The treatment of acne scars depends on the type of scarring it is. Typically, when a patient presents to me with acne scarring, I will treat each scar individually as required, and then consider fractional laser for the involved areas. The treatments of each indivicual scar depends on the type of scar and other features of the scar including width and depth of the scar, and what the edges are like.
My favourite treatment for suitable acne scarring is dermal fillers, especially hyaluronic acids, which include Restylane, Perlane orJuvederm. Patients LOVE this treatment as it takes about 30 minutes and gives an obvious instantaneous result.
My second favourite treatment for acne scarring is ablative fractional laser, where the laser causes hundreds of “pin holes” in the skin and new skin regrows. This only treats about 10% of the surface area of the skin, so multiple treatments are necessary to get decent results. I recommend a minimum of 5 treatments of fractional laser.
Other treatments I use for acne scars include subcision, punch biopsy, punch grafting and ablative laser.
If the scars are keloid then treatments might include silicon gel sheeting and intralesional steroid injection.
A factor that is often overlooked in the management of acne scarring, is that acne scarring often gets worse with aging. The main reason for this is due to volume loss, so it is extremely important, as the patient ages, to keep on top of their facial volume. There are many fillers which are great for this, including Restylane SubQ, Perlane, Radiesse, Sculptra and Modelis.
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