Surgical or cosmetological treatment options for removal of acne scars are many. The choice of treatment depends upon the cosmetic disfigurement, type and depth of scar and the expertise available at the treatment center.
Principles of Surgical Removal of Acne Scars
Surgical removal or cosmetological treatment of acne scars are based on three major principles:
- Resurfacing or abrading the surface of the scar and surrounding healthy tissue so that new epithelization occurs: This is useful in superficial scars. Resurfacing is done through chemical peels, exoderm lift, cryoslush, laser resurfacing and lights.
- Filling the depressed scar: Scars are more visible due to the shadow of the sloping sides in deep acne scars. This is rectified through injection of dermal fillers and raising the base of the scar to the surface level.
- Interventional Surgical Procedures to remove or correct the acne scars, like dermabrasion, punch excision, subcision, acne scar revision, soft tissue augmentation etc.
Surgical and Cosmetic Procedures to Treat Acne Scars
The common surgical and/or cosmetic procedures to treat acne scars are described below:
- Chemical peels: Superficial and shallow acne scars may be treated with chemical peels. Commonly used chemical agents in peels are trichlor acetic acid (TCA), glycolic acid, phenol, salicylic acid, lactic acid, tretinoin and resorcinol.
- Dermabrasion: Dermabrasion is used in the treatment of both shallow and deep acne scars. They are also useful to get rid of hypertrophic acne scars. The superficial layers of the skin and scar tissue are abraded with the help of a high speed rotating brush with a diamond tip. Micro-dermabrasion using aluminum oxide crystals are also effective in getting rid of superficial scars.
- Exoderm lift: This is a risky procedure that could produce a dramatic result in getting rid of deep acne scars and hypertrophic acne scars. If not done cautiously, though, the procedure can scar the face for life. Hence a small test area is first treated with the combination of chemicals including phenol, resorcinol, citric acid etc and natural oils (total about 12 components in the exoderm lift).
- Needle Subcision of Individual Acne Scars. Cutting off fibrous sheaths beneath depressed atrophic acne scars releases the scar and brings it to the surface level making it less conspicuous.
- Acne Scar Revision. Each acne scar is dealt with on its own merit and corrected with surgical procedures including excision, subcision, punch float, graft etc.
- Laser Resurfacing of Scars. Lasers act in different ways to improve the acne scarring: resurfacing and tissue augmentation. Fractional laser and laser ablation are useful in treating superficial and medium depth acne scars.
- Cryoslush. Cryoslush or cryo-peeling with CO2 snow results in peeling and remodeling of the scar tissue.
- Soft-tissue augmentation. The depressed acne scars are lifted by infiltrating the dermis with artificial fillers. This is temporary and has to be repeated every six to eight months.
- Electrodessication can be used to remove hypertrophic scars.
- Excisional surgery is performed along with grafts and/or resurfacing techniques to treat medium and deep scars in some cases.
It is to be noted that keloidal tendency is an absolute contraindication for almost all of these procedures. Keloidal acne scars are treated with intralesional steroids injections, intermittent topical steroids and application of silastic gel sheets for larger keloids.
The latest techniques introduced into the surgical treatment of acne scars have given new hopes and cosmetically satisfactory results to the acne sufferers worldwide.
Acne Scar Surgical Treatment: Related Articles
- Acne Scar Treatment: Management of the Scarring Caused by Pimples. Acne scar treatment depends upon the depth and extent of scarring and the type of the pimple scars.
- Medical Treatment of Acne Scars: Non-surgical Management of Acne Scar. Medical or conservative treatment is suitable for superficial or shallow acne scars and acne skin blemishes.
- Acne Scar Removal with Chemical Peels: Using Peeling Agents to Remove Acne Scarring. Among acne scar removal non-surgical techniques, chemical peels are the most effective procedure for superficial acne scarring.
Sources:
- Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009; 60:S1-50.
- Simpson NB & Cunliffe WJ. Disorders of the Sebaceous Glands in Rook’s Textbook of Dermatology. 2004; 7: 43.1-43.75.
Disclaimer
The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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