Acne scars are of 6 types- Brown, white, red, papular, depressed and keloids. Medicines have a role in red, white and brown scars, but, you would need multiple procedures at a dermatologist clinic to treat depressed or raised scars.

In this article, I have compiled treatment options for different types of acne scars. At the end of the article, we have an interview with celebrity dermatologist Dr Rinky Kapoor on the role of LASER on acne scars.

Type of acne scars and treatment

 

Brown spots:

brown or black spots occur after healing of bigger red or pus-filled pimples, especially if you squeeze them.  These dark spots are called post-inflammatory hyperpigmentation. They respond nicely to skin lightening agents like glycolic acid for non-sensitive skin and niacinamide/lactic acid for sensitive skin.

BRANDS RECOMMENDATIONS:

  • The Ordinary The Ordinary Lactic Acid 10%:  Apply this serum on the dark spots at night for sensitive skin. You can apply it on the full face after your dark spots fade for even skin tone and gentle exfoliation of lactic acid.
  • StBotanica AHA Glycolic Acid 8% Face Serum: can be used on dark spots at night for non-sensitive skin. Once, dark spots fade away, apply this serum on full-face for improving skin tone, exfoliation and anti-ageing effect. Stop if it causes irritation. Do not use in the morning even with SPF.

 

Red scars:

They appear if the red pimple is left untreated or squeezed. They are stubborn and take time to vanish without treatment. In most cases, they turn to depressed scars over a period of 3 months, if left untreated.

You can use Hexilak gel twice a week on red scars, benefit will be evident in 1-3 months. If you don’t see results, then consult a dermatologist.

Depressed scars:

Bigger pimples might leave depressed scars after healing. These are of 3 types:

  • Icepick scars have a narrow mouth but are deep, they look like big open pores.
  • Box scars are big crates like shallow scars with sharp edges
  • Rolled scars are big crates like shallow scars with sloping edges

 

Depressed scars do not respond to any medicine or home remedy, especially if they are older than a month or two. The reason is that there is a loss of skin tissue, that can be only regenerated by procedures at dermatologist clinics. These procedures involve microscopic controlled injury to the skin, following which new skin cells form in epiderms and new collagen in the dermis. The new skin is much more youthful and blemish-free compared to that before the treatment.

The scars approve gradually, results are evident in 3 rd sitting and you might need 5-7 sittings if your scars are big or old. Therefore, early treatment is advocated for reducing acne scars.

 

Here is the list of procedures available for acne scars:

Micro-needling:

  • Device: This procedure uses a dermapen to make microscopic holes in your skin.
  • Response rate: varies from 30-50% after 5 sittings.
  • Downtime: Skin stays red for 3 days.
  • Best for: This is the treatment of choice for those who are still breaking out because it also helps in reducing acne in long term as per my experience.

 

Non-ablative lasers like Erbium glass lasers

  • Device: LASER is used to make microscopic holes in your skin.
  • Response rate: varies from 50-60% after 5 sittings.
  • Downtime: Skin stays red for 3 -7 days.
  • Best for: This is the treatment of choice for those who have mild to moderate acne scars especially box scars and rolled scars.

 

MNRF

  • Device: This procedure uses a device that has releases radio-frequency energy through micro-needles that are used to make microscopic holes in your skin.
  • Response rate: varies from 50-60% after 5 sittings.
  • Downtime: Skin stays red for 3 -7 days.
  • Best for: This is the treatment of choice for those who have moderate acne scars.

 

Fractional CO2 LASER:

  • Device: This procedure uses a Fractional CO2 LASER to make microscopic holes in your skin.
  • Response rate: varies from 60-70% after 5 sittings.
  • Downtime: Skin gets red and then turns dark, exfoliates over 7-10 days.
  • Best for: This is the treatment of choice for those who have very bad acne scars, who are not responding to the above treatments.

 

Papular scars:

They appear as round skin coloured bumps, commonly on the chin and back. These can be removed by dermatologists with help of RF machine.

Keloids:

Severe nodulocystic acne might heal leaving big raised scars much bigger than the original cyst because unchecked scaring process. These can be treated by dermatologists with help of injections.

White spots:

Rarely, pimples might heal with loss of pigment. In this case, it is advisable to consult a dermatologist to stimulate pigment as soon as possible with prescription-based medications.

ROLE OF LASER IN ACNE SCARS

We did an interview with Dr Rinky Kapoor, (a celebrity dermatologist who had been part of consultation panels for Femina Miss India pageants and Dance India Dance) on the use of LASER for acne scars. She can be reached at www.theestheticclinic.com, and her blogs can be read at www.rinkykapoor.com Read further to know her experience on the use of LASER treatment on acne scars.

Which type of LASERS is used for treating acne scars?

Dr Rinky: Acne scars are best treated with fractional ablative lasers, more specifically the fractional carbon dioxide laser. Occasionally, fractional radiofrequency treatments may be combined with the above to give desired results. Non-ablative lasers like Erbium glass lasers help for milder scars.

How is LASER treatment for acne scars performed?

Dr Rinky: LASER for acne scars should be performed by a dermatologist/plastic surgeon trained in laser operations, that too on Asian skin types. After applying an anaesthetic cream for about 1 hour to make the skin numb, LASER shots are given to the skin in multiple passes in the affected areas. This takes about 15-20 minutes. The parameters used for each patient differs depending on the sensitivity of the skin, depth and extent of scars, skin colour of patient, etc. After the session, ice is applied to soothe the skin and the patient can return home once the procedure is done.

How many sessions are needed to achieve the results?

Dr Rinky: Depending on the age, depth, the extent of scars, skin colour of patient, etc. 3-6 sessions are needed for achieving desired results.

 

Can anyone make out that I am taking LASER treatment for my scars?

Dr Rinky: Post-treatment there is redness and occasional swelling of face for 2-3 days, after that there are tiny brown spots in the treated area for a day or so, and then the skin brightens up and returns to normal. Fresher skin is much more youthful and blemish-free compared to that before treatment.

 

What are the common side effects of this treatment?

Dr Rinky: The common side effects are:

  • Burning sensation immediately post-treatment for 3-6 hours.
  • Redness and occasional swelling for 2-3 days.
  • Dryness of skin for a week or so.
  • Sun sensitivity for a few weeks.
  • Brown spots on the treated areas for 2-3 days.
  • Pigmentation/long term redness especially in dark-skinned patients if the treatment is not done by an expert.
  • Reactivation of herpes and other skin infections in susceptible individuals.

What is the average cost of LASER sessions for acne scars?

Dr Rinky: Rs. 25,000 for the entire face, Rs 12,000 for scars on cheeks, per session. This is one-third the rates charged in the USA or Europe, for the same treatment. LASERS are the best hope for all those who wish to get away with their acne scars, and now you all know what to expect from such treatment and how they are done. So, if you can afford one, step into a cosmetic dermatologist clinic and embark on the journey of clearer skin.

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