There are a variety of surgical approaches to the elimination of acne scars. Many of these treatments can also be used for wrinkles, sun damage, liver spots and other types of lesions and scars. Some of these techniques do not offer permanent treatment for acne scars. For more information and to find out what kind of treatment is right for you, see your dermatologist.
Doctors have been using dermabrasion to eliminate acne scars for over 100 years. It is better for shallow acne scars rather than deep, "ice-pick" scars caused by severe acne. The doctor uses a liquid spray to freeze the skin. Local anesthesia may be used. A high speed rotary instrument with an abrasive wheel or brush is used to "sand" the skin. It removes the upper levels of the skin surface and improves irregularities. A new, smoother layer replaces the abraded skin as it heals. Skin should heal in about 10 days, but it may be red for up to 12 weeks.
Microdermabrasion is ideal for dark-skinned patients who have mild acne scarring, because it does not cause discoloration. Its effects are similar to a chemical peel. The process involves blasting the skin with tiny sterile particles to wear away the top layer of skin. It requires no anesthesia, and little recovery time. Few studies have measured the technique's long-term effects.
Excision and punch replacement graft
This technique is for deep, depressed "ice-pick" acne scars. The doctor surgically removes the scar and replaces it with skin from elsewhere on the patient's body, usually from behind the ear. This treatment is usually the most successful for deep scars.
Collagen, other synthetic materials, or the patient's own fat is injected under a depressed scar to elevate it to the level of the surrounding skin. This treatment is currently a temporary solution - collagen implants last about six months - but research is under way to make it more permanent. There is no recovery time with this procedure.
Laser surgery is used for shallow scars. The laser removes skin so that a new layer can grow in its place. It can take only a few minutes for small areas or an hour for larger areas. Laser treatment offers an alternative to traditional scalpel therapy. It is bloodless and precisely controlled, which limits scarring and risk of infection. Laser surgery can cause uneven skin tone in people with darker skin. Healing should take a few days to a week. Redness may last for several weeks and the skin may maintain a pinkish tone for several months after surgery.
Read a clinical review on laser resurfacing for acne
Chemical peels are for light scarring and are less effective than other treatments. They involve the application of acid to the skin to remove the top layer, so that smoother layers can surface. Some redness, swelling, flakiness and dryness can be expected after the treatment, and can last for a few days and up to several weeks.
Read more at the American Society for Dermatologic Surgery.
Last updated: 12-Oct-10