Acne scar treatment involves either light or laser therapy depending on the types of scarring you have. There are two types of acne “scarring” that can be left behind after a breakout. All it takes is one lesion to possibly leave long-term evidence of acne for years to come. First, there are two different types of acne scarring 1) post-inflammatory hyper pigmentation (aka red, purple or brown discoloration that slowly fades away) and 2) depressed scarring such as pock mark or ice pick scars caused by cystic breakouts. In order to understand what treatments are best, we need to explain what is physiologically occurring at the level of the skin with each of these types of scars.
Post-inflammatory Hyper pigmentation (PIH)
Post-inflammatory Hyperpigmentation, or PIH is the skins natural response to inflammation. PIH develops when a stimuli such as an acne breakout causes inflammation, which triggers the skin to produce too much melanin (aka pigment) as a protective measure. This pigment is produced in excess causing a red, purple or brown spot to be left behind weeks to months after a breakout has healed. PIH is typically caused by pustular and nodular inflammatory acne. The best acne scar treatment for PIH is an Intense Pulsed Light (IPL) due to its ability to target and lighten pigment that is darker than the surrounding skin color. Keep in mind, the IPL is only appropriate for light to medium skin types. If you have darker skin with PIH, your best option is a chemical peel. Your esthetician will make a recommendation on the best peel for you.
Good news- PIH is not truly a scar and will go away with time or quite quickly when treated with an acne scar treatment such as IPL or peel!
Depressed (Pock Mark or Ice Pick) Scarring
Depressed acne scarring is caused by loss of collagen after a cystic breakout and is unfortunately, a true scar. The nature of cystic acne is that it develops deep within the skin and continues to erupt and spread, destroying and breaking down collagen in the process. Collagen is what gives our skin thickness and volume. When collagen is lost naturally by the aging process or due to trauma in the area one will see wrinkles, lines, sagging skin or depressed skin tissue. Collagen is also responsible for youthful looking skin, the best acne scar treatments are laser procedures used to treat wrinkles and sagging are also used to treat acne scarring. The best laser treatments for depressed acne scarring are CO2. Ablative CO2 treatments are rather antiquated these days making Fractional CO2 laser the most effective and best acne scar treatment option. The CO2’s long wavelength gives it the ability to deeply penetrate the skin below the epidermis, which is where our collagen is located. The laser causes a minor injury and the body then responds by making new collagen and rebuilding the thickness of the skin.
Ineffective Acne Scar Treatment
It is also important to also talk about what will not work for (depressed) acne scarring. To improve the damage that has been caused to the collagen layer, treatments such as microdermabrasion, chemical peels, IPL and Yag lasers will not stimulate any result. This is because these treatments do not penetrate deep enough or at all in the case of microderm and peels therefore are a waste of time and money. In my clinic, I see people everyday with acne scarring and somewhere along the way they were either told or read that one of these treatments may work…please do your homework before committing to any procedures.
Fractional CO2 acne scar removal, along with other acne treatments, we perform in our Denver clinic. Feel free to email me any questions or book a complimentary 15-minute phone consultation to discuss what is best for you. I offer complimentary in-office consultations as well.
If you are not in the Denver area, I suggest finding a prominent physician in your area that does these treatments.