After the red pimples from acne subside, many people are left with dark marks and skin indentations or persistent elevations. Dark marks which are not indented are called pigmentation. These can be managed with surface treatments such as facials and exfoliating creams containing vitamin A. Red marks which are not indented are called erythema, and can be improved with lasers or pulse light therapy. In contrast, scars are characterized by loss of volume (atrophic scars) or increase in volume (hypertrophic scars/keloids).
Our studies suggest that as many as 50% of acne patients will have residual acne scars. This percentage is higher with greater severity of acne and with delay to effective treatment of acne. While acne itself can have negative consequences on the psyche of those affected, negative impacts can be long lasting with acne scarring.
Our recent research has shown that atrophic acne scars can resolve over time and that this improvement can be further enhanced with use of topical retinoids such as adapalene, or possibly tretinoin and tazarotene. In clinical studies performed here and in France, we showed that use of an adapalene/BPO combination gel reduced the risk of atrophic acne scars while treating moderate and severe acne. Furthermore, another study showed that adapalene could reduce the appearance of facial scars and was associated with an increase in skin collagen formation.
Acne patients present with multiple types of acne scars. Atrophic acne scars are classified based on shape and profile including ice pick scars, boxcar scars and saucer and rolling scars. As most patients have varying types and numbers of scars, there is no single acne scar correction therapy that is effective for all. Treatments for acne scarring should start with the use of topical retinoids to enhance collagen formation, and should then be individualized depending on scar type and number. With extensive atrophic scars, subcision is used to reduce tethering of scars to deeper layers. This will allow further treatments to enhance elevation of these indented scars. Trichloroacetic acid spot treatments can be used for ice pick scars. Additional treatments include fractional laser therapy or micro-needling/radiofrequency for ice pick and boxcar scars and addition of fillers to elevate rolling and saucer scars. Platelet rich plasma therapy is frequently used to enhance collagen formation.
These various options require individualization and treatment planning for patients. We can schedule an appointment for you to evaluate your scars and to provide an individual treatment plan for scar repair.