Acne Scars

What are acne scars ?

Acne scars are textural abnormalities of the skin that are left behind after the healing of acne lesions. These range from shallow depressions to sharp "ice pick" pits to white elevated bumps. Acne lesions can also initially heal, leaving brown or red discoloration behind, but these generally fade over time without treatment and are not considered true scars. A topical bleaching cream can be used to speed up the fading of the brown discoloration. 

What are the treatment options for acne scars ? 

Soft depressed scars can be filled in by the injection of filler substances such as collagen. Mild scars can also be improved with microdermabrasion (also referred to as a "power peel" or "dermapeel"). This technique uses fine crystals to buff the superficial skin (much more superficial than laser resurfacing). For a more thorough treatment, dermabrasion has traditionally been used for the correction of acne scars. However, more recently the CO2 and ER:YAG lasers have been more commonly used. These lasers allow for precise removal of tissue whilst simultaneously rejuvenating the skin. The cost of these procedures varies depending on the surface area to be treated and the type of procedure used (see "How many treatments are necessary?" below). These types of procedures generally require a pre-treatment consultation where these issues can be discussed. 

How many treatments are necessary ? What are the costs ?

Microdermabrasion requires multiple treatments, initially at two- to three-week intervals. If collagen is used, a pre-treatment skin test must be administered one month prior to the first treatment. The more aggressive techniques of laser abrasion and dermabrasion require a considerably larger investment of time and money. 

What treatments are considered medically necessary vs. cosmetic ?

Treatment for acne scarring is considered cosmetic; consequently, treatment expenses are not covered by medical insurance. 

What will I look like immediately after the treatment ? How long will it take to heal ?

Recovery time is minimal; most people can get right back to work after a treatment session. Collagen treatment also requires minimal recovery time. For the more aggressive treatments, post-operative care will be quite eventful and may include treated areas remaining pink for a month and some major swelling. These techniques require much greater preparation as a patient. With proper preparation and follow-up care, a patient can get back to work after about two weeks and will be able to apply makeup after two and a half to three weeks, with pigmentation normalizing in about two to three months. 

Is treatment permanent ?

Improvements via laser abrasion and dermabrasion are permanent and can give dramatic results compared to the more mild treatments.  However, realistic expectations must be maintained. Repeat treatment can be performed after one year. Collagen injections are only temporary and must be repeated every three to six months to maintain the improvement. It often requires two to three treatment sessions to reach an optimal result.

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