Getting rid of acne scars - Microdermabrasion/Laser/Peeling?
I have made an appointment with my Derm for consultation. I have
indicated that I'm interested in Microdermabrasion but I'm still
researching.
Right now, my main concerns are with red acne scars that never seemed
to entirely disappear and pitted ones too.
Which method is the best for the above? And the fastest to see
results? Of course costs is an issue here too. Or should I just stick
to OTC creams?
With acne or chicken pox scarring the problem is a difference in topography
whereby the scar surface is at a deeper level than the surrounding skin.
This is due to the active disease process destroying the deeper layers of
the skin. Without this structural support the skin caves in in the area
creating a depression or pit.
The scars are noticeable because of the shadows that fall over them in a
fashion analogous to the shadow on a street with tall buildings on either
side. To rectify this you need to raise the street &/or lower the buildings.
The best current techniques to do this are to make small incisions around
the edges of the small scars without excising any skin. This does not add
new scars to the skin surface because the incisions are made within the
confines of the acne or chicken pox scar pit. Not every scar is a candidate
for this.
The scar has to be small enough & the depth of the pit must have enough
remaining layers of skin to contract with healing. As these incisions heal
the scar is squeezed
by the surrounding healing procees. This causes this skin to pucker-raising
the street. About 6 weeks later CO2 or Erbium laser may be used to even out
the skin
surface under magnification but is not always necessary. Some physicians
place a dermal filler to raise
the scars but there currently are no very good fillers available although I
have had some good
results with this technique. Using laser alone only results in a 30 to 60%
improvement. Despite this it may
take more than one laser resurfacing to achieve the desired improvement.
Additionally, the acne would need to be quiescent to carry out this therapy.
The treatment can also reactivate acne so close post treatment follow up is
called for. I refer patients with active acne to dermatologists as they are
better equipped
than I to handle active acne. In some cases the depressed areas can be quite
large in which case the only advisable treatment is scar excision.
Accutane slows the skin healing process which can lead to increasing
scarring. Thus, one should wait at least 12 months after stopping accutane
before undergoing the surgical procedures described above.
The ultimate goal seldom achieved is to hide a scar so that it is not
visible to the unaided eye & the area in question looks as though nothing
untoward has occurred.