Skin scarring, especially atrophic acne scars (or what many of my patients refer to as pitted or depressed scars), is such a common skin woe that can seriously affect many people regardless of severity.
Acne scar treatment - with its wide array, is unsurprisingly overwhelming for most patients who are looking to start their treatment. They range from:
- Different fractional resurfacing lasers
- Microneedling RF
- Pico lasers
- Subcision
- Chemical peels
- Fillers
- Rejuran S
- NeoGen Plasma STAR
A few important factors that would first go through my mind when selecting a scar treatment include:
- Severity and amount of scarring (E.g. an isolated but deep box scar left after an unfortunate chickenpox infection might do well with just one punch excision and possibly a session of laser after to enhance healing; while someone with less deep but more extensive scarring would require a full course of laser resurfacing.)
- Type(s) of atrophic scars that are present (and what predominates)
- Skin type and overall skin condition of the individual
- Lifestyle preferences
Atrophic scars can be an ice-pick, box or rolling scars. Different types of scars guide initial treatment selection. E.g. more fibrotic rolling scars usually need subcision with laser; box scars CO2 laser resurfacing.
Some patients have predominately one type (e.g. icepick scars on the nose). But many patients suffering from more extensive significant scarring often have a combination of different types of atrophic scars. Hence, in reality, a combination treatment approach is often required for more effective and efficient treatment in this group.
I've seen significant improvements with SmartXide CO2 laser in many patients over the years, alone and in combination with other modalities like subcision, natural fillers, and Rejuran. But it might not be my first choice in every person walking into the door, depending on their skin type, overall skin condition and whether they are able to tolerate any social downtime such as a few days of skin redness.
For patients who seek acne scar treatment but are still battling breakouts, I think a treatment such as NeoGen Plasma skin regeneration would be a good starting point since this would help them gain better acne control whilst starting to improve new and remodel the older mature scars.
Whereas I see encouraging results with Sylfirm in someone with sensitive skin that's prone to breakout and is troubled by persistent red scars and some depressed scars.
I hope that helps…a little. I think the overwhelming range of modern treatments is actually a good thing. That offers choices and possibilities because each of us not only has a different skin type, scar types or severity, but our bodies can react and heal very differently with various treatments as well.
I hope you will find a doctor whom you can communicate comfortably with to guide and fine-tune your scar repairing treatment regime soon.
