Skin ExpertsSkin ConditionsAcne Scars

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Acne Scars

Acne scars are usually the result of inflamed blemishes caused by skin pores engorged with excess oil, dead skin cells and bacteria. The pore swells, causing a break in the follicle wall. Shallow lesions are usually minor and heal quickly. But if there is a deep break in the wall of the pore, infected material can spill out into surrounding tissue, creating deeper lesions. The skin attempts to repair these lesions by forming new collagen fibers. These repairs usually aren't as smooth and flawless as the original skin.
 

Acne Scars

LaKimerly M. Coates, MD, discusses acne scarring and repair options.

What you need to know

Two main types of acne scars:

Hypertrophic or keloid scarring:

These scars are caused when the body produces too much collagen as acne wounds heal, resulting in a mass of raised tissue on the skin's surface.

Atrophic or depressed scarring:

These scars develop when there is a loss of tissue. There are two common types of atrophic scarring. "Icepick" scars are usually small, yet obvious holes in the skin. "Boxcar" scars are depressed areas, usually round or oval in shape with steeply angled sides, similar to chickenpox scars. 

 

Do's and Don'ts

Do...

Stay out of the sun. Overexposure to the sun can darken scars and make them look more prominent.

Don't...

  • Irritate inflamed skin. Overwashing or scrubbing scarred areas can further reduce skin elasticity and heighten the appearance of the scar.
  • Pick at scars. Bacteria from unwashed fingers and nails increase the risk of additional cysts forming, leading to the development of a larger scar.
  • Give up on acne scars. New techniques - some non-surgical - can dramatically improve both the depth and appearance of acne scars.


Before (left) and after (right) PDT - acne and acne scars
Photo courtesy of Mitchel P. Goldman, MD

Why treat acne scarring?

Physical, emotional and social reasons for treating acne scars include:

  • Improved appearance
  • Enhanced self-esteem
  • Promotion of better skin health

General questions to ask before procedure

  1. Is a doctor on site?
  2. Is the doctor board-certified in dermatology or in another specialty with equivalent training and experience?
  3. Was my medical history taken?
  4. Was I given an initial evaluation to determine if the technique or procedure is appropriate for my skin type?
  5. Did the doctor show me before-and-after photos?

Questions to ask the dermatological surgeon 

Acne Scar Questionaire

  1. Which acne scar procedure is the correct one for me? (What are the options?)
  2. What is the estimated cost of the procedure?
  3. How long is one appointment?
  4. How often will I need to receive treatment to remove my acne scars?
  5. How far apart are the treatments?
  6. What are the common side effects or complications associated with the procedure?
  7. How can I prepare for the treatment/procedure?
  8. Does acne scar removal hurt?
  9. What are my pain management and anesthesia options?
  10. How long is the recovery time associated with my procedure?
  11. Do you have before-and-after patient images to help to prepare me for what to expect?
  12. Will someone walk me through the process before going in for treatment?
  13. What are the risks?
  14. What should I expect after the procedure is performed? (i.e., short-term and long-term effects; activity restrictions; expected recovery period)ontent...