For 80 per cent of people with acne vulgaris – to give the skin condition its full title – scarring can be an issue. Atrophic scars, which have a pitted appearance, are most common and make up 90 per cent of facial acne scarring. These are caused by loss of underlying body tissue, such as muscle or fat. Hypertrophic and keloidal scars are mainly found on the torso, notably the back and shoulders.
“Acne scarring is common, but does not have to be suffered in silence. There is a huge amount that can be done by seeing the right practitioner, from medical grade skincare, to chemical peels to microneedling to laser treatments,” says Cosmetic Dermatologist Dr Anamica Prasad of Faciem Dermatology.
Active agents which work well in acne include salicylic acid, benzoyl peroxide and Vitamin A which all help to reduce the hyper-activity of the sebaceous gland. “The right skincare and a detailed skin and medical history is a must in order to treat acne effectively,” says Dr Prasad. “If the scarring is mild, medical grade skincare will often help improve scarring as well as prevent it.”
Acne scar chemical peels work by applying a chemical solution to the skin, which exfoliates the treated skin to reveal clearer skin with reduced blemishes and scarring.
There are three overall types of chemical solution used for this kind of treatment: alpha hydroxy acid (AHA) or glycolic acid, trichloroacetic acid (TCA), and phenol. Typically, AHA peels are the gentlest; TCA peels are slightly stronger and phenol peels provide the deepest level of peel.
The peel solution causes the skin to blister and peel over a few days, so you will probably want to plan this kind of treatment to avoid any big social events. As the treated skin comes off, fresh new skin replaces it.
Chemical peels for acne scarring tend to be best suited to people with superficial acne scars. Always consult an aesthetics professional when thinking about a peel. They are not suitable for women who are pregnant or breastfeeding
Dermal fillers, such as Belotero, Radiesse and Restylane are frequently used to treat acne scars due to the immediate and long-term improvements they provide. These fillers are made from hyaluronic acid, a substance which occurs naturally in the body.
The treatment helps to raise pitted skin, break down the scar tissue and stimulate collagen production to reduce the appearance of the scars. This is a popular choice of treatment, not only because it requires minimal downtime and gives immediate results, the rejuvenating effect of the dermal fillers can lead to continued improvement of the skin, requiring fewer, less aggressive treatments over time.
Botulinum toxins are a newer addition to cosmetic artillery that can be used to combat acne scarring. They can also be used to complement a dermal filler treatment by stopping any scarring from growing larger. Toxins are injected into the area where muscle contractions pull on the acne scar. This relaxes the area which in turn limits stress on the scar tissue and likelihood of it stretching.
Research has shown that laser therapy can effectively reduce the appearance of acne scarring and there are various types of laser treatment to address different types and depths of acne scars.
Using focused light therapy, a specialist dermatologist will either remove the outer layer of the skin’s surface or stimulate the production of new skin cells to cover damaged skin cells. Laser treatments can also be used to lighten redness around healed acne lesions.
Ablative or laser resurfacing improves the appearance by removing the outer layer of skin and in doing so the damaged skin cells at surface level, whereas fractional laser resurfacing penetrates a deeper layer of the skin’s surface to remove dark pigmented cells. This procedure also stimulates collagen production and skin cell renewal, which can make your scars appear less noticeable over time.
Instead of working on the top layer of skin, non-ablative laser resurfacing is less invasive than ablative treatments. It works by heating up the inner layer of skin without destroying it to stimulate collagen production and cell renewal to replace damaged skin cells.
Downtime for laser treatments can vary depending on the type of laser used. Typically, you can expect it to take up to 10 days to heal fully.
Microneedling and PRP
Microneedling involves rolling an automated needling device over the skin to stimulate your skin’s natural ability to heal itself and enhance the production of collagen and elastin, which in turn helps to reduce acne scars.
Research has found that microneedling is most effectively used in conjunction with platelet rich plasma (PRP) therapy. This involves injecting platelets derived from your own blood to help improve collagen manufacture, which aids the process of smoothing acne scars.
There is little downtime with this type of treatment because there is no tissue destruction. The small channels created in the skin heal quickly and the healing response begins immediately.
Dr Prasad says, “While there is a lot that can be done for acne scarring, nothing comes close to preventative action. Often people come to me wanting to treat their scarring, while their acne is still active. All we would be doing is battling the immediate problem without addressing the acne and shutting down the cause.
"With my clients, we look at long-term solutions to arrest acne with medical grade skin care that is centred around vitamin A and sebaceous gland control and if necessary oral medication as well. We can then look at treatment of scarring. My advice would be to seek help from an experienced practitioner, who can help you to confirm diagnosis, review your skincare in detail, manage the condition and avoid scarring in the first place.”
Anamica Prasad, Dermatology & Aesthetic Doctor
I have been passionate about Dermatology, both Medical and Cosmetic, since 2002. This passion continues today and just...Book with Anamica Prasad