour. This folk remedy is widely used as a tonic after peeling.

One of the reasons for the appearance of acne is non-observance of hygiene rules

Also, experts advise using a clay mask. Traditional medicine is prepared on the basis of white clay, 50 grams of which is diluted in warm water. It is necessary to dilute the clay until a pasty consistency is obtained.Rose oil is added to it in the amount of 10 drops. The mask is applied to the area of ​​the scars for 15 minutes. After this time, the mask is washed off with warm water. It is recommended to carry out the procedure once a week. The duration of therapy is 3-4 months.

Oat scrub is useful. To prepare the drug, you need to take coarse oatmeal in the amount of 5 tablespoons. It is poured with half a glass of kefir and mixed thoroughly. It is necessary to apply the medicine to the skin.After applying it, it is recommended to hold the mask for another 15 minutes, and then rinse with water. The procedure is recommended to be carried out once every three days.

Coffee peeling is prepared on the basis of coffee grounds that remain after brewing coffee. Sunflower oil is added to it and mixed thoroughly. The mass must be applied to the face for 5 minutes with massage movements. After that, the folk medicine is washed off with warm water. The procedure is performed once a week. With its help, keratinized epithelium is eliminated, and regeneration is accelerated, metabolic processes in tissues are stimulated, and scars are reduced.

After cleansing procedures, apply a moisturizing cream to your face. With its help, the skin is nourished.

Before using a particular remedy, it is necessary to determine the presence of allergic reactions to it. That is why it is recommended to consult a doctor before using a certain folk remedy.

Use of medications


Drug therapy has a high effect in the treatment of scars.It must be used as directed by a doctor who will first assess the condition of the dermis.

In most cases, patients are prescribed:

1. Dermatix. The drug is developed on the basis of silicone and silicon dioxide. With its help, it is possible to carry out not only treatment, but also the prevention of scars of varying complexity.
2. Kontraktubex. Thanks to the universal components, with the help of the drug, collagen production and the elimination of small scars are carried out.
3. Mederma. The drug is widely used for keloid and other types of scars.
4. Quotlan. The production of a cosmetic product is carried out in the form of a cream. The drug eliminates a variety of problem areas on.

With the help of medications, the disease can be cured in the initial stages if the scars are fresh.

To ensure the most effective treatment, the prescription of pharmaceutical drugs should be carried out by a doctor.

Use of cosmetic products


In some patients, almost all of the facial skin is covered with scars. To align it, you must use the appropriate cosmetic products.

Carrying out cosmetic procedures is an effective way to eliminate scars

Chemical peeling is quite effective. For the procedure, salicylic, glycolic, trichloroacetic acids are used. They help to exfoliate tissues and also stimulate the production of new cells.The procedure should be carried out once every two weeks.

Laser resurfacing will help get rid of. With this procedure, hypertrophic scars are removed. It is quite painful, but effective. The rehabilitation period is 2 weeks. In order to obtain the highest possible result, it is necessary to carry out 5 procedures. The interval between them should be three months.

Microdermabrasion is recommended. When using this method, the apparatus acts on the pits mechanically.The protruding sections are cut off layer by layer using special equipment. As a result, the scar is gradually smoothed out to match the skin level.

Phenolic peeling is effective. Scar treatment with this method consists in the use of phenol. It cleans the skin, reduces and removes pimples from acne. After carrying out one procedure, the effect of the influence is already observed. the patient becomes clean and smooth.

Cosmetological methods of scar treatment are quite effective.The choice of a particular one is carried out by a cosmetologist, depending on the condition of the patient’s skin.

Scars are a rather unpleasant phenomenon on the patient’s skin, which remains after acne. For their treatment, you can use a variety of means, the choice of which is carried out by a specialist, depending on the condition of the patient’s skin.

On the video – an informative story of a specialist:

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Acne and pimples themselves cause a lot of worries about the aesthetics of appearance, but the traces that from time to time remain after them can become a prerequisite for even severe mental complexes.

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It is enough to form a large pimple or to settle several close, so that after them a noticeable mark remains on the skin.

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In its place, there is a small hole (a hole after a pimple), which is evenly tightened, overgrown with connective tissue.

protein on the face from dark spots

• hygiene rules were not followed;
• bacterial infection has joined;
• the pimple was squeezed out, while not skillfully;
• acne covered significant areas;
• Skin is very tight and sensitive.

Will a beautician help get rid of dark spots

• hypertrophic
  – if the connective tissue in place of the skin warped by the pimple has formed with excess, in this case it protrudes above the surface in the form of a dense nodule, in our awareness, this is a scar, in other words, a scar;
• atrophic
  – if the connective tissue has not completely covered the hole formed after the pimple, we call such scars pits.

• rounded
  – these are arcuate pits, resembling a wave, depressions of various sizes, their edges are smooth;
• rectangular
  – a depression in the skin with straight edges, often remains after poor squeezing of acne;
• chipped
  – cone-shaped depressions, the walls of which converge in the middle, the most difficult to heal.

If a hole remains on the skin after squeezing out the pimple, do not entertain vain illusions, it will not disappear without the help of others.

1. Collagen injections
   – make the skin at the injection site smooth and elastic. This method is suitable for the most severe cases, but the result is temporary (although it can be quite long). Collagen injected into the area of ​​the fossa does not eliminate it, but only makes it invisible.

dark mask for dark spots purchase

It will take time for any of your actions to give a good result. Get ready for a stubborn struggle for an even skin texture.

traditional medicine mask for dark spots

Shallow atrophic scars can be tried to be removed at home.The meaning of all actions should be reduced to renewing the skin.

gel from dark spots on the face in the pharmacy


2. But we must not forget about moisturizing the skin, without this it will be difficult for the regeneration processes to proceed. Use special products and drink more than 2 liters of water per day. It is also important for the normal functioning of skin cells and their repair.

perfume from dark spots

oreal from dark spots

• Preference should be given to greenish or dark clay.

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How to get rid of blackheads in one go

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Korean cosmetics anti-dark spot mask

There are many different procedures for smoothing skin relief on the face (we will talk about them below), but it does not matter which of them is suitable for each person.

baimiss from dark spots

Depending on the depth and size, the pits can be removed from the skin surface or made less visible.

cettua blackhead stripes buy

The pharmaceutical industry produces certain creams and ointments that are specifically designed to combat scars and scars.

how to clear the nose from dark spots reviews

The advantages of these funds are that you can use them at home at a comfortable time. Well, the cost is even lower in comparison with cosmetic procedures.

how to get rid of acne and dark spots at home in a day video

Chief among them – the duration of implementation, for some funds – up to six months.With all this, the outcome is not guaranteed. In other words, the fossa may become the least noticeable, or it may be completely smoothed out, but how it will actually be is not clear in advance.

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• Quotlan
  is a cream of Russian production, registered as a cosmetic product, in other words, it has fewer contraindications and side effects in comparison with medicines.It can be used as a versatile remedy for any skin problem, including acne and blemishes. It has bactericidal, analgesic and regenerating properties. Ideally, its application should be started from the moment of the formation of an acne, which threatens to leave traces of its stay on the skin (it is better if it is an area with thinner skin – on the cheeks, chin, forehead).
• Kontraktubex
  – the gel is specially designed to prevent the formation and fight against various types of scars and scars, including atrophic ones.It has fibrinolytic (dissolves blood clots), keratolytic (softens the stratum corneum of the skin), anti-inflammatory properties, stimulates regeneration.It can also be used at the stage of abscess breakthrough. For a more effective effect, it is recommended to pre-steam the area of ​​application or, after applying the gel, close this area with a plaster.
• Mederma
  – gel, also used to eliminate the effects of acne. More effective for fresh scars.It helps to even out the skin tone with scar formations. The gel is not recommended to be applied to unhealed wounds.
• Kelofibrase
  is a cream with anti-scar activity. Improves microcirculation of blood at the site of application and maintains the water balance of cells in this area. It is based on urea, a powerful natural ingredient with a moisturizing and antimicrobial effect.

If the pits on the skin are old (formed more than a year ago), then the use of these funds can give an effect only as part of a complex effect.

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How to get rid of blackheads and oily sheen

• Laser resurfacing.
  The upper layer of the epidermis is removed using a laser. After that, it takes time to recover (from 2 weeks), but the pits are noticeably smoothed out. The method has good reviews. Sometimes one procedure is enough, but in difficult cases it may be necessary to repeat it.
• Dermabrasion.
  This is a mechanical method of removing the top layer of the skin using special brushes and other tools.It is carried out under local anesthesia, since the process is painful.

Treatment for blackheads in the eyes

• Chemical peeling.
  The action is similar to the previous methods, only it is carried out due to chemicals, acids, which corrode and exfoliate the stratum corneum of the skin. It will help with shallow rounded pits.

Effective face cleansing from dark spots


3. Usually a small amount of powder is diluted with water to a creamy mixture and applied to the skin for 15 minutes.

• Own adipose tissue transplant
  patients at the site of atrophic scar formation. The effect of this procedure lasts up to 1.5 years. After which it will have to be repeated.
• Surgical method.
  Used for deep pits if other treatments have failed. The edges of the fossa are incised and it heals again.
• Chemical reconstruction
  with trichloroacetic acid. The method is still in the early stages of approbation.It consists in the treatment of atrophic scars with a highly concentrated solution of this acid. Studies have shown high efficiency in rectangular pits, but this technique has not yet become widespread.

Traditional methods of treatment can get rid of shallow pits with a minimum investment of both time and money. Here are some recipes.

how to get rid of blackheads on the face quickly

• Vishnevsky’s Liniment, honey and alcohol (vodka) are taken in equal amounts and mixed.The mixture is applied to the face for 40 minutes daily. The course of treatment is more than a month.
• Grate ripe tomato without peel. Apply daily to face, rubbing in lightly. Leave it on for 20 minutes and wash off.

from blackheads garnier

• Badiagi mask has an exfoliating and absorbing effect. Dilute the powder as directed, add a little lemon juice and a few drops of tea tree oil. This remedy will also help with acne spots.also fine wrinkles.
• Apply a little lavender oil to a cotton pad and apply to the affected area for a quarter of an hour. Repeat every other day.
• Beat the fat sour cream in a blender with the same amount of lemon pulp. Apply the resulting mass for 15 minutes. It is enough to do it in one day.

Blackhead Cleansing Strips

• Finely grated fresh cucumber, apply to skin for 15 minutes daily.
• Powdered sandalwood is mixed with rose water, applied to the face and left overnight.
• Apply cocoa butter daily to problem areas by gently rubbing it into the skin or using your fingertips.
• Dilute 1: 3 apple cider vinegar with water. Freeze in the form of cubes and rub the problem areas with one piece of ice daily.

Are the clean and clear strips effective against blackheads?

• After all, it is here that all skin irregularities are accessible to the eyes of others.And the problems arise most of all in this part of the body, since rarely a woman has not squeezed out an unsuccessfully appeared pimple.
• Products with salicylic acid in the composition fight well with skin irregularities. This component promotes faster exfoliation and renewal of the stratum corneum.

This component not only mechanically removes dead cells of the epidermis, but also saturates the skin with useful substances, improves metabolic processes in its cells.

Pits and scars on the nose are not uncommon.Internal acne often appears here, leaving behind unsightly marks.

how to get rid of black and white acne

First, do not forget about proper nasal skin care. It is quite thin here, but it is highly susceptible to pollution, which must be disposed of in a timely manner. Along the way, you can smooth out the unevenness of the relief.

At the last stage of its existence, the contents of matured blackheads come out, freeing the duct of the sebaceous gland.

Unfortunately, the cosmetologist will not always help, but modern cosmetic procedures from time to time actually work wonders.

• Take fine sea salt or grind it yourself.
• Mix with honey and rub this mixture gently into the skin of the nose in a circular motion.
• Leave it on for 10-15 minutes, let the skin absorb the nutrients from the ingredients.
• Rinse off and apply moisturizer.

On other days, use other products that exfoliate the top layer, enhance blood microcirculation, and stimulate regeneration.

from blackheads for men

If the fossa is very deep (this often happens on the wings of the nose), then do not waste time and consult a beautician.

clinique blackhead masks

This is not always possible, but almost always, timely and correctly carried out acne treatment will not allow a scar to form in its place.

efaclar from blackheads

Pimples after acne do not always appear when squeezing out pustules. Such traces remain after large or subcutaneous elements.It is difficult to get rid of them, but it is possible. In severe cases, modern cosmetic procedures will come to the rescue.

And pits, you need to do your best to promote the skin regeneration process. The damaged area will renew itself over time and become healthy. The most effective way to restore the upper layer of the epidermis is exfoliation. It must be carried out several times a week. For these procedures, all scrubs are suitable, which contain natural particles and extracts.Herbal extracts disinfect the skin, relieve irritation, and promote rapid healing of small wounds. Milled apricot pits serve as granules. Prefer mild scrubs that won’t irritate your skin.

Effective agent that promotes resorption of pits
and after scarring, is a clay mask. Pay particular attention to green and clay types. Since it is they that contain a large amount of various useful substances that are responsible for the regeneration of the skin.To prepare the mask, take about half a tablespoon of green and dilute it with a little water. Mix thoroughly. As a result, a creamy gruel should form. To speed up the healing and smoothing effect, add a few drops of essential oil or tea tree oil to the mask. They have an excellent antiseptic effect. Apply the resulting mixture to problem areas for about ten minutes. Then wash off with cool water.

When choosing facial skin care products, give preference to those that contain salicylic acid.It is able to help old skin to exfoliate, thereby accelerating the renewal process of the upper layers of the epidermis.

One of the most important steps in the skin recovery process after acne
is her hydration. For cleansing, choose oil-free light gels with natural extracts. Thanks to them, the skin will be evened out and renewed.

Acne is formed on the skin due to a malfunction of the sebaceous glands, under the influence of hormones. They appear in most people, starting in adolescence. After
Their disappearance sometimes leaves scars that cause concern to their owner. You can deal with problem areas of the skin with folk remedies.

Instruction

Prepare a green clay mask. Dilute following package directions. Add 5 drops to 1 tablespoon of rosemary. Apply the composition only to problem areas. Wash off after 15 minutes. Repeat the procedure every three days for 2 months.

Dilute 1: 3 apple cider vinegar with water.Freeze the mixture. Use ice cubes to rub your face daily. To get rid of old ones, apply a napkin on your face soaked in vinegar solution for 5 minutes every other day.

Brew 2 tablespoons of colorless henna with boiling water until mushy. Close the lid and leave for 15 minutes. Apply a warm mass to problem areas in a thick layer. Keep until dry. Rinse off gently. Colorless henna cleanses and regenerates the skin, does not cause allergies.

Mix white clay (two tablespoons), turmeric (half a teaspoon) and burnt (quarter teaspoon).Dissolve one third of the finished mixture in water, adding a few drops of lavender oil. Hold the mask for about ten minutes. Repeat 2 times a week until the effect appears. Turmeric smoothes scars, dissolves scars, prevents the appearance. To enhance the effect, you can steam the skin with hot water before the procedure. Better mask

90,000 Facial scars. Why do scars appear?

Scars on the face as a consequence of acne. Why do scars appear?

All scars appear at the site of the former inflammation.Not every inflammation causes a scar, but without scar inflammation, there certainly won’t be. The larger and stronger the inflammation, the deeper the scar. Therefore, scar prevention is the reduction of inflammation.

Any inflammation can provoke the formation of a scar on the skin.

Just when the skin is healthy, acne (acne) does not develop for a long time, the inflammation heals imperceptibly. If you have been suffering from acne (acne) for 3, 5 or more years, the skin is “tired” and the inflammation can turn into a scar.

How to improve skin health?

There should be enough fat in the skin – it is useful to take omega-3 fats or eat fish 3-4 times a week.There should be enough vitamins – A, B, C and E. You should not wash your skin often and rub it.

But, unfortunately, these are weak factors. The main thing is to reduce inflammation. To do this, you need to carefully treat acne with a dermatologist.

Not scars: red spots

Large red spots remain on the skin after inflammation in many people. They last for a long time, and one might think that they are forever. But these are not scars! They disappear without a trace in a maximum of 2 years. It is better not to try to treat them in any way, they will pass on their own.

Enlarged pores

In a person with oily skin (and almost all acne patients have oily skin), the pores can expand. Sometimes they expand a lot, which may bother you. It is difficult to stop this process, but there is one good piece of advice. Wipe your skin with a piece of clean ice daily in the morning. The blood will rush to the skin, it will become more elastic and the pores will shrink.

Scar treatment

It is impossible to completely get rid of scars. But you can make them less visible.To do this, dermatologists use different techniques, but they can only be applied after the acne has been healed.

Important!

Scars always seem to their owner more terrible than they really are. Seriously, other people don’t look at your face, they often don’t notice the scarring at all. If your scars are very pronounced, of course, others will notice it. But just as they notice a bald person or a very snub-nosed person. No one will treat you badly because of this.

There are contraindications.Read the instructions or consult a specialist.

How to get rid of acne scars?

Details

Author: LDC Neuron

Published: 08 November 2015

Acne and pimples often leave behind scars.And it turns out that getting rid of one problem, a person gets another. If you are faced with acne scars, then do not despair. There are remedies that will help, if not completely tighten, then at least make the scars invisible.

First of all, we recommend that you visit a good dermatologist who will prescribe the most effective medicines for you. And of course, alternative medicine offers its services. Below we will tell you what recipes you can make at home to heal acne scars.

Consider how to remove scars and acne scars:

1. Apple cider vinegar. Take 1 tablespoon of apple cider vinegar and mix it with 3 tbsp. spoons of warm water. Soak a cotton swab in vinegar water, wring it out, and wipe problem areas. Repeat the procedure in the morning, afternoon and evening. If this is not possible, then you can simply in the morning and in the evening. The tool has worked well in the fight against this problem.

2. A more difficult to prepare, but no less effective remedy against scars, is a clay-based mask.Recipe: Green Clay – 1 tbsp spoon; warm water – 1 tsp; rosemary essential oil – 2 or 3 drops, depending on your personal tolerance. Stir all ingredients until smooth. You need to apply it to previously prepared skin. This means that problem areas must be washed and dried so that the skin, in those places, is clean. Then apply the mask, and, after a quarter of an hour, wash off the mask with warm boiled water. The remaining clay can be wiped off with a cotton swab dipped in warm water.It is recommended to do masks up to 3 times a week, with breaks for a day or two.

3. Cucumber juice or cucumber lotion. Just apply it on acne scars for a quarter of an hour. Then wash it off with standing or boiled water at room temperature. And in conclusion of the article, we want to say that you do not forget about a dermatologist who will advise you on remedies or procedures that will help get rid of scars with less time.

4. Essential oils. It is advised to use essential oils based on avocado, tea tree, lavender, rosemary extract.They need to wipe the scarred areas. ATTENTION! If you are allergic to any of the components, then do not use oil based on it. Essential oils can be purchased freely at the pharmacy.

5. The recipe for honey solution is very simple. Take a glass of warm boiled water and add one teaspoon of any honey to it. Stir until honey is dissolved in water. Spread honey water on the scarred areas of the skin. Let it sit for 5-10 minutes and rinse with warm water. You can also apply honey masks on your face

6.Parsley infusion will help get rid of scars. It is very easy to make it. Take 30 g. plants, chop finely and brew 1 tbsp. boiling water. Let the broth infuse for about 2 hours. Then strain and pour into an ice-freezer and put in the freezer. You get squares of healing ice, with which you will need to wipe the scars up to 3 times a day. The skin will also need to be prepared before this procedure. It is best to do this with makeup removers.

And in conclusion of the article, we want to say so that you do not forget about a dermatologist who will advise you on remedies or procedures that will help get rid of scars with less time.

ldc “Neuron”

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90,000 Question: How to get rid of hollows in the thighs? – Sports and Fitness

Contents of the article:

HOW TO ROUND HIPS IN A WEEK At Home * quick results *

Video taken from the channel: VERYOMIN health and fitness

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HOW TO INCREASE HIPS IN WIDTH WITH EASY EXERCISES

Video taken from the channel: VERYOMIN health and fitness

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HOW TO INCREASE HIPS IN HOUSE WIDTH PER WEEK * fast result *

Video taken from the channel: VERYOMIN health and fitness

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Top 3 SUPER exercises from “dimples on the hips”

Video taken from the channel: mimiFIT

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HOW TO REMOVE PITS on POPE? Getting rid of the pits on the buttocks and rounding the ass

Video taken from the channel: FitnessoManiya

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How to make the Hips WIDER and remove the DIMMERS on the BUTTS.How to increase the width of the hips, expand the buttocks.

Video taken from the channel: NG fitness. Training, weight loss. Fitness blogger.

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8-minute workout to get rid of dimples in the hips

Show Description

How to get rid of dimples on the thighs? Tight hips are an important part of good shape, and in this video you will find exercises that will help you lose weight, add relief to your thigh muscles and make them more rounded ..
By the way, if you have dimples on your hips, don’t worry – everything is fine! Did you know Marilyn Monroe had the same? Yes! But this is Marilyn Monroe, so what’s the difference? But, if you really want to get rid of them, we have prepared special exercises for you….
Time codes:
Swing legs to the sides 0:28.
Squats 0:56.
Side lunges 1:23.
Squats to the side in increments of 1:49.
Back Squat 2:22.
Cross lunges 3:02.
Abduction of the thigh to the side from the knees 3:30.
Swing back on all fours 3:59.
Glute Bridge 4:20.
Lateral leg raises lying down 4:45.
Rainbow 5:12.
Plank Raises 5:43.
Exercise for biceps when carrying packages 6:29.
Hands in good shape while washing windows 6:49.
Squats when putting away dishes 7:04.
Lunges when vacuuming 7:19.
Jack jumps as you take the wash down 7:44.
Bicycle when watching TV 7:59.
Scissors when lying on the couch 8:19.
# dimples thighs # ​​thighs #adme.
Other videos that may interest you :.
3 Simple Exercises To Remove Fat On The Hips https://www.youtube.com/watch?v=LVt5GKnwaOE.
10 exercises for toning hips in 10 minutes https://www.youtube.com/watch?v=G2GgJS_FJSA.
7 Exercises to Lose Thigh Fat Fast https://www.youtube.com/watch?v=f7xjJ2sTWVE.
Music: Epidemic Sound https://www.epidemicsound.com/.
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Operation dimplectomy (dimples on the cheeks) in Stavropol

Dimples on the cheeks indicate attractiveness and charm. Nature has not endowed all women and men with dimples.Plastic surgeons can solve this flaw in nature by performing plastic surgery on the face.

Dimplectomy – what is it?

Dimplectomy – plastic surgery, during which dimples are created on the cheeks. The operation is not difficult, it is performed on any skin, color and type. It is important to remember, having created pits on the cheeks, it is impossible to get rid of them, only to change the depth.

Before carrying out and starting the face plastic surgery, there is a mandatory consultation with a doctor, during which the specific location of the dimples should be discussed.

In time, the operation does not last long, about an hour, after which the face will become charming and charming. A surgical incision is made on the inside of the cheek on the mucous membrane; postoperative rehabilitation and inpatient recovery are not required. A slight swelling will be noticeable, it will come down in a couple of days. The dimple will become noticeable immediately after the plastic surgery on the face. All the symptoms of the operation will disappear, and when you smile, you will have charming dimples on your cheeks.

Why dimples?

Why do many people dream of creating dimples on their cheeks, can you do without them? It has long been believed that a hole gives a certain charm, expressiveness, trust and sympathy.A person who smiles and at the same time a dimple appears is able to arrange the interlocutor and thereby influence his decision-making. But from the point of view of science, this phenomenon is only a physiological defect against the background of the genetics of the zygomatic muscle. In almost all children at an early age, you can find a dimple on the cheeks due to their plumpness, but not all of them remain; in many children, the deepening disappears with age.

Requirements for performing dimplectomy

As mentioned earlier, dimplectomy can be performed on anyone.To carry out plastic surgery on the face, it is imperative to undergo a medical examination, since this is a surgical intervention during which local anesthesia is used, and after that, antibiotics prescribed by the surgeon are required. If health problems are detected, the doctor will be advised not to perform a dimplectomy, otherwise the consequences can be very different.

An experienced surgeon works in our clinic who will perform a dimplectomy if no contraindications are found.

To calm down and fearlessly fulfill your dreams, we will describe in detail the course of face plastics, dimplectomy:

• The location of the dimple on the cheek is agreed with the doctor and marked with a marker.
• Local anesthesia is administered.
• A small incision is made on the inside of the cheek with a surgical instrument.
• In the incision, the surgeon removes small globules of fat.
• Using a special thread, the incision is pulled together and then a dimple is formed.

At the end of the operation, the doctor examines and prescribes the necessary course of antibiotics to exclude unwanted consequences.

How to get rid of scars and scars and restore skin

Scars and scars can seriously complicate the life of the most confident person in their own attractiveness. Skin lesions that do not heal over time do not affect health – a person with acne marks on their cheeks or scars from abdominal surgery may have perfect tests and well-being – but they do affect psychology.

Scars attract attention, distinguish us from other people, do not allow us to enjoy our own reflection in the mirror or wear revealing clothes. That is why, at the Cleo Line clinic, we use modern methods of laser and other therapies to get rid of scars and scars, to restore the skin.

What are scars and scars

Scars and scars are connective skin tissue that forms after the healing of burns, injuries, operations, and inflammatory processes. The types of scars also include stretch marks (striae) – narrow wavy stripes with grooves of atrophied tissue, which can be white or red-purple.Stretch marks appear in places of greatest stretching of the skin – for example, on the stomach of pregnant women or people who have greatly recovered in a short time, on the hips and armpits of adolescents, who sharply, for a short period of time, are stretched in growth.

Reasons for the appearance of

• Operations, including caesarean section;
• Burns;
• Inflammatory diseases;
• Acne;
• Injuries – cuts, animal bites, etc.etc .;
• Cosmetology procedures – removal of piercings, moles.

For stretch marks, the reasons are different: puberty, hormonal imbalance, sudden weight gain or growth spurt, and even heredity.

Types of scars and scars

Normotrophic scars are most often located at the same level with the skin, they are less noticeable, the easiest to correct and differ mainly in shade – they are somewhat lighter than the skin.

Atrophic scars occur after an inflammatory process or injury, they are not as elastic as normal tissues, they have a concave surface.A typical example of atrophic scars is stretch marks and post-acne.

Keloid scars can have different shapes, they are elastic, dense, usually with a smooth surface. The appearance of keloid scars can lead to discomfort: burning, itching, even pain. Usually, such formations protrude above the surface of the skin. They have clear boundaries. Keloid scars can grow and reappear after removal. Most often formed on the outer surface of the shoulder, in the sternum and upper body.Difficult to correct.

Hypertrophic scars protrude above the skin surface. Most often they have a pink tint, and are formed due to the large area and depth of the wound, surface infection or other unfavorable conditions for the healing of damaged tissue. It is a mature connective tissue covered with a layer of the epidermis. Within six months after the appearance of hyperkeratosis gradually disappears, the progression of the scar stops.

Treatment methods

Apart from surgery, there are several ways to treat scars: cryotherapy, wearing compression garments, silicone medications, enzyme injections, and hormone therapy.But the most effective, patient-safe and widespread method is laser therapy.

The laser has a high-precision effect with a controlled depth, so it does not damage healthy tissues. The procedures practically do not bring any unpleasant sensations, and the recovery period is minimal. The laser removes “extra”, that is, scar tissue and stimulates the production of collagen – the site of radiation heals, and after several procedures there is not even a trace of the scar. The number of procedures is individual, depending on the age of the scar and your characteristics.

Plasmolifting is used to enhance the effect of the laser and stimulate the smoothing of the skin relief. The patient’s own blood plasma is injected into the scar area. This procedure allows the skin to recover faster, stimulates the production of natural collagen and elastin. Plasmolifting is also effective in treating acne. The second option for injection “help” to the laser is mesotherapy. We use only drugs that are approved by the Ministry of Health of the Russian Federation and have all the necessary quality certificates.

Chemical peeling will also help smooth out small scars – it is effective in treating small atrophic scars.A series of peels allows you to even out the texture of tissues and skin color.

Special medications can be used to treat keloid scars. They are prescribed only by a doctor – consultation is required!

Readings

There is only one indication for the treatment of scars and scars – their presence. If you have acne, traces of burns, operations, injuries, stretch marks or other scars that cause discomfort, sign up for a consultation – you can get rid of skin imperfections in several procedures.

Contraindications

• Age under 18;
• Pregnancy;
• Cancer diseases;
• Diabetes mellitus;
• Exacerbation of chronic diseases;
• Inflammatory diseases;
• Skin infections;
• Photodermatitis;
• Epilepsy;
• Mental illness.

Who performs the treatment

Specialists with medical education are engaged in the treatment of scars at Cleo Line.Doctors-dermatologists have many years of experience, before starting the removal procedure, they conduct a consultation, where they collect anamnesis, learn about the presence of indications and contraindications.

Treatment results

After treatment in the clinic, the relief of the scar is leveled, it itself decreases in size, the color is as close to healthy as possible. The scar becomes invisible. You can enjoy your reflection in the mirror again, wear revealing clothes and forget about complexes.

Care and Recovery

After laser resurfacing, the skin recovers rather quickly.However, in the first few hours after the procedure, redness and discomfort may appear. If they cause you discomfort, a cooling compress can be applied to the treatment site.

Within 3 days after the removal procedure, do not wipe the treated skin with alcohol-containing substances. It is forbidden to visit the sauna and pool, take a hot bath, or sunbathe.

The skin needs to be moisturized. Or use special medical gels and creams that your doctor will prescribe for you.

Each patient in the Cleo Line after the procedure is given detailed care instructions.

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