Acne Scar Removal

Acne is a frustrating skin condition that can affect people of all ages. Even though we feel isolated in our battle; acne actually affects up to 75% of adults and teens, at some time in their lives. While active, the goal is to be rid of it. Once it has calmed down, our thoughts move to finding a way to remove the scarring that can occur with and after being afflicted with acne.

Here is a snap-shot of how acne scars make an impact: acne scars effects millions. It is a billion dollar industry, and the millions who suffer seek help from ads, dermatologists and surgeons, every year. Perhaps you are one of them.

When looking for ways to remove acne scars, it is best to learn about the different type of acne scars and the best ways to reduce or eliminate the appearance of acne scarring.

There are different types of acne scars, but here are the primary types:

• The most common form of scar left by acne is the atrophic scar (concave 'pock' mark). Whether raised or dipped, the margins of the scar tissue do not match the level of the other skin on our face or body. The objective in scar removal is to reduce the scar, or surrounding skin, to a smoother, more even level or eliminate the scar, altogether, if possible.
• Hypertrophic, or a raised scars are called; hyper pigmentation - which leaves the skin on the same level, but leaves a discoloration which does not go away.

When acne has been brought under control; it can be a relief - but, the scarring it leaves behind can result in loss of confidence in our appearance. Wanting to 'put our best face forward', it is understandable that the business of combating acne is very viable. But so much of the industry is focused on treating the condition, it isn't always as apparent what to do afterward. At that point, what we really want to know is, "What is the best method of removing the scars; and how can I get started in finding out what will work for my skin, my scars and my expectations."

What Causes Acne and Scarring?

There are different causes for acne - hormonal, clogged pores and oil glands, bacteria, poor diet, folliculitis (inflammation of the hair follicle) and other reasons. However, the end result is the skin follicle becomes blocked, and expands. Because it is unsightly, many people have the urge to 'make it go away faster' by squeezing, probing or picking at it. This is counterproductive, and can increase the likelihood and severity of scarring. When the infection or 'clog' has been removed, the skin contracts again - leaving a pit in the surface layers of the skin. When severely disturbed, a raised bump, or 'keloid scar' - which is generally shiny, fibrous, pronounced, and often discolored will appear - where there was once smooth, level skin and smaller pores.

Different Skin Types, Acne and Scarring:

• Fair or thin-skinned individuals have more fragile skin that scars rather easily, and a tendency toward slower healing and pigment changes.
• Olive complexions have skin that is more resilient, and is less prone to severe scarring. In addition their collagen can be rebuilt more readily.
• Black skin is supple, but depending upon the depth of the scar, can cause severe pigment discrepancies (deep scars can actually show up as much lighter or darker). It is imperative that each factor be taken into consideration, and the treatment tailored accordingly.

Over-The-Counter Acne Scar Treatments

Because acne is condition that affects many people psychologically, as well as physically, we will do anything to rid ourselves of it. The science of acne treatment is a billion dollar industry and competitors want us to be convinced that "their system" is the magic wand you are seeking. Trying to choose between treatments can be confusing, whether cosmetic and dermatological or more invasive, like skin resurfacing. Whether we turn to our local pharmacy, makeup counter or are provoked to purchase products that are sold via televised commercials and the internet; everyone is looking for products that will work for them. And for mild or temporary cases; over-the counter-exfoliators, Benzoyl Peroxide gels and creams, salicylic, alpha-hydroxy, glycolic, lactic acid products, anti-bacterial washes, and the like will take care of a certain percentage of acne cases with a minimum of scarring.

For mild scarring, there are over-the-counter products (such as Mederma, various lightening lotions and gels, self-dermabrasion kits) that can help reduce the discoloration and appearance of acne scars. These products contain very small percentages of active scar removal, or pigment lightening ingredients to reduce the likelihood of burning the skin or complications that can the scarring worse. The results are expected to be proportionate to the small percentages of active ingredients. Regardless, they should be used cautiously. As laymen, most people are not trained skin experts, and the results can vary greatly. These products should always be applied to a small area first to test for a possible allergic reaction.

For more stubborn, prolonged or severe cases, a licensed dermatologist or scar removal specialist is highly recommended. Of course, ideally; trained professionals are best able to assess your individual needs, and assess the scar removal products and procedures that will work best with the type of scar(s) you are having treated, and your personal skin type.

Because healed tissue that results in a scar is harder and less supple than the surrounding skin, this creates a 'disruption' in the skin's natural collagen production and results in collagen building blocks. Left untreated, they can affect the surrounding skin, and elasticity, which may become more pronounced as we age. The sooner scarring is addressed, the better the results can be. However, it is never too late to explore our options; and as technology continues to grow by leaps and bounds - the more viable scar removal choices we have at our disposal.

Cosmetic Acne Scar Removal Treatments and Laser Procedures

Choosing the correct method for your scar removal will be accomplished between you and your scar removal expert, but here is a basic explanation of some different procedures that are used (singularly, and in combination with each other) in effective scar removal treatments.

Laser skin resurfacing offers many different systems to remove scars. There are various laser manufacturers and FDA approved systems. Laser skin resurfacing aids in scar reduction and elimination by ablating the outer most layers of the skin, resulting in a smoother appearance. Laser procedures are used to diminish scars by peeling away raised areas, and leveling scars and their boundaries to match the surrounding skin through use of heat. In essence, it is a laser-aided form of dermabrasion, intended to remove dead skin cells, stimulate collagen, and give the skin the ability to regenerate fresh cells.

Keloid Scar Removal:

Keloids are raised scars caused by overgrowth of the collagen fibers that assist in the healing of wounds, and continue to move beyond the boundaries of the original wound (and sometimes continue to grow or change with time). They are typically rubbery, shiny and fibrous - often with pigment that differs from the surrounding skin. They can also hurt or itch and affect surrounding skin. The darker the skin tone, the higher incidence for forming keloid scarring. There is also speculation that it can be hereditary. They are the trickiest scars to heal, and especially with acne, the necessity to try to avoid the development of keloids is important. Prompt attention to keloid scars is also suggested, to minimize or reverse the scarring as much as possible. The course of treatment would need to be carefully considered and discussed between you and your acne scar specialist, dermatologist or cosmetic surgeon.

Here are several treatments currently utilized to minimize keloid damage and growth:

• Intra-lesional corticosteroids - steroid injections into the scar to reduce inflammation
• Excision - Cutting out the fibrous tissue.
• Silicone gel sheeting - used especially in individuals know to be prone to keloid scarring, and to prevent excess tissue from forming on mew injuries. Assists the hardened skin to become softer, and as a preventative measure, when possible.
• Cryosurgery - Freezing off the excess tissue
• Radiation therapy Interferon injections - For treatment-resistant keloids, or in conjunction with other methods.
• Pulsed dye laser - Laser that utilizes corrosive dye, circulated at very high speeds.

Mederma:

Mederma was once only available by prescription, but was eventually approved for over-the-counter sales to the public. It is a topical gel used to assist in diminishing mild scars. Its primary ingredient is derived from onions, which have scar-healing properties. Those with an allergy to onions (which is a basis of other OTC scar removal products, examples: Cepalin, and Contractubex), should seek other scar removal treatments. As with any topical remedy, read the label and ingredients carefully and perform a patch test first.

C02 Lasers:

Using non-invasive 'light technology', and carbon dioxide with a 10,600 nm infrared beam that is well absorbed by water in our cells - allows for scar removal at a deeper level, without the invasiveness and prolonged healing process of older methods. The Co2 laser targets the more superficial layers of the skin and is best known for excellent results in healing acne scars and resurfacing problem areas, with decreased healing time. Below are specific brand name treatments:

• Deep FX & Total FX CO2 Laser: Deeper resurfacing and all -over skin tightening, scar and damage removal.
• Active FX: A fractional laser procedure that produces dramatic results in one session (so that you can return to your normal routines rather quickly.

Profractional Laser Removal

Fraxel Laser:

There are three varying levels of Fraxel treatments that range from a very minimal option for "freshening" the skin - through the correction of severe damage. Depending upon your personal requirements, you can opt for a single treatment or a series of treatments (it may be that different units are used for different results).

• Fraxel re:fine is a good choice for a 'youthful pick me up'; minor pigmentation, uneven skin tone, fine lines and acne scars, and would be considered more of a preventative maintenance treatment. The recovery time is quite short. Many patients return to their regular activities the same day.
• Fraxel re:store: is the most widely-used and popular choice, covering the range between mild and severe skin damage. It is suggested for moderate scarring (especially acne scars), wrinkles, pigmentation issues, and more. The recovery is only slightly longer: estimated at 1-2 days before resuming regular activities.
• Fraxel re:pair: is designed to handle severe damage, hyper pigmentation and deeper acne scars, while it tightens and diminishes unevenness. It has the added feature of being excellent at reviving loose skin and can be used as a pre-emptive facelift (in other words, it be used as a preventative measure against future loose skin). Even though the re:store can take on more difficult skin issues, the recovery time is still quite short, at an estimated 7 - 10 days until regular activities are resumed.

Co2 Fractional Laser (SmartXide):

This method is used to strip the skin of years of damage and scarring. The Co2 Fractional laser delivers tiny columns of heat deep into the skin - removing old skin cells, inducing new collagen formation (which continues to build for months after the procedure) and skin tightening. The added attraction of this method is the faster healing time, and ability to have the procedure with only a local anesthetic or numbing cream.

The SmartXide Laser system has the advantage of variable settings to customize the level of heat necessary for your particular treatment. It is recommended for women with lighter skin tones, as it is quite effective at lightening the discoloration and uneven skin tones that acne can cause.

Erbium Laser Peel:

This procedure is used to tighten and smooth irregularities in pigmentation and texture of the skin. The Erbium Laser Peel is a computer-controlled, safer, milder form of peel with a short healing period. In comparison with a chemical peel, the Erbium Laser Peel is highly controlled for fine-tuned accuracy, to micro-customize the level of scar removal to each patient. The procedure generally takes less than 30 minutes, with only a topical or "twilight sleep" anesthetic. Depending upon your level of scarring, and needs, you may be eligible for 'The Weekend Erbium Peel' that can be administered on a Friday - allowing a person to resume their regular work, school or other weekday activities the following Monday. It is a wonderful choice for people who do not have the luxury of taking time away from their busy schedules or who may have fragile skin, milder scarring or medical conditions that would be better served by a less-invasive scar removal method. Additionally, depending upon where your scars are located, there are facial areas that are more delicate (such as the neck, lips and eyes). These areas can be safely and effectively treated without concern. The design and lower level of heat sloughs skin and increases collagen production like the other laser treatments, but at a lower level of penetration.

This advanced laser is quite an amazing technological breakthrough, which combines an optical fiber with the rare earth element, Erbium. The combination creates an intense, but more stable wavelength that provides the specialist with maximum effect, control and safety. Because it is a less invasive method of scar removal, it can also be combined with other treatments, such as Photofacial, Botox and dermal fillers.