There are several techniques for acne scar correction, and they will be described below.

• Reduction of pigment:

This is done using fading creams such as Hydroquinone, Kojic acid, and retinoids
- Tretinoin, Adapalene, Tazarotene, etc. This pigmentation is called post- inflammatory pigmentation and is more common in patients with darker skin, who have picked at their lesions, or who have large or very inflamed pimples. This can take many months to improve, but with consistent use of the above creams along with meticulous use of sunscreen it will resolve. Chemical peels and microdermabrasion are also helpful and may be suggested. In general, lasers are not recommended.
Pigmentation can only be corrected once the acne is significantly better.

• Redness:

This occurs after active acne has improved, and there is some remaining redness. This is treated with mild steroid creams, anti-redness creams, and effectively with redness reducing lasers such as the V-beam laser. This can be discussed further. It will take several treatments with the laser to improve the redness.

• Acne Scars:

1. – Dermal grafting: This is the most effective treatment of correcting shallow acne scars. In this technique, the area behind one of the ears is numbed with a local anesthetic, and small pieces of skin are removed and the area is stitched from the inside. There is no need to remove these stitches and they dissolve. In most cases this area heals well and is very difficult to see if anything has ever been done. The skin is removed, processed and small slits are then made above the shallow scars, and the skin from behind the ear, which has been processed, is then inserted. Small steri-strips which are usually flesh colored are applied and fall off within 2-3 days. There is minimal care required afterwards, and it is very difficult to detect if anything has been done after 2-3 days. This is an effective treatment, and is done several times to improve the scars. It lifts the scars so that they become shallower, and less visible. The risks of this procedure are sometimes pigmentation and redness can occur though this does improve, occasionally small cysts can occur at the sites of these grafts and can be drained easily, and very rarely infection or persistent bleeding though this is quite rare. A test site is almost always done prior to larger areas being treated to make sure that this works well. Please see the drawings provided.
2. – Subcision: This is a technique where a small needle is introduced underneath the scar, the needle is then moved underneath the skin to create a small wound underneath the skin that is not visible, and when the body heals this area it brings in collagen, to lift up the scar. This will often take 2-3 treatments per site to see improvement. The biggest risk of subcision is that it may not work.
3.  – Correction of pits: These types of scars are more difficult to treat with the above techniques so we now either use a special acid called TCA, which converts the scars from pitted scars to more shallow scars, which are easier to treat. We can also remove these scars and stitch the areas. The risks of TCA treatment for pits include pigmentation, redness, and failure. Several treatments may be needed.
4. – Laser treatment: This is done to improve the texture of the scars after the above three techniques are done, once the shallow and pitted scars have been elevated or improved. In general, it should not be done before as the improvement with laser is best once the above methods are used. The risks of laser include pigmentation and redness, especially in people of darker skin. Almost always a test site is done first to make sure that this is not occurring. Lasers take several treatments to show maximum improvement.
5.  – Chemical peels and microdermabrasion: These can also be used to improve scars once the above techniques are used. By themselves, initially, they may not be effective.

We have an interest and expertise in acne scarring, and have been doing the above techniques for over 30 years. If you should have any questions please do not hesitate to contact us.

Referenced from “Acne Scarring"