Dr John Anne asked:


Acne is a skin problem typically occurred as a result of clogging up skin pores by dead cells mixed with skin oils. Acne scars are typically categorized under three heads, as described by Jacob et al (2001). According to this categorization system, icepick, rolling and boxcar are the three types of acne scars prevalent worldwide. Icepick is the type of acne scar that refers to as a sharp narrow scar resembling like punctured with an icepick. This type of scar is narrower than 2mm and is lengthened through the deep dermis or subcutaneous layer.

Icepicks can not be cured with regular skin resurfacing treatments such as laser resurfacing or dermabrasion as because they are so deep down through the skin. Rolling scars are typically occurred on the subcutaneous tissues below normal appearing skin. These types of scars can be treated by rupturing up the subcutaneous fibrous bands. The third category on the list is boxcar scar which is generally found on the skin as a round to oval depression along with sharp vertical edges. This article sheds light on various segments associated with the acne scar treatment and its usages.

In practice, there are several methodologies that can be used as a mode for acne scar treatment; however, you need to be selective by analyzing its probable risks and benefits. In some cases, doctors and dermatologists prefer to recommend a combination of treatment, rather than using any single acne scar treatment. Let us explore few effective acne scar treatment procedures.

Dermal Fillers

There is a wide range of dermal fillers that can be recommended by dermatologists ensuring to provide a smoother look on the skin. It is injected on the skin to make the surface raised. Typically, human collagen, polytheyl-methacrylate micropsheres with collagen, bovine collagen, hyaluronic acid derivatives and fat are used as dermal fillers. However, these fillers do not offer any permanent solution, hence further injection is necessary.

Laser Resurfacing

Many skin problems get cured by laser surfacing. Two types of laser surfacing are commonly used – carbon dioxide and erbium: YAG. It follows the mechanism of skin burning of outer skin layer to a specific depth. The healing process is followed with a restructuring of skin texture using newer appearing skin. The post-operative phase matters a lot for ensuring the actual success of the surgery.

Punch Excision

It is essentially used in boxcar and icepick types of acne scar treatment. A punch biopsy tool is used as according to the size of the scars. Scars are expunged with the help of the punch tool and the open skin edges are stitched up together. This newly developed scar however fades in time.

Skin Graft Treatment

This is an extended part of punch excision, a type of acne scar treatment. In this method, open skin edges are not stitched up rather the scar area is grafted with skin taken from the back of the ear. At the post-operative phase, variation in color and texture may be noticeable; however, it can be corrected successfully using laser resurfacing technique.

Punch Elevation

In this method, a punch biopsy tool is used to remove the base of the scars. After removing, the punch tool is used to elevate the base and to attach it to the surface area of the skin. This acne scar treatment is beneficial in terms of reducing the risk of getting skin in different color or texture.

Subcutaneous Incision

This method is particularly useful for treating rolling scars. It works by breaking the fibrous band which is responsible for developing rolling scars. The process is done using a beveled needle below the skin. It is kept parallel to the skin surface and then the needle gently cuts tethering bands. There are mainly two apparent risks associated with this procedure. One is bleeding and the other one is development of subcutaneous nodules. However the possibility of risks can be minimized with appropriate medications.