Severe acne scarring can be a devastating reminder of an unsightly condition. Before treating severe acne scars successfully, it’s important to understand that there are several different kinds of acne scars:
Ice pick scars: These are deep, narrow scars that form pits in the skin and are the most common sign of acne scarring.
Box car scars: These are angular scars with well defined edges that usually appear on the temple and cheek area. These can be either superficial or deep and resemble chickenpox scars.
Rolling scars: These are wide, shallow scars that give the skin a wave-like appearance.
Keloid scars: Keloid scars are overgrowths of collagen at the site of the wound that often form to be much larger than the original acne wound. Keloid scars are firm and rubbery to the touch and may itch.
Hypertrophic scars: These are raised scars that remain within the boundary of the original acne wound and are also formed by the overgrowth of collagen at the inflammation site.
Treating severe acne scarring often involves serious, invasive surgical procedures. Below are a number of treatment options depending on the type and severity of the scars. All these treatments must be performed by a medical doctor, may require anesthesia, and can require a lengthy recovery time.
Dermabrasion is a form of skin resurfacing. Not to be confused with microdermabrasion. Dermabrasion removes the top layer of the skin with a tool equipped with rotating wire brushes. This can be effective at removing the top layers of deeper scars. Multiple sessions may be required to achieve the full effect, and dermabrasion is often used in tandem with punch techniques and subcision to ensure a smooth, even finish at the skin’s surface.
Laser resurfacing is another form of skin resurfacing. It is based on the same philosophy as dermabrasion, but uses lasers instead of a wire brush. Laser resurfacing is often used in conjunction with punch techniques and subcision, and multiple sessions may be required. Fractional laser, meaning that only a fraction of the skin surface is exposed to the laser beam, allows for very precise treatment, faster healing and minimal discomfort.
Commonly referred to as ‘fillers’ – augmentation is used to treat all scar types. Augmentation is the injection of filler under the scars to raise them to the skin’s surface. Fillers can be made of various forms of collagen, a patient’s own body fat, synthetic and other materials, including hyaluronic acid. Most fillers are temporary (biodegradable), requiring continued treatments every three to six months to maintain their effect. Some, newer, synthetic fillers can last up to two years. Using a patient’s own body fat can enable the treatment to last 1-3 years. So far PMMA (polymethylmethacrylate) is the only filler believed to be permanent.
The best solution for deep, individual scars is a surgical procedure called a punch technique. An instrument resembling a cookie cutter is used to punch the scar out from the surrounding tissue. There are three punch techniques. In the first punch technique, the scar is replaced with a skin graft. In the second punch technique, the scar is removed, then the surrounding tissue is closed and allowed to heal with treatment to keep it from scarring again. The third punch technique leaves the scar behind but separates it from the tissue underneath, allowing it to settle into a place that is more flush with the skin.
Subcision is another surgical treatment that is used for almost all types of depressed scars. A tool is used to separate the scar from the underlying tissues, allowing the scar to rise to the top of the skin and create a smooth surface. One to three treatments are typically necessary to achieved desired effect.
Covering Scars – Makeup Technique That Works!
Makeup artist Wayne Goss has been practicing his craft in the UK since his early 20s. His technique for covering acne scars is one we like and worth trying.