What causes acne scarring? There are different kinds of acne scarring which can be textural and/or contour irregularities such as:
- ice pick scarring
- atrophic scarring
- hypertrophic scarring.
Ice pick scars are deep pitted scars with steep edges. Atrophic scars are pitted but have smooth borders and are not as deep. Hypertrophic scars, more common on the back and chest, are thick lumpy scars that sit above the surface of the skin.
Color changes in acne are more common than scarring and can resolve but may take years to completely disappear. Color changes come in three basic varieties: post inflammatory erythema (pink and purple patches at the site of acne lesions), post inflammatory hyperpigmentation (brown/black discoloration at the site of the acne lesion), and post inflammatory hypopigmentation (white marks at the site of a healed acne lesion). Post inflammatory hyperpigmentation is very common in those with darker skin tones or in those who tan easily and can significantly worsen the appearance of acne.
What is the procedure for treatment of acne scarring? Acne scarring is permanent but can be treated. No treatment is 100% effective and the best result is improvement, not perfection. Treatment of scarring may require a combination of treatments. I achieve the best results by surgically excising the deepest scars if required and then using fractional CO2 laser resurfacing to treat all the remaining scars (Fraxel:Repair). Some shallow depressed hypotrophic scars may also require dermal fillers or subcision to finish off the result.
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