What is Acne scarring
Acne is a common yet distressing condition that affects both males and females. It is a chronic skin disease of the oil follicle (sebaceous follicle) characterised by four main pathological changes—increased oil/sebum production, comedone formation, colonisation of the skin with Cutibacterium acnes (C. acnes) and resultant inflammation.
Many people suffer from acne in their youth and a smaller number in their adult years. This may result in permanent scarring which can have a significant impact on a person’s self-esteem.
Symptoms
Acne scars can be classified into several categories:
- Ice pick scars: pitted scars
- Boxcar scars: pitted scars with steep sides and a flat bottom
- Rolling scars: the contour is rolling and uneven
- Hypertrophic or keloid scars: thick lumpy scars
- Atrophic scars: flat, thin or depressed scars
This may be complicated by discolouration or pigmentary changes:
- Post-inflammatory erythema: pink or purple flat patches
- Hypopigmentation: pale or white marks
- Post-inflammatory hyperpigmentation: brown patches, typically seen in people who tan easily or have a darker skin colour
Many people suffer from acne in their youth and a smaller number in their adult years. This may result in permanent scarring which can have a significant impact on a person’s self-esteem.
CAUSES
The cause of acne scarring is directly related to the presence of inflammatory/active acne, its duration, the extent of skin involved and the treatments used to manage the condition. One of the very common mistakes that we see often, is ‘picking’ and other self-directed treatment aimed at the inflammatory lesions of acne. This unfortunately often leads to scarring.
ACNE SCAR TREATMENT
As different categories of scars usually coexist in patients, combining several treatment modalities is usually required to improve scarring. It is important to firstly treat active/inflammatory acne to avoid further scarring. A number of techniques can be then be used to treat acne scarring and each technique may be more suited to a particular type of scarring.
1. Ice pick and box car scars
These deeper scars are best treated using surgical techniques, such as excision, subcision and punch grafting. They usually co-exist with other types of scarring and, therefore, additional treatment is usually necessary. The trichloracetic acid (TCA) CROSS technique is particularly effective for these types of scars.
3. HYPERTROPHIC OR KELOID SCARS
These scars can be treated with direct injection (intralesional injection) of corticosteroid into the scars, combined with silicone gel type dressings and laser treatment.
2. ROLLING SCARS
Rolling scars are more complex in nature and require different treatments modalities. This primarily involves medical treatment and procedures aimed at improving volume loss.
4. ATROPHIC SCARS
There are treatments that offer excellent results with this kind of scarring.
Associated discolouration can be managed with vascular laser and picosecond pigment laser depending on the colour involved.
HOW ARE WE UNIQUE
We specialise in assessing the precise nature of your scarring, formulating a treatment plan using a combination of treatments that will most effectively target the types of scars that you have.
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