This scar was left from a pimple, I wonder what my treatment plans are? will it be less noticeable over time or should use some kind of filler compound? What can be done to reduce the pigmentation in the surrounding areas?
How Can I Treat This Deep Acne Scar? (photo)
Doctor Answers 8
Combination approach with lasers and subcision likely to help
Thanks for your question about a very common issue that has not had a great solution until recent years with the development of the fractionated lasers which were developed at Harvard Medical School/Massachusetts General Hospital by Dermatologists. I think a combination of a fractionated laser together with subcision would be the first line approach to this issue. Good luck.
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Deep acne scar treatment options
Treatment options would include subcision of the deep scar, excision perhaps followed by laser treatments, laser treatments and fillers. You may require a combination of treatments. Your other scars would benefit from subcision, laser treatments and possible fillers as well. Retin-A cream can help fade pigmentation and smooth skin, as well as treat acne. You should consult a dermatologist or plastic surgeon who can assess your scars and discuss your options with you.
Deep Acne scar and how to treat it
Your scar looks discolored and red. The most effective way would be to excise the scar and then consider resurfacing. Lasers would help but not as much as excision in my opinion.
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Treatment of Acne Scars
Acne scars may be treated utilizing many different modalities including surgical excision and closure, punch release and suturing, punch skin grafting, subcision, fat grafting, injection of temporary fillers like Radiesse, Restylane, Juvederm or permanent silicone injections, and finally laser or dermabrasion. It is difficult to tell from your picture which of these modalities would be ideal for that scar because I use them in different situations. It seems though you may be concerned with some of the redness or hyperpigmentation in the scar which hints that it may be from a recent outbreak (less than 1 year). Redness or hyperpigmentation can last up to a year and usually will resolve on its own. it may be hastened by the topical treatment with retin-A and hydroquinone. The element of acne scars that usually requires treatment is depression. If that scar is or becomes depressed you may want to seek out one of the above treatments.
For a single deep acne scar, excision is sometimes the best option.
A single deep acne scar may best be treated with simple excision. If a residual scar is left from the excision, laser scar revision may be able to blend the surgical scar. I would recommend extensive subcision and Fraxel Repair laser for the rest of this patient's scars. Some fillers may also be necessary to achieve the best results.
Subscission, fillers and perhaps fractional ablative laser
The large deep scars could be undercut ["subscission"] for example using the tip of a 16 ga needle.
Volume could be restored, for example by very controlled injections of Juvéderm® using a BD-!! 31 ga syringe.
Finally, fractional ablative laser [for example, Cutera's Pearl Fractional] could be used to turn on the repair and remodelling processes to improve the smaller scars.
I think I also see some deep, narrow ["icepick"] scars -- these might respond best to CROSS treatment using 90% TCA, administered every 2-4 weeks, maybe half a dozen times.
Treating a Deep Sunken Acne Scar
The treatment would depend on the scar's maturity. The scar can be released from the scar tissue pulling it down and dimpling it followed by filling with either fat or a filler such as fat, Restylane, Perlane, Juvederm or Radiesse. Surgical removing the scar and closing the depression with approximating the edges of the defect together is another option. You should consult a member of The American Society of Plastic Surgeons - wwwPlasticSurgeryorg to learn your options.
Peter A Aldea, MD