|What is acne scarring?|
Acne is a skin condition that affects up to 80% of people in their teens and twenties, and up to 5% of older adults. While many people recover from acne without any permanent effects, some people are left with disfiguring acne scars. There are some topical skin care products and medications that can improve mild scarring, but most acne scars are treated with a combination of procedures.
Early acne scars
After an acne lesion has healed, it can leave a red or hyperpigmented mark on the skin. This is actually not a scar, but a post-inflammatory change. The redness or hyperpigmentation is seen as the skin goes through its healing and remodeling process, which takes approximately 6-12 months. If no more acne lesions develop in that area, the skin can heal normally. Any colour change or skin defect still present after 1 year is considered to be a permanent defect or a scar.
|Treating early acne scars|
The post-inflammatory changes caused by acne are part of the skin's natural healing process. There are certain practices and medications that can help facilitate this healing process.
Dermabrasion is a cosmetic medical procedure in, which the surface of the skin is removed by abrasion (sanding). It is used to remove sun-damaged skin and to remove or lessen scars and dark spots on the skin. The procedure is very painful and usually requires a general anaesthetic or twilight anaesthesia, in which the patient is still partly conscious. Afterward, the skin is very red and raw-looking, and it takes several months for the skin to regrow and heal. Dermabrasion is useful for scar removal when the scar is raised above the surrounding skin, but is less effective with sunken scars. Laser dermabrasion is much easier to control, much easier to gauge, and is practically bloodless compared to classic dermabrasion.
Microdermabrasion comes from the above mentioned technique dermabrasion. Microdermabrasion is a more natural skin care that is a gentler, less invasive technology for doing an exfoliation on the skin. The goal of microdermabrasion is to eliminate the superficial layer of the skin called the epidermis. If the surface of the abraded skin is touched, a roughness of the skin will be noticed. The roughness is keratinocytes, which are better hydrated than the surface corneocytes. Keratinocytes appear in the basal layer from the proliferation of keratinocyte stem cells. They are pushed up through the cells of the epidermis, experiencing gradual specialisation until they reach the stratum corneum where they form a layer of dead, flattened, strongly keratinized cells called squamous cells. This layer creates an efficient barrier to the entry of foreign matter and infectious elements into the body and reduces moisture loss.
Keratinocytes are shed and restored continuously from the stratum corneum. The time of transit from basal layer to shedding is generally one month. Corneocytes are cells derived from keratinocytes in the late stages of terminal specialisation of squamous epithelia. Microdermabrasion is done to eliminate some of the corneocytes. These cells are responsible for the impermeability of the skin. The minimising or elimination of scars, skin lesions, blotchiness and stretch marks from the skin can be an easy process with the use of skin exfoliation. The result depends on how well the procedure known as skin remodeling works. Results are optimal and fewer treatments are needed with more recent and/or superficial scars. Still, microdermabrasion can be used on scars that showed up during puberty or many years later.
Fractional laser resurfacing is a procedure, which wounds the skin using microscopic pulses of light. Over the course of several treatments scars are softened as the body regenerates the areas of microthermal wounding. Laser resurfacing is a technique used during laser surgery wherein molecular bonds of a material are dissolved by a laser. CO2 or erbium energy is used to treat the areas of discoloration closer to the surface and also penetrates deep into the dermis, eliminating damaged cells and stimulating the growth of new collagen. Collagen is stimulated for up to 6 months and this new collagen regeneration lifts and supports the skin's surface. The generation of the new skin cells in combination with collagen stimulation dramatically improves the appearance of acne scars. Depending on the depth of the scars, some patients may require anywhere from 1 to 3 treatments for acne scar removal.
Chemical peels improve and smoothen the texture of the facial skin using a chemical solution that causes the skin to blister and eventually peel off. The regenerated skin is usually smoother and less wrinkled and scarred than the old skin.
Subcision is a process used to treat deep rolling scars left behind by acne or other skin diseases. Essentially the process involves separating the skin tissue in the affected area from the deeper scar tissue. This allows the blood to pool under the affected area, eventually causing the deep rolling scar to level off with the rest of the skin area. Once the skin has leveled, treatments such as laser resurfacing, microdermabrasion or chemical peels can be used to smooth out the scarred tissue.