Dermabrasion for acne scars
Dermabrasion is no longer considered the gold standard for acne scar treatment, especially for the full face resurfacing that may be needed. Dermabrasion can give an excellent result for small scars and even the wrinkles around the lips but for deeper lines or full face treatments then lasers such as the CO2 are excellent tools
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Acneic or pitted scarring tend to be difficult problems to treat. For this type of scarring, dermabrasion works very well at improving the texture of the skin. Not only does it plane the skin mechanically, it induces new collagen production within the dermis, further improving the skin’s appearance. Improvement should be seen, and multiple treatments may be required. Other treatments such as deeper chemical peeling and laser resurfacing may help, but generally not to the extent that dermabrasion will. As a consequence, it is still considered the “gold standard” for deeper scar management.
I would not consider dermabrasion the gold standard for acne scars. If you've ever seen the device, it best resembles an industrial electric sander. Before the advent of laser therapy, it's all we had. Don't get me wrong, I've seen some remarkable dermabrasion results - it's not that the procedure doesn't work most of the time, but its so very unpredictable. The lack of consistent results with dermabrasion is why we don't offer it in our Practice. Once you damage deep collagen with this device, we can only hope that your own healing process relayers new collagen in a reliable, smooth fashion. The damage is hard to uniformly distribute with this device, so you've got some areas healing faster and better than others, and a mix of results. The CO2 or Fraxel laser is a preferred alternative here - I consider it to be the new gold standard for acne scar resurfacing
For Acne Scars, Treatment(s) Should Be Tailored To The Specific Kinds Of Scars
Today, we have fortunately progressed far beyond the stage that dermabrasion is all we have to treat acne scars. So, I would have to question the contention that it remains the gold standard it once was two decades ago. In fact, I would have to contend that a one-size fits all approach, like traditional dermabrasion, or more recently the use of fraxel lasers, for all acne scars would no longer be considered best medicine.
For pit scars, for example, we can offer the punch excision and CROSS techniques. For depressed acne scars, rolling and box scars, we can perform subcision, with or without the injection of volumizing agents. To blend the surface of the off-colored scars with the remainder of surrounding normal skin, we can perform fractional medical microneedle therapy, and for more resistent sites, we might opt for a more focused spot dermasanding technique. For a more detailed discussion of each of these individual methods for acne scar treatment, I suggest you check out the archives of RealSelf.com, and I would strongly urge consultation with a board certified aesthetic core physician experienced with all these approaches.