Acne scar treatment approach

Philip Young, MD answers: Acne scar removal - what approach works?

I am still trying to figure out what is the right laser and/or treatments for me. I have had acne for 2 decades and now want to get rid of the deep scars and wrinkles.


Philip Young, MD
4 months ago

There are many ways to improve Acne scars.  It really depends on how they look and what are the characteristics of the scars. If they are depressed the scars need to be elevated and then allowed to heal. Many times you can carry the laser resurfacing at the same time the depressed scars are elevated to the level of the rest of the skin.  If they are white, excision of the white scar is the most definitive way of improving this.  If they are raised, sometimes the laser can be used to level the scar down to the rest of the skin.  There are times when the leveled scar doesn't heal as perfectly and then requires more extensive resection reclosure and then delayed resurfacing 6-8 weeks later.

Fraxel and fractionated lasers can help but usually take more treatments then more traditional laser resurfacing.  There results are more subtle but usually people heal faster and have less downtime but this is not sometimes the case in many situations.Active Fx would be a great choice and most definitive. There are many ways to improve Acne scars. It really depends on how they look and what are the characteristics of the scars. If they are depressed the scars need to be elevated and then allowed to heal.

Many times you can carry the laser resurfacing at the same time the depressed scars are elevated to the level of the rest of the skin. If they are white, excision of the white scar is the most definitive way of improving this. If they are raised, sometimes the laser can be used to level the scar down to the rest of the skin. There are times when the leveled scar doesn't heal as perfectly and then requires more extensive resection reclosure and then delayed resurfacing 6-8 weeks later.

Fraxel and fractionated lasers can help but usually take more treatments then more traditional laser resurfacing. These results are more subtle but usually people heal faster and have less downtime but this is not sometimes the case in many situations.

More aggressive peels combined with dermabrasion can also help acne scars. Dermabrasion uses a machine that spins a wire brush that can take down the layers of the skin to the right depth to remove scars. Dermasanding is another technique that uses medical grade sandpaper to do the same in a more conservative and safer way with less aerosolized particles that can transmit infections.

Before these treatments, optimized medical treatment is prudent to try first.

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