There are different types of Acne Scars. Some scars are depressed, or atrophic, meaning they sit below the surface of your skin.
Why do indented acne scars occur?
Indented (atrophic) scars form when there is an injury or inflammatory reaction (e.g. acne) of the skin which results in the destruction of its underlying collagen fibres and fat. A depression results when the skin is unable to regenerate these tissues well. Indented scars can be broadly classified as ice prick, rolling and box scars.
Are there methods to prevent indented scars from forming?
In general, the formation of indented scars can be minimised by keeping a fresh wound clean, moisturised and covered with dressing, minimising wound tension via reducing movement to the affected area and not peeling off the scab formed. Specific to acne scars, the time till treatment of acne strongly correlates with increased risk of scar formation. Early treatment of acne using topical creams and lasers therefore can help to reduce subsequent scarring. Of note, topical retinoid (vitamin A) is an important and effective tool that interrupts the acne inflammatory process therefore preventing scar formation.
What treatment options are available to treat indented scars?
Selection of treatment options depend on the type of indented scars (ice prick, rolling and/ or box scars) and patient’s skin type (skin tone and sensitivity). Treatments can be classified as damaging (resurfacing lasers, radiofrequency microneedling and TCA cross chemical peel) or regenerative (Hyaluronic acid fillers versus bio-stimulators which can give longer lasting results via collagen stimulation). Subcision is first performed to release fibrotic tissues that pull the skin down causing indentation before regenerative products are injected via a blunt tip cannula. A combination treatment approach tailored to the patient and the type(s) of scars is the gold standard compared to using a single treatment modality. It is important that your physician is equipped with the skills and has the whole array of treatment options available to offer.
Will my skin become more sensitive after these treatments?
Fractional lasers for scar resurfacing are safe and do not result in more skin sensitivity in the long run provided that proper post treatment care is administered. Apart from routine usage of moisturiser and sunblock, important post treatment care include cooling with ice packs or devices immediately to reduce the heat generated from the laser procedure which can transiently increase skin sensitivity post-treatment. Other important strategies include the use of hydrating masks and topical medications such as a low potency steroid applied for a couple of days post laser. Subcision and filler do not cause more skin sensitivity and in fact helps to moisturise the skin.
Written by Dr. David,
MBBS,MRCS
8 Medical Aesthetic Clinic
Disclaimer: The material contained in this is for informational purposes only and do not constitute medical advice. The content is not intended to be a substitute for doctor’s advice, diagnosis, or treatment.
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