Question

Dermabrasion didn't help my deep acne scars. What else should I try?

I had dermabrasion done at the beginning of this summer. My dermatologist said my scars were deep enough that the laser would not make enough of a difference. I am still healing (it's August), just redness. I still have my ice pick scars and am disappointed by this. The dermabrasion did improve my scars but not the deeper ones. I would like to try something else, laser...??? Any advice?

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Asked by: Christina W

Answers (2)

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August 25, 2008
D.J. Verret, MD
D.J. Verret, MD
Board Certified
Facial Plastic Surgeon
Answer by D.J. Verret, MD

Ice pick scarring is a difficult problem to correct. There are several treatments I will use for patients with ice pick scarring. The first is to use a punch biopsy tool to elevated the skin around the scar. The incision is then allowed to heal and about 3-4 weeks later, I use either dermabrasion or dermasanding to smooth the area. Another option is a process called subcision. The basic ides is to use some type of needle to undermine the scar and then fill the area to prevent the scar from reforming. The filler can be either a temporary or permanent filler, though often even a temporary filler will produce a permanent result. The last option is direct excision. This produces excellent results and sometimes needs to be combined with dermabrasion or dermasanding.

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August 21, 2008

ice pick acne is a very difficult problem

Shahram Salemy, MD
Shahram Salemy, MD
Board Certified
Plastic Surgeon

Christina,

What you are describing is a very difficult problem that we encounter in plastic surgery.  As you know, options include laser, dermabrasion, or direct excision of the scars.  The reason why these scars are so noticeable is because they are deep, and anything that deep on the skin will cast a shadow which is what catches the eye when you look at it.  So the key to fixing this, regardless of the type of treatment, is to make the scars less deep so that there is very little shadow remaining.

For patients whose skin does not respond to lasers or dermabrasion, I will sometimes directl excise the deepest scars and then close the skin.  This can be done with just a local anesthetic and with several small (a few millimeters long) incisions.  I find that these scars heal very well and will look far better than most acne scars.  I will usually treat a couple of the worst areas first and see if the patient likes the result, and then come back for the rest.

I hope that helps,

 

Dr. S

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