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How common is scarring in acne?


Acne is basically a scarring condition and even mild acne needs to be treated early. As much as 95% of all people with acne have some degree of scarring.


What types of scars seen in acne


Acne scars can be classified into the following types

Atrophic scars - these scars are thinner than normal skin

     Ice pick scars - deeper than they are wide. usually quite narrow

     Boxscar scars - wider than they are deep, with sharp margins

     Rolling scars - saucer shaped, with shallow, curved margins

Hypertrophic scars - thicker than normal skin

Keloidal scars - very thick hard scars

Additional types are 

     Pigmented scars

     Erythematous scars



What treatments are available for acne scars:


The treatment of acne scarring is individualised depending on various factors including skin type and depth and extent of the scars.


1.  Ice pick scars are typically excised with a punch and stiched with fine suture.2.  Rolling scars are treated with subsicion, a technique where a needle with a flat sharp end is passed to and fro under the skin to break up the fibrous strands which pull the skin downwards to produce the scar.

3.  The non ablative Frax laser is used to smoothen the skin after any surgical treatment that may be required.

4.  Microneedling is an alternative option.

5.  Fillers may be used before or after laser treatment. These do not last forever in the skin and need to repeated at about 9 month intervals.6.  Individual ice pick scars may be treated with TriChlorAcetic acid (TCA) as a spot treatment directly in the scar (CROSS treatment)

7.  Chemical peeling may be beneficial at the onset of acne treatment to hasten resolution on the acne. It is also used for mild scarring

8.  Microdermabrasion is useful for mild scarring especially pigmented scarring, in which it may be combined with pigment lightening medication.

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