Effective Acne Scar Treatment Option
Acne is often a temporary skin disorder, most often caused by hormones, excess oil production, bacteria or when hair folicles are clogged by oil and dead skin cells. Acne scars are most often the product of an inflamed lesion, such as a papule, pustule, or cyst. Inflamed blemishes occur when the follicle, or pore, becomes engorged with excess oil, dead skin cells, and bacteria. The pore swells, causing a break in the follicle wall. If the rupture occurs near the skin’s surface, the lesion is usually minor and heals quickly. When more serious lesions arise, deep inflammation happens, causing a deep break in the folicle wall, with infected material spills out into the dermis and destroying healthy skin tissue causing the dermis to be damaged and form scars on the skin.
To repair the damage done to the dermis, the skin forms new collagen fibers. Collagen is the fibrous protein that gives the skin its strength and flexibility. Unfortunately, the finished “”repair job”” never looks as smooth and flawless as before the injury.
Inflammation is the single greatest gauge of scar development.
The greater the inflammation on the skin, the more likely scarring is to occur. Deep breakouts that take a long time to heal also increase the chance of scarring. Blackheads, whiteheads, and other non-inflamed blemishes typically don’t cause scarring because these types of lesions don’t injure skin tissue.
Types of Acne Scars.
Acne scars are a common problem that affects many people both young and old. It can cause distress and affect the self-esteem and self confidence in many people. To recommend the most suitable treatment for you, we must first identify the types of scars you may have, in order to conclude the best treatment for your skin.
Acne scars fall into two main categories: those caused by a loss of tissue (atrophic scars), and those caused by an excess of tissue (hypertrophic scars). Within these categories, there are four main types of acne scars: ice pick, boxcar, rolling, and keloid scars. Often, what is taken to be an acne scar is not a true scar at all, but rather post-inflammatory hyperpigmentation (PIH). This temporary discoloration of the skin will eventually fade on its own. Certain treatment medications, such as Dual Yellow Light and Retin-A, may speed the fading time.
How does RF subscision acne scar treatment treat acne scar?
Acne scars are often very difficult to treat. While fractional Laser is excellent for treating some acne scars, subcision acne scar treatment is a clinically proven treatment that is specifically beneficial for people with depressed scars such as rolling scars and boxcar scars. In this treatment, a blunt special RF cannula will be inserted under the skin, where the radiofrequency waves will be emitted to break and subcise the underlying fibrous tissue thereby releasing and lifting the depressed scar, restoring the smooth contour of your skin. In fact, multiple healing processes bring about acne scar improvement. The mechanical action of the needle and release of the scar tissue creates a pocket of blood beneath the skin. Blood vessels which are disrupted during the subcision allows blood to accumulate into the treated area. This blood clot prevents short-term reattachment of your scars and contains growth factors for healing. This creates an environment for collagen regeneration and improvement of your scar appearance over time.
The radiofrequency waves will also stimulate new collagen formations improving
- Skin complexion
- Skin elasticity
- Skin lifting
- Facial contouring
- Reducing wrinkles
The treatment for this RF subscision acne scar is almost painless and comfortable. There will be minimal bruising and bleeding as it uses a blunt cannula, however there will be no downtime. You can resume to your daily activities immediately. Only a few skin insertion points are required as each entry point covers a large area. Apart from the volume treatment, the subcision can also be filled with injectables to help boost skin regeneration and anti aging simultaneously.
Treatment for The Different Types of Acne Scars
1) Ice pick scars are deep, very narrow scars that extend into the dermis. The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice pick scars seem to make a small, thin, deep hole into the skin. Some may look like a large, open pore.
How They Develop: Ice pick scars develop after an infection from a cyst or other deep inflamed blemish works its way to the surface. Skin tissue is destroyed, leaving a long, column-like scar.
2) Boxcar scars are round or oval depressions with steep vertical sides. Wider than ice pick scars, boxcar scars give the skin an uneven, pitted appearance.
How They Develop: When an inflammatory breakout destroys collagen, the tissue is lost. The skin over this area is left without support, creating a depressed area. Boxcar scars can be superficial to severe, depending on the amount of tissue lost.
3) Rolling Scars
This type of scarring causes rolling or wave-like depressions across otherwise normal-looking skin. Rolling scars differ from boxcar scars in that they aren’t sharply defined. The skin itself looks uneven and craggy.
How They Develop: Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. These bands pull the epidermis, binding it to deeper structures of the skin. It is this pulling of the epidermis from within that creates the rolling appearance of the skin.
4) Hypertrophic and Keloid Scars
Hypertrophic scars are raised, firm scars that grow above the surface of the skin. Hypertrophic scars caused by acne are most often found on the torso, especially in men, but they can happen anywhere on the body. Hypertrophic scars are more common after a deep wound or trauma.
Keloids are a more severe type of raised scar. They differ from hypertrophic scars in that keloids grow larger than the original wound. They can send out raised, lateral shoots that expand much farther than the wound itself, and can continue to grown long after the original wound has healed. Some people are more prone to developing keloids.
How They Develop: Unlike ice pick and boxcar scars, hypertrophic scars are not caused by a loss of tissue. Rather, they develop because of an overproduction of collagen. In the case of keloids, it’s like the skin doesn’t know that the wound has healed, and continues to produce collagen.
5) Post-Inflammatory Hyperpigmentation
Discoloration left on the skin after a pimple has healed isn’t a true acne scar, but rather post-inflammatory hyperpigmentation. It’s incredibly common for people with acne. Post-inflammatory hyperpigmentation is a flat area (neither raised nor pitted) that ranges in color from pink to red, purple, brown, or black, depending on your skin type.
How It Develops: Post-inflammatory hyperpigmentation develops when a wound, rash, pimple, or other trauma causes skin inflammation. As the skin heals, it produces too much melanin (the substance that gives skin its color) leaving a darker area.
Doctor’s Advice & Recommendation
Why is subcision one of the recommended Acne Scar Treatment?
There are no risk of Post-inflammatory Hyper-Pigmentation and patient able to see visible results instantly and this treatment is versatile as it is able to treat almost all scar type.
How do I know that subcision for acne scars is the procedure for me?
The most important step to treat acne scars is to identify your scar type.
Rolling scars as well as bound-down and tethered scars need subcision treatment. If you see a depression/ dent when you smile or talk, this means that your scars are attached to the underlying structures such as the muscle layer and SMAS. Lasers cannot penetrate to the depth of muscle layers – not even with deep microneedling devices. Hence, you will need more than lasers to remove these stubborn scars.You will need subcision to release those tethered scars.
What Type Of Scars Are Suitable For Subcision?
Subcision is an excellent treatment option for the following types of scars:
Rolling acne scars
Stretchable scars from injury or surgery
Can subcision for Acne Scars be combined with other acne scar treatments?
Mixed acne scarring is the most common form of acne scars. Therefore, combination treatments are necessary for acne scar revision.
Most patients who have acne scars will have a variety of scar types including rolling, atrophic, ice pick scars, together with boxcar scarring. I usually combine subcision together with energy-based devices like RF microneedling or Erbium Yag lasers and ablative RF technology to treat.
In summary, subcision for acne scars is a very useful modality for the treatment of acne scar types. I have always prefer to use a combination of laser treatments with subcision for optimal acne scar results.