Perhaps the question should be more appropriately rephrased to "What options are available for treating acne scars?" A face to face consultation with a board certified aesthetic physician with extensive experience in treating acne scars with all modalities is your best bet. However, in general terms there are a couple of procedures that have stood the test of time that are less invasive and entail less post-treatment downtime than traditional dermabrasion.Subcision is an approach directed at freeing up bound-down scar tissue, such as acne scar tissue, and elevating the surface. Under local, the scar tissue is broken up and the overlying tissue freed up to float to the surface and more normal collagen production promoted in its place. The procedure requires only minutes to perform and may be repeated one or more times in order to achieve better cosmesis every six to eight weeks. Fractional Microneedle Therapy, aka medical microneedling, may represent a viable, minimally invasive option for improving the color and texture of the surface of such kinds of scars, since surface color is typically off-white rather than normal flesh-tone..This technique has been used successfully for years to treat all kinds of scars, including those arising from acne. Unfortunately, by contrast, I have not been impressed with the results of lasers, including the fraxels, as unfortunately evidenced by your own experience with them.Microneedling for small areas, as in this case, can be performed using a Dermastamp. The Dermastamp employs an array of needles that pierce the surface of the scar to break up the surface tissue and create microchannels. Treatment requires only the use of topical or local anesthesia and takes only a minute or so to perform. The microwounding of the skin allows for the triggering of a cascade of events that result in new collagen formation (collagen neogenesis), but also makes possible disruption of troublesome surface discolorations. Two to four treatment sessions are usually required at a six week intervals for optimal results. Adding a topical bleaching agent to the regimen immediately following treatment can also be helpful, as can the adjunctive use of a home Dermaroller along with a mild prescription bleaching cream. This modality is associated with little post-treatment hyperpigmentation even in people of darker flesh tones, a possibility that incidentally does pose real concern with the use of fractional lasers.
