Scarring, Scars, Scar Treatment
Scars are the result of tissue remodeling after skin injury. Acne scars are typically seen along the cheeks and chin in acne-prone individuals even after successful acne treatment. Acne scars are seen in two primary varieties: rolling scars and ice-pick scars. Rolling acne scars are shallow and mild "hills and valleys" seen mainly on the cheeks. Ice-pick scars are the deeper, focal, square and angulated scars. The treatment for rolling acne scars includes dermabrasion, infrared laser therapy, surgical subcision, and injectable fillers such as Restylane®, collagen, or silicone. The treatment for ice-pick scarring includes punch excision as the primary mode of therapy followed by 80-90% trichloroacetic acid and the other modalities listed for rolling scars.
Laser treatments have been used for acne with variable success. The non-ablative lasers (do not peel off the skin) have variable results and are best suited for those patients with slightly noticeable rolling acne scars. The ablative lasers (peel off the top layer of skin) are the gold standard for all types of acne scarring, but have significant downtime. Newer laser treatments include the use of fractional resurfacing laser technology (Fraxel®, Starlux®). The data is still quite new, but the results noted have been extremely promising
Other regular scars on the body can be benefited by different means. While a scar is meant to last forever, unsightly scars may be surgically revised by your dermatologist or plastic surgeon. Topical treatments, such as silicone gel sheets and mederma, are numerous and are met with variable success.
Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California
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