Acne scarring is a common and bothersome aspect of acne, which some patients may not even realize is developing.
Research by Dr. Tan and colleagues have shown that acne scarring can affect those with even mild forms of acne. In a video interview for Medscape in New York City on January 6, 2018, he was interviewed by Dr. Emil Tanghetti of Sacramento California, a dermatologist expert in laser therapy.
They discussed the findings that acne affects up to 50 million people in the United States and that acne scarring can be seen across the spectrum of acne severity from mild to very severe. Risk of scarring escalates with acne severity, family history of scarring, the duration of inadequately treated acne, and squeezing and manipulation of acne lesions. The most highly affected and at risk patients for scarring are those with severe or greater levels of acne. There are multiple psychosocial consequences associated with acne scarring including reduced self-confidence and adverse impact on quality of life, plus they can be viewed by others as being less healthy, less confident and less successful.
The development of acne is related to the severity and duration of acne inflammation. This inflammation of the skin around the pilosebaceous unit leads to damage of the deeper skin structure by enzymes called matrix metalloproteases. The sooner the inflammation is effectively treated, the less the acne and the lower the risk of scarring. There are multiple treatment options for acne and the major focus should be on effective and timely reduction in inflammation to reduce acne as well as to reduce the risk of scar formation. Additionally, the early use of topical retinoids such as tretinoin and adapalene may be helpful in repair to the deeper skin structures. In the presence of active acne, the combination product adapalene and benzyl peroxide gel has been demonstrated to be helpful in reducing the risk of further acne as well as improving acne itself. Recently, the higher dose combination product has also been shown to be effective in reducing acne scarring.
There are a number of ways to evaluate acne scarring including its severity. Some of these measures are developed for clinical studies while others are available for determining corrective procedures. Dr. Tanghetti discussed multiple treatment options for scars including laser resurfacing, the use of subcision and fillers, and the role of microneedling and radiofrequency devices. Dr. Tan concurred that these are also options that he offers his patients at the Healthy Image Center. The use of combined treatments may be particularly effective in improving acne scars.