It is fair to state that the medical or non-surgical treatment of acne scars is far from satisfactory. These conservative types of treatments are limited in their usefulness due to the superficial mode of action of the topical applications.
Acne Scar Medical Treatments
Most superficial acne scars are skin colored, but some of the scars may be brownish or grayish black in color. The aim of medical or non-surgical treatment of acne scars is twofold: one, to reduce the pigmentation, if any; and, two, to gently abrade the skin to remove the superficial scars and stimulate regeneration of new skin underneath.
Topical Applications Useful in Acne Scars
Most topical applications used to treat superficial acne scars are exfoliants which remove the superficial cells in the skin and cause mild abrasion of the skin to smooth the surface out.
- Topical Tretinoin: Topical tretinoin has a dual role to play in acne scars. It acts against normal acne bumps and also straightens out mild superficial acne scars. It loosens the epidermal debris and dead cells and removes them to give the skin a fresh, shiny appearance. By affecting the epidermal cell turnover, tretinoin help prevent blockage of the sebaceous and hair ducts and also plays a role in inhibiting inflammatory response within. Topical tretinoin is not effective in deep and medium depth acne scars.
- Glycolic Acids, from strengths 20-70%, are used as chemical peels and are useful in superficialacne scars.
- A combination of mandelic acid and salicylic acid is used as a peel and is useful in some types of superficial acne scars.
- Tap water iontophoresis with added tretinoin, estrogen and associated electric stimulation of skin (ESS) was found effective in reducing acne bumps and also fading superficial acne scars.
- Ablation of the scars with sterile needles followed by application of copper peptides improves the appearance of acne scars by stimulating collagen production.
- Topical steroids under occlusion may be used for short lengths of time for hypertrophic acne scars. These have to be used very carefully as they may initiate fresh attacks of acne bumps.
- Intralesional steroid injections and silastic gel sheeting are effective to reduce the size of keloidal acne scars.
- Hydroquinone 2-4%, Kojic acid 4%, Liqorice extract 10-40%, Arbutine 1%, Azelaic acid 15-20% are used in combination with the exfoliants to reduce the pigmentation of the scars. Topical tretinoin is sufficient in most cases to get rid of the pigmentation in acne scars, though.
- Finally, there are a number of camouflage creams available in the pharmacies which would hide the ugly acne scars and blemishes temporarily. The technique of application for camouflage creams for acne are similar to the camouflage of vitiligo patches, though tackling the depth is an important differentiating factor.
In addition to the above, there are many OTC products and home remedies purported to be effective for acne scars, the claims about the usefulness of most of them are unfounded and unpredictable. Some, like citrus fruit juices, contain alpha hydroxy acids which cause superficial exfoliation; but at the natural strengths, are unable to produce much improvement in acne scars.
Medical Treatment of Acne Scars: 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 pimples.
- Causes and Prevention of Treatment Failure in Acne: Why are the Acne Medications Not Effective at Times?. There are many causes for treatment failure in acne, including noncompliance, wrong choice of medication, improper directions and drug resistance.Acne Scar Surgical Treatment: Cosmetic Acne Scars Removal. There are a number of effective surgical and cosmetic treatment options for acne scar removal.
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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