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The treatment of Acne Scars should always be deferred until all active acne has been eradicated and there are no more major outbreaks.
As a cosmetic clinic that regularly witnesses the self-consciousness, desperation and psychological effects that acne scarring inflicts on patients, we are disappointed that the prescribing of the retinoid-derivative drug (Government regulations prevent us from mentioning it by name) – widely regarded as the ONLY REAL CURE FOR SEVERE OR REFRACTORY ACNE – is not made available to ALL Medical Practitioners, and most importantly to General Practitioners who are the very doctors whom acne sufferers usually first consult.
We believe that if General Practitioners were allowed to prescribe this drug as a treatment for acne BEFORE facial scars developed, the incidence of Acne Scarring would dramatically drop!
Unfortunately, once Acne Scars develop, there is little that can be done to remove them completely. In most cases, the best we can offer are treatments to lessen their appearance and make them less conspicuous. That is why it’s so important to treat acne early and prevent scarring from occurring in the first place.
Basically, the shape and depth of your acne scars as well as your skin type, will determine which acne scar treatment, or combination of treatments, is best for you. As most people have a variety of scar shapes and depths, more than one type of treatment may be necessary to deliver the best possible result.
At your Initial Consultation, our doctor will carefully assess your skin and the shapes of your scars and then explain which acne scar treatment, or combination of treatments, is the most appropriate for YOU.
Treatment Options For Acne Scarring
Medical-Grade Micro-Dermabrasion to reduce the appearance of the acne scars. Please note that Micro-Dermabrasion does not significantly reduce the depth of the acne scars. It more changes the light-reflective properties of the skin and thereby the scars may appear less conspicuous.
Micro-Dermabrasion is NOT the same as Surgical Dermabrasion which was once very popular for acne scarring but it had the unfortunate side-effect of permanent hypopigmentation (loss of skin colour). For this reason, Surgical Dermabrasion, has been largely replaced by Laser Skin Resurfacing (see below).
Collagen Induction Therapy, or simply ‘CIT’ for short, and also known as ‘Skin Needling’ is a treatment that aims to stimulate collagen synthesis and thereby improve the appearance of the acne scars. However, and in all honesty, it rarely does much to improve the appearance of acne scarring. Sadly, we regularly hear stories of people having been sold expensive courses of Skin Needling without any discernible improvement of their scars. Although our Skin Technician does perform Skin Needling for other conditions, we do not recommend it as a first-line treatment for Acne Scarring simply because we have more effective treatment options such as Laser Skin Resurfacing (see below).
Dermal Fillers to fill out the acne scars is one of our most frequently performed treatments. It is by far the best option for ‘valley’ shaped acne scars which are less responsive to Laser Skin Resurfacing. Using a very fine needle, Dermal Filler is injected into each ‘valley’ scar to raise the depressed scar up to the level of the surrounding skin surface. If this is an option for you, our doctor will then explain the various Dermal Fillers you can choose from.
Surgical Excision of the acne scars is an option for those scars that will not respond to any other treatments. The methods include simple excision, punch excision and punch grafting. They can all be easily performed under Local Anaesthesia in our Clinic’s own Operating Theatre. However, bear in mind that surgical excision will always leave a surgical scar, so you need to consider which of the two scars – the acne scar or the surgical scar – would be less noticeable.
Laser Skin Resurfacing is one of our most frequently recommended treatments for Acne Scarring. It delivers its best results with the shallow ‘pitted’ type of acne scars and shallow ‘crater’ shaped acne scars. It is not very effective on ‘valley’ shaped scars. Laser Skin Resurfacing to small areas of the face can be performed under Local Anaesthesia +/- Mild Sedation. However, if Cheeks or Full Face are to be resurfaced, this is best done in a Day Hospital under General Anaesthesia administered by our Specialist Anaesthetist. In either situation, you can go home 1-2 hours after your procedure. Laser Skin Resurfacing requires 9 days’ downtime following which you will return to the Clinic to be checked and have prescribed a cream to settle the normal post-operative redness.
At Sydney Cosmetic & Plastic Surgery Clinic, we use a computerised Fraxel Repair’ CO2 Laser for the treatment of Acne Scarring. Being a Fractional CO2Laser, it removes only microscopic columns of skin and leaves intact skin in between to initiate the healing process, shorten recovery time, and reduce the chances of hypopigmentation (loss of skin colour).
Please note the ability of the laser to remove acne scars will also depend on their depth because the laser cannot remove scars that are deeper than the laser can safely reach. Accordingly, you must not expect that every acne scar will disappear. Realistically, you should only expect a reduction in the number and depth of the scars.
PLEASE NOTE: Laser Skin Resurfacing may not be an option for those with olive, brown or Asian skin because of the risk of pigmentation complications.
Types Of Acne Scars & Their Treatments
Essentially, the shape and depth of your scars as well as your skin type will determine which treatment, or combination of treatments, is the most appropriate.
‘Rolling’ or ‘Valley’ Scars are difficult to remove with any form of skin resurfacing such as Chemical Peeling or Laser Skin Resurfacing. We find that Dermal Fillers to raise the depressions to the level of the surrounding skin surface are usually the best option for this type of scar.
‘Ice-Pick’ Scars are small, deep pitted scars. Punch excision is usually the best option to remove these unless they are very shallow in which case Laser Skin Resurfacing could be a worthwhile consideration.
‘Boxcar’ or ‘Crater’ Scars, if shallow, may respond to Laser Skin Resurfacing, otherwise Dermal Fillers to raise them to the level of the surrounding skin surface could be an option.
‘Hypertrophic (Raised) Scars’ respond best to surgical excision or Laser Skin Resurfacing.
As most acne scar sufferers have a variety of scar types, more than one type of treatment is often necessary.
At your initial consultation, our doctor will carefully assess both your skin and your scars and then explain which treatment, or combination of treatments, you can consider.
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