WHAT ARE ACNE SCARS?
Acne scars as a result of extreme acne, are permanent textural modifications and indentations that appear on the skin. For the temporary red and brown markings left early after acne has happened, the word “scarring” is not used because these marks can nearly certainly improve without treatment.
WHAT CAUSES SCARRING DUE TO ACNE ?
Huge pus-filled spaces known as acne cysts form in extreme acne. During the healing process, these cysts damage skin tissue that is not replaced. It normally leaves behind an indentation (or scar) on the face until the cyst finally empties and the region heals. The scarring on the chest and back (known as “hypertrophic” or “keloid” scarring) can be lumpy.
WHAT DOES THE SCARRING OF ACNE LOOK LIKE?
Acne scarring on the face of depressed regions of varying sizes occurs as disruption to the skin structure. Scars tend to be elevated and lumpy on the back and shoulders. Scars are typically the natural colour of the skin. For several years, some keloid scars can stay red.
TYPES OF ACNE SCARS
There are following types of acne scares;
Box car scars are depressed scars that, with well-defined margins, are shallow to medium in width, most usually found on the cheeks and temples. This form of scarring reacts well to various therapies, including complete resurfacing, fractional lasers, dermal fillers and radiofrequency treatments, because of the relatively shallow depth.
Deep and narrow scars which reach into the lower layer of the skin are ice pick scars. Procedures like fractional therapies are not as successful as TCA CROSS (trichloroacetic acid chemical repair of skin scars) due to the depth of ice pick scars.
The basis of ice pick scar care is either to improve the scarring extent or to excise the pick itself (remove it surgically). Deep ice pick scars can be improved by treatments such as punch excision or TCA CROSS. Laser resurfacing offers the final touches until wounds are brought up to a shallower surface.
3. Rolling, Atrophic and Depressed Acne Scars
Rolling acne marks tend to appear on the skin as undulations and depressions. It is possible to anchor such scar areas to deeper structures. For the treatment of rolling scars and tethered marks, a range of procedures may be used, including suspicion, fractional laser resurfacing, radiofrequency and dermal fillers. Freeing up attached wounds and covering depressions with collagen is the basis behind scar revision. For the best possible result, this type of acne scarring would typically take multiple therapies.
The most prevalent method of acne scarring is this. Many individuals, including tethered or anchored scars, ice pick scars, box car scars and rolling scars, may have a combination of acne scars. Different forms of acne scars require multiple therapies and the optimum result is thus achieved by a personalised approach to scar revision.
5. Red Acne Scars- Macular Scars
On the cheeks and forehead areas, macular acne scars are usually seen and present as red areas. They arise as a result of scarring from early acne. Without care, this type of scarring can fade over 6 to 12 months, but vascular laser treatment may also speed up the resolution of scars. For better outcomes, multiple therapies are needed.
6. Lymph Hypertrophic and Keloid Scars
Lumpy red scars, most frequently found along the jawline, abdomen, chest and back regions, arise from this form of acne scarring. Lumpy wounds are better treated by a sequence of injections of corticosteroids. Many individuals would need 2 to 4 shots spaced 6 weeks apart. Redness of scars may be treated with vascular lasers, but the best outcomes may need 3 to 4 treatments.
HOW IS ACNE SCARRING TREATED?
For acne marks, there are several therapies available that can strengthen and soften the colour of the scarring. It can require a variety of therapies. Expecting a return to fully natural skin after surgery is impractical.
Four key variables will depend on the optimal treatment:
i. Skin type (the type of skin is graded according to the amount of skin pigment)
ii. “Scar type” (rolling," “atrophic,” "“box car”, “ice pick” or “anchored” can be scars)
iii. Available downtime (time the skin takes to recover after the procedure)
iv. Procedure cost (more complicated procedures involving lasers and fillers typically cost more than basic procedures such as radio frequency and skin needling. Certain procedures carry a Medicare reimbursement, such as complete laser resurfacing or scar revision done by experts).
The different methods of treating acne scarring are listed in the following detail.
1. Fillers
Injections of hyaluronic filler are better used for atrophic scars and rolling scars. They have the benefit of quick change and low downtime. Initially, care is repeated at 6 monthly intervals, but the duration may gradually be lowered to twice annually.
2. Intralesional Corticosteroid
Intralesional corticosteroid treatments with lumpy acne scars are better used. There could be multiple injection therapies needed. Vascular laser therapy can also be associated with this treatment.
3. Laser Treatment
Laser therapies are available in two primary types: ablative and non-ablative. Lasers that ablate (or injure) strip thin layers of skin. Non-ablative (non-wounding) lasers promote the formation of collagen and tighten the skin beneath. Although non-ablative laser resurfacing is less invasive and requires less healing time, for deeper wounds, it is less efficient than ablative laser resurfacing.
i. Fractional Non-Ablative Laser
a. It has been demonstrated that varying wavelengths of fractional laser instruments boost acne scarring.
b. They are best used for rolling scars and atrophic scars.
c. Any transient redness may be caused by these lasers, but the skin surface does not completely crack.
d. Quick turnaround times, the ability to handle darker forms of skin and a higher safety profile are the benefits of non-ablative fractional lasers.
e. During fractional laser therapy, healing time ranges from 3 to 8 days.
f. A sequence of fractional laser treatments (2 to 5) can help most individuals. Compared to lighter skin types, darker skin types will normally need further care.
ii. Ablative Laser
a. The “gold standard” for the treatment of box car scars is ablative lasers.
b. Two modes of ablative lasers are available, fractional ablative and completely resurfacing.
c. CO2 lasers are better used on lighter skin types when completely ablative, whereas erbium lasers offer a broader protection threshold for darker skin types. The safety profile of fractional CO2 / Erbium lasers is better than that of totally ablative lasers and can be used in all skin forms.
d. Longer healing periods that can be up to 2 weeks are the drawback to ablative lasers. Redness after ablative lasers is a prominent side effect.
4. Radiofrequency
Radiofrequency is a form of scar remodelling that is non-invasive. In early acne marks, atrophic scarring, rolling scars and in darker skin forms, this therapy is best used. New types of RF involve skin needling, which deepens the dermis (skin) with greater energy.
5. TCA CROSS (Chemical Reconstruction of Skin Scars)
This procedure uses TCA of high intensity (50-100 percent). For ice pick scars, this method of scar revision is suitable and can be easily used for all skin types. For best outcomes, 2 or 3 therapies are optimal.
6. Surgical method of scar removal
Procedures such as punch excision, punch elevation and subscision also remain a useful way to heal deep ice pick wounds as well as anchored or tethered scars. In several situations, several months after, laser resurfacing is accompanied by surgery.
7. Skin needling
In the treatment of acne scars, skin needling may be effective. Skin needling, as the name suggests, brings needles of different depths (0.5 to 3 mm) into the skin’s dermal layers. Pen-held instruments have increasingly replaced skin needling rollers.
This therapy is suitable for darker skin forms, but it is not as successful as fractional laser therapies. Needling cuts down scar tissue and encourages the production of new collagen. Lasers provide controlled heating of the dermal membranes, leading to greater collagen relaxation and more successful scares revision.
8. Dermabrasion
Laser treatment have now largely replaced full dermabrasion.
WHAT ARE THE HOME REMEDIES FOR TREATING ACNE SCARS?
Various remedies are available to treating the acne scares at home. This treatment takes time but have no harmful effect; including
• Salicylic Acid
• Retinoid
• Alpha Hydroxy Acids
• Lactic Acid
• Coconut oil
• Shea Butter
• Aloe Vera Gel
• Raw Honey
• Baking Soda
• Lemon Juice
WHAT IS THE LIKELY OUTCOME OF ACNE SCARRING?
Improvement rather than complete removal or “cure” is the ultimate purpose of healing acne scars. The degree of change depends on the type of scar and the individual’s skin colour. The acne scars of each person poses a particular challenge for the specialist. Treatments, along with the preferences, tools and standards of the practitioner, are customised to the aims, tolerances, acne scar form and skin type of each person.
Treatment of darker skin types is especially difficult as laser therapy can be associated with post-treatment colour changes, most commonly seen as transient darkening of the skin. The use of conservative conditions, fractional lasers, post-procedure fading creams and photoprotection will help produce appropriate outcomes in this subgroup of individuals.
IS IT OK TO PUT VASELINE ON ACNE?
Vaseline can trigger the outbreaks of pimples on acne-prone skin. There are some other lotions and moisturizers to moisturize our face but don’t put basil or petroleum jelly.
CONCLUSION
Acne scarring is a major problem for many people even for men and women. Fortunately it is treatable condition. Using a detailed scare mobile program, nearly all acne scars can be dramatically reduced or eliminated without any expensive procedures as well as there are some natural remedies which can eliminate it with the passage of time. But no doubt, acne scars are disgusting and effects the personality badly.