Article by Steven H. Dayan, MD
Chicago Facial Plastic Surgeon
Frequent acne inflammation extending down into the deepest layers of the skin can result in scarring. For some, acne scarring may be a sign of character (think of famous actors like Tommy Lee Jones or Edward J. Olmos) but for others acne scars can be shadow capturing nuisances that are difficult to camouflage. Many people are self conscious of the scarring and seek any improvement they can get. There are multiple approaches to treating acne scars, some are very aggressive and others mild in nature. No matter the method, there is not yet one proven method for completely removing the scars. However, we can make them better. In my experience patients with acne scars are thrilled with even a modest improvement in the appearance of their skin.
Before undergoing any treatment to improve acne scars it is important that active acne is under control or not occurring as these treatments may increase the possibility of aggravating or stimulating acne break outs. If you are experiencing acne breakouts we may put you on a regimen to treat the acne first. Once under control, we will recommend a treatment option for you that best meets your goals.
I perform numerous methods for treating acne scarring including Roll CIT, subcision, fat transfer, fillers and fractionated resurfacing. The treatment best for your skin will be determined during a consultation All treatments are performed during an in-office procedure.
Roll CIT involves penetrating the skin to stimulate collagen growth. In this way, the acne scars are broken up. Following this procedure patents can expect three or four days of slight redness and bruising. Most of my patients undergo this procedure over a long weekend to give themselves time to heal before returning to their normal routines.
Many patients combine Roll CIT with subcision which is a procedure that releases the scar from the underlying subcutaneous tissues.
Subcision allows the scar to elevate up and out. Subsicion produces best results when combined with a facial filler or fat transfer. Both fat transfer and hyaluronic acid can be placed in the pocket that is created under the scar by the subcision technique to further elevate the scar and minimize its appearance. Fat transfer also contributes to the production of newer and healthier looking skin cells. After a series of 3 treatments patients report a 25%-75% improvement in the appearance of their scars. The addition of subcision and fillers may slightly increase the downtime, but most people return to their regular schedule within 5 to 7 days.
Fractionated resurfacing laser is a newer method for treating acne scars and is also very effective. However, the laser is best suited for patients with fair skin tones. Patients with darker skin are at a slight risk for skin color changes. Fractionated lasers can be performed in the office and a series of treatments (at least 3) is recommended. Treatments can be separated a month apart. The results of this treatment can be improved upon by adding fat transfer or hyaluronic acid fillers.
Fillers alone can provide immediate improvement for many people. While this treatment can be performed in minutes, there will be slight bruising which will take a few days to dissipate. However the pinpoint bruises can easily be covered with make up.
There are multiple options for treating acne scars which is method is best for you can be determined during your consultation.