Acne scars can be classified on several levels, but most common is to differentiate rolling vs. ice pick vs. box car scars (Dermatologic Surgery by C. Jacob and J. Dover). For very focal scars that are characterized as rolling, subcision can be very helpful (Dermatologic Surgery by M. Alam) and fillers such as Restylane as well as JuveDerm can show dramatic results as well. For focal more ice-pick type scars, there is a study out of Asia that shows great results from using very high concentration 100% TCA not as an overall peel, but focally at the scar. For focal boxcar type scars, sometimes a punch elevation or punch graft is done. For more widespread scars of various kinds, we often perform non-ablative fractional lasers over several treatment sessions (sometimes 5-8)--and these have very little downtime, usually patients are just pink for 2-3 days. For patients with more widespread scars that want to see results more quickly, ablative fractional lasers work great but do require 4-10 days of downtime for each treatment (usually less treatments than ablative fractional lasers).
Is Chemical Treatment or Laser Peel the Only Treatment Available for Acne Scars After Accutane ?
Doctor Answers (3)
There are many types of acne scars and many treatments.
Many treatments for acne scars
Rafa, There are many ways to treat acne scars but it depends on the nature of the scars. If you have many crater-like scars on the face than fractional laser resurfacing should help you with little down time. If the scarring is severe then you might consider a more aggressive laser. If just a few scars, they can be treated with repeat saline injections, release of scar tissue and then add a filler etc.. Have your dermatologist have a look and discuss options. Would not do anything until several months after finish accutane if you have taken that recently.
Web reference: http://brookwooddermatology.com
Acne scar treatments
There are a number of different acne scar treatments. The choice depends on the type of scars, the patient, and how many scars there are.
If it is one or a few scars, then methods such as dermal fillers or subscision can be helpful in improving them.
If there are multiple atrophic (ice pick, box car, etc) scars that descend below the surface then a resurfacing method works best, such as fractional laser. Chemical peels and dermabrasion are also used to treat multiple acne scars.
Treatments for acne scars should be undertaken after 24 months post Accutane, as Accutane predisposes the skin to scarring, most likely due to its effect on oil glands.
For hypertrophic scars and keloids, intralesional injections of Kenalog are the first line treatment.
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