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Acne scars are the worst ever! They damage the skin texture and usually associated with an impact on your psychological state too…! However, the available treatment options are many and can deal with your acne scars perfectly within a short period of time.
The available acne scars treatment options can range from needling, surgery, dermal fillers, microdermabrasion, chemical peels, and laser applications that come in many different brand names that work by different mechanisms; creating a perfect and even skin surface.
If you already have acne scars and you don’t know how to deal with and you can’t decide which treatment option you have to choose and get perfect results…this type of questions could be only answered by your dermatologist that will examine your scars professionally and then decide which kind of treatment options is going to be used depending on the type of acne scars and its severity…What? Type? Severity?
Acne scars are not all the same, for you it is the imperfections that you would like to rid yourself of it, while, for your dermatologist they are types that are classified into three main categories as follows; Depressed, Raised, and Discolored type.
Regarding their names and features; they are as follows;
Type of acne scars that usually develop on the forehead and cheeks area in form of red and flat areas of mostly hypopigmentation. they may fade away on its own within a period of six months to one year, however, this is rare! The available treatment option, in this case, is laser skin resurfacing.
Based on research, it has been found that “Atrophic acne scars are more common than keloids and hypertrophic scars with a ratio 3:1. They have been subclassified into ice pick, boxcar, and rolling scars. With atrophic scars, the ice pick type represents 60%–70% of total scars, the boxcar 20%–30%, and rolling scars 15%–25%”
- Boxcar acne scar
Annoying type of acne scars that usually develop on the cheeks and temples in form of deep & broad depressions taking the round or oval shape, it is also associated with sharp, vertical, and defined edges. One of its characteristics is that it causes damage to the small area in comparison to other acne scar types.
- Ice-pick scars
They are mainly developing into the cheek area. Actually, this type almost resembles to boxcar acne scars as they are characterized by its deep depressions. however, they are narrow in comparison to boxcar scar size.
Either Boxcar scar or Ice-Pick scars; are very difficult to be treated by chemicals peels, or microdermabrasion due to its deep depth! Therefore, most of the dermatologists usually recommend using either “Trichloroacetic acid” (TCA) chemical peel, for the purpose of raising the depth of scar or using surgical excision procedure, followed by laser skin resurfacing procedure that can smooth the surface of the skin giving you great final look.
- Rolling Scars (Boxcar)
The most common type of scars that mainly affect your cheeks area due to inflammation of acne, they are characterized by its broad, rounded, and sloping edges depressions shape. Having rolling scars is no longer a problem because rolling scars are very respondent to most of the treatment options such as chemical peels, microdermabrasion, dermal fillers, and most of the laser applications
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Hypertrophic scars or Keloid Scars
Sometimes, scars could be developed due to abnormal wound healing process…how?
Those types of scars could be easily formed due to the presence of excessive scar tissue. Scars like hypertrophic or keloid scars are an example of this type with a little bit different such as; hypertrophic scars are usually developed after the injury while keloid scars are developed after passing long-time on the injury, another difference is that hypertrophic scars appear within limit boundary while keloid usually overgrows wound boundary. However, Both of them are characterized by their red, raised structure, and their itchy feeling.
Based on research, it has been that treatment options are available with the aid of laser applications such as “Pulsed dye laser or long-pulsed Nd: YAG laser therapy as the target of these lasers is the blood vessels. Thus, we speculate that laser therapy largely treats pathological scars by decreasing blood vessel numbers, thereby inhibiting the inflammatory signals arriving from the blood vessels.” in association with surgical excision if needed. Moreover, most of the dermatologists don’t recommend using chemical peel option as hypertrophic scars respond less to chemicals.
Red Erythematous Acne Scars
Type of scar that falls under the category of acne scars discoloration, it usually appears in form of small red scars that arise due to the damage or dilatation of blood capillaries found under the skin in association with the presence of acne.
Your dermatologist will prescribe some medications that mainly works on blood vessels dilation and will treat the affected area by laser applications such as a pulsed dye or argon applications that usually provide perfect results.
Laser applications are worldwide using in the treatment of different types of scars; we will provide you with a full guide for the available laser treatment options that is done through laser…keep scrolling.
When we talk about laser skin resurfacing, we usually classified laser into two categories which are;
1- Ablative laser
It is said to be invasive application or wounding laser application as it requires the removal of thin layers of the skin that is usually
Called the “Affected area”; They work by vaporizing the outer layers of the skin. As a result, the skin starts to remodel itself and start to produce more collagen, therefore, an ablative laser can be used for the treatment of acne scars.
Ablative laser comes in two different forms which are;
Co2 Resurfacing laser
The most familiar cosmetic procedure that uses a laser beam for the purpose of removing the affected skin “Acne scars”; many dermatologists said that the procedure is almost similar to other cosmetic procedures such as chemical peels, however, Co2 laser resurfacing works by vaporization instead of chemicals.
How co2 Resurfacing laser works?
Based on research, it has been found that; “The CO2 laser takes the CO2 laser beam and fractionates, or pixelates that beam into thousands of tiny little shafts of light. These tiny shafts of light penetrate into the deeper layers of the skin. The skin then repairs those tiny shafts by pushing out the old sun damaged skin and replacing it with new skin. The “collateral” heat damage also helps to shrink existing collagen”
How about its effect on acne scars specifically?
Generally, dermatologists usually recommend using co2 laser because unlike other treatment procedures; Co2RE provide a full control on the treated area and this is luckily a big advantage in treating acne scars especially when a person suffers from different types of acne scars in the same area.
Co2RE is also recommended for those who suffer from the following points;
- Moderate to severe acne scarring
- Large acne scars as it helps reduce their appearance
- Sharp and sloping edges as it helps gentle and minimize their sloping
Based on a published article entitled “Fractional CO 2 lasers for the treatment of atrophic acne scars” that is carried out by Department of Dermatology, Mount Sinai Medical Center, New York; it has been found that “There are a multitude of treatment options for acne scars including chemical peels, surgical excision, and fillers, but the advent of laser surgery has greatly improved our ability to treat patients with acne scars. Ablative resurfacing lasers employ an aggressive approach in that they heat and vaporize superficial skin layers, including the epidermis and upper dermis. The healing process induces neocollagenesis and collagen remodeling, which is responsible for the improved appearance of atrophic scars. Complications associated with ablative resurfacing include a long recovery period and considerable risk of adverse effects like infection, depigmentation, scarring, and discomfort.”
Moreover, you should be informed that Co2 laser application has two different ways for delivering laser into the skin which are;
- Active Fx laser; Offers treatment session that targets the superficial acne scars
- Deep Fx laser; Offers treatment session that targets deep acne scars
In conclusion, Active Fx and Deep Fx are same lasers that target different spot sizes.
Another laser system that found in form of ablative laser, that mainly used for the purpose of skin repair from acne scars, pigmentation inconsistencies, and many other skin problems.
How Er: YAG works?
Erbium laser works by generating a laser beam of a certain wavelength that has the ability and affinity to absorb water! Yes, water…our body is all about water under the skin, the laser system of this type is mainly attracted to water; therefore, a tissue that contains water is vaporized and the excess heat generated usually provide a high level of skin penetration as a result; all the affected skin is removed, associated with collagen remodeling.
How about its effect on acne scars?
Erbium considered as effective for those who suffer from mild to moderate acne scars. However, erbium considered as less effective for those who suffer from deep acne scars in comparison to co2 laser technique.
Based on research entitled “Treatment of acne scars using fractional Erbium: YAG laser”; it has been found the following:
- Fractional Erbium: YAG can be a safe and effective option for the treatment of acne scars and offers faster recovery time and fewer side effects.
- Fractional Erbium: YAG was associated with sustainable improvement in the appearance of all types of acne scars, which includes the softening of scars as well as the reduction of scar depth
- Most of the patients begun to show visible improvement following only one session.
It is said to be a less invasive application or non-wounding laser application as it usually works only by the “Stimulation of collagen” and this could be done as the laser heat up the fibroblasts and then stimulate them to form collagen.
Non- Ablative laser comes in two different forms that can perfectly treat you acne scars which are;
Pulsed Dye Laser (PDL)
It seems from the name that this type of laser requires using specific dye suspension and this dye substitute the laser beam role. Pulsed Dye Laser is said to be effective for treating active acne scars, reduces the acne symptoms by the inhibition of sebum production, and kills the acne cause bacterium that is called “Propionibacterium acne”.
The PDL could be perfectly teat the mild acne scar. However, it is not a good choice for treating severe acne scars because the PDL cannot penetrate the skin and reach the deep layer.
Nd: YAG laser
The terminology stands for Neodymium-Doped Yttrium Aluminum Gamet; this type of laser uses the same technique of Er: YAG as follows; This type of laser uses the infrared laser in order to heat up the water found underlying the skin, as a result; skin resurfacing occur, eliminating acne scars.
Nd: YAG laser considered as perfect for treating deep acne scars & the red erythematous acne scars. However, dermatologists didn’t recommend using this laser type in case of treating active acne scars.
3- Laser type found in Ablative and Non-ablative form
Fraxel Laser Technique
The widely spread laser option that works for creating fresh and healthy skin that is free of any kind of imperfections. Fraxel laser has many forms, one of those forms is Fraxel re:store that is considered as non-ablative treatment which works mainly by using a beam of laser that creates small zones and controlled micro-injury into the skin for the purpose of;
- Promoting rapid healing process
- Stimulating the collagen production
- Eliminating the affected skin “Acne Scars” and replace it with new one
The Fraxel laser can provide you immediate and noticeable results that continue its improvement gradually within the first 6 months as the collagen starts to restructure itself. The Fraxel laser has the ability to work on most of the acne scars types; however, Fraxel laser can only work on white to brown skin patients and this considered a disadvantage.
Last but not the least, acne scars are easy to be treated and the choice is less complicated with an excellent dermatologist and excellent guidelines.