Which is the best method to treat boxcar acne scars? (photo)

Doctor's Answer

Acne scars can be classified into hypertrophic or atrophic in nature. Hypertrophic scars are usually thickened and raised lumpy scars, which are usually more common over the chest and back but can occur over the face as well. With regards to the face, 80-90% of the time, atrophic scars are formed as sequelae of acne. This is due to the aberrant production and degradation of collagen during the inflammatory and healing process of acne, which leads to a net destruction of collagen and loss of volume. Atrophic acne scars include ice-pick, rolling and boxcar scars, based on their depth and size of destruction.

Boxcar acne scars can be treated with resurfacing lasers such as fractional CO2 laser, radiofrequency micro-needling(INFINI) to induce collagen production and volumisation of the scar, as well as using Picolaser(PICOSURE)'s Diffractive Lens Array(DLA) technology to create Laser-Induced Optical Breakdowns(LIOBs) beneath the surface of the scar. This creates a powerful stimulation of the healing cascade which allows the skin to rejuvenate and heal/repair scars by the formation of new collagen and elastin, but with shorter downtime and discomfort. This is also suitable for rolling scars and ice-picks scars.

Ice-pick scars are best treated with TCA CROSS, chemical peels and in some instances, punch excision. Rolling scars are best-treated with subcision, radiofrequency micro-needling(INFINI), fractional lasers. And as mentioned above, rolling scars and ice-pick scars show marked improvement with the new Picolaser(PICOSURE)'s DLA technology. Shallow atrophic scars can also be treated with fillers after improvement with the above modalities.

In my practice, I adopt a combination therapy approach and employ different treatment modalities to treat acne scars. From the picture, you do have a combination of different scar types and you should get a proper assessment by an experienced doctor who will discuss with you the best options to treat your scars.

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