Acne Scarring

In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair.

The occurrence and incidence of scarring is still not well understood. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others.

Acne scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin, but scarring also may arise from more superficial inflamed lesions. Nevertheless, the only sure method of preventing or limiting the extent of acne scars is to treat acne early in its course, and as long as necessary. The more that inflammation can be prevented or moderated, the more likely it is that scars can be prevented.

The scars caused by increased tissue formation are called keloids or hypertrophic scars. Both hypertrophic and keloid scars are associated with excessive amounts of the cell substance collagen. The excess collagen becomes piled up in fibrous masses, resulting in a characteristic firm, smooth, usually irregularly-shaped scar.

The following is a list of different types of acne scars:

The results of most treatments vary from 30 to 70% improvement. Any better result should be considered as a bonus.

  • Ice-pick scars are acne scars associated with loss of tissue which usually occur on the cheeks. They are usually small with a somewhat jagged edge and steep sides-like wounds from an ice pick. This type of scar is like a small channel, usually not wider than 2 mm on the surface. It reaches from the skin surface into the deep dermis, sometime into the sub-dermal tissue.
  • Keloidal acne scars which are raised and thickened scars which and usually occur in the darker skin type patients. These scars as best treated with intra lesional steroids, Titan infra red light, Laser Genesis and Carboxytherapy treatments.
  • Rolling scars are the most common and most disfiguring form of acne scars. They are soft scars, superficial or deep and are soft to the touch. They have gently sloping rolled edges that merge with normal skin. They are usually small, and either circular or linear in shape. In most cases the lower part of this scar type is connected to the deeper fascia by collagen fibers. According to the tens of thousands of acne scar treatments performed worldwide within the last 3 years with the Dermaroller Skin Needling system, this acne scar responds the best to Skin needling. Depending on the affected skin area and quality of the scars several treatments (2 to 5) may be necessary in order to achieve a maximum possible result
  • The Boxcar Acne scar is a depressed fibrotic scar that is usually quite large with sharp edges and steep sides. The base of these scars is firm to the touch. Ice-pick scars may evolve into depressed fibrotic scars over time. These scars respond well to a combination of Dermaroller ™ Skin Needling and Laser Genesis ™ treatments. Dermal fillers injected into the lesion also improve the appearance of the acne scar with time.
  • PIH or Post Inflammatory Pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people, but occasionally is seen in people with white skin. Early treatment may minimize the development of post-inflammatory pigmentation. Some post-inflammatory pigmentation may persist for up to 18 months, especially with excessive sun exposure. There is wide range of topical products that can be recommended for home care, which will be discussed during your consultation.

In Office Treatments:

At Body Renewal a number of treatments are available for acne scars. The type of treatment selected should be the one that is best for you in terms of:

  • your type of skin,
  • the cost of the treatment,
  • the downtime that you can afford, and
  • what you want the treatment to accomplish.

The objective of scar treatment is to give the skin a more acceptable physical appearance. Total restoration of the skin to the way it looked before you had acne is often not possible but scar treatment does usually improve the appearance of your skin.

The scar treatments that are currently available at Body Renewal include:

  • Dermaroller ™ Skin Needling is similar in principle to chemical and laser resurfacing techniques. The dermis is directly injured to initiate a wound healing response that ultimately increases dermal collagen production and deposition by fibroblasts and improves acne scarring.
  • Laser treatments with Laser Genesis or Pearl Laser may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions.
  • Hyaluronic dermal fillers are injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Hyaluronic acid treatment usually does not work as well for ice-pick scars and keloids.
  • Carboxytherapy is a novel way to improve acne scars.
  • Needle stamping is a novel way of treating isolated ace and chicken pox scars. It works on the same principle as Dermaroller™ Skin Needling but only small isolated scars are treated in one session. 2 to 6 treatments are needed for best results.
  • Crystal Microdermabrasion is a surface form of dermabrasion. Rather than a high-speed brush, crystal microdermabrasion uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. If microdermabrasion with compressor is used, a considerate amount of skin can be removed for more impressive results. This procedure has a downtime of 7 to 10 days and runs the risk of post dermabrasion hypopigmentation.
  • With normal microdermabrasion, only the very surface cells of the skin are removed, so no additional wound is created and there is no downtime. Multiple procedures are often required but scars may not be significantly improved unless combination treatments are done.
  • Keloidal acne scars are treated by injecting steroidal drugs and Botox into the scar after a Laser Genesis treatment.
  • There are a range of Chemical Peel that can also assist with acne scarring, for a full comparison please see Summary of Peels. The correct treatments will be recommend on your initial consultation and progress tracked throughout your treatment course.

At Body Renewal we pride ourselves on careful attention to each patient. A highly professional team led by a medical doctor assesses every patient and an appropriate combination treatment is recommended. Every client is provided with a customized solution depending on expectations, budget, anticipated downtime and medical conditions. A series of 4 to 6 treatments are usually necessary to treat acne scars.

Body Renewal Tip:

Acne scars in skin of colour have traditionally been very difficult to treat with lasers. At Skin Renewal a series of Laser Genesis treatments combined with Carboxytherapy or Dermaroller™ Skin Needling / Dermapen is promising to be one of our star performers for acne scars in people of colour. Combined with suitable pigmentation inhibiting products and the correct home care, Post Inflammatory Hyperpigmentation PIH can also now be successfully treated.

Frequently Asked Questions

  • 1Why choose Body Renewal for your acne treatments?
  • 2Why does your Body Renewal doctor check for low stomach acid during your consultation for acne?
  • 3Why is stomach acid important for health and skin conditions?
  • 4How important is stomach acid?

At Body Renewal all patients with skin conditions are treated holistically by our qualified medical doctors who have experience in treating acne. In other words, in an acne consultation at Body Renewal, your doctor will take a comprehensive history to ensure that there are no underlying medical conditions which are contributing to you acne.

There are numerous significant medical conditions that are associated with acne that need to be identified and addressed. Conditions such as low stomach acid, dysbiosis and leaky gut all compromise skin but more importantly which have future health ramifications such as auto immune disease, food sensitivities, allergies, asthma, depression and even cancer if they are not adequately addressed.

In addition, low stomach will eventually lead to low levels of Zinc and other important minerals and vitamins which are essential for good healthy skin.

At Body Renewal every new patient is checked for low stomach acid. A complimentary Betaine HCl acid test is explained and done in every consultation because:

  • Adequate stomach acid is essential for absorption of the minerals zinc, magnesium, calcium, iron and folate which are essential for healthy skin.
  • Adequate Stomach acid prevents dysbiosis.
  • Adequate stomach acid will help prevent a "leaky gut "with all its health ramifications from developing.
  • Adequate stomach acid is essential for absorption of the minerals zinc, magnesium, calcium, iron and folate which are essential for healthy skin.
  • Adequate stomach acid is necessary for the absorption of the B vitamins.
  • Stomach acid activates protein-digesting enzymes and is necessary for proper digestion of protein.
  • Adequate stomach acid is necessary for the pancreas to release its cascade of digestive enzymes for absorption of carbohydrate and fat.
  • Sub-optimal fat digestion means we won't benefit from the anti-inflammatory properties of omega-3 fats,nor the wide array of beneficial effects of fats for fertility, skin health, immunity, etc.
  • Adequate stomach acid destroys pathogens (bacteria, fungi, parasites etc) and a lack of stomach acid can lead to bad bacteria proliferating in the small intestine dysbiosis (bad bacteria) and unwanted parasites which have Health Renewal ramifications down the line.

How can we expect to stay healthy and have healthy skin without constant breakouts and other Skin, Body or Health Renewal conditions if we have chronically poor nutrient and mineral absorption due to incomplete digestion?

Having normal levels of stomach function the first important domino in a row of dominos: Ifstomach acid is adequate, the rest of one's digestion and absorption won't be compromised and the first domino won't fall and immune dysfunction is less likely down the line.

If digestion in the stomach is compromised due to low stomach acid, then the fall of the first domino will occur and the breakdown and absorption of nutrients in the stomach and beyond won't be optimal. In fact, digestion and absorption can be reduced to the point where even if someone is consuming a nutrient-dense diet, they can suffer both sub-clinical and overt deficiencies because they're not assimilating those nutrients because they have low stomach acid. Get your stomach acid checked by our Body Renewal Doctors.

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