Acne scars appear when your skin is unable to rejuvenate itself after an acne lesion goes away. The inflammation associated with the lesion can damage skin tissue causing it to collapse and leave a scar. These scars can manifest in many forms including “ice pick” scars which are deep, narrow scars, “boxcar” scars which are shallow, broader indentations and even raised, keloid like scars.
This is an example of the boxcar variety of acne scars.
We still do not know why some people get more acne scarring and some people less – the tendency is genetic, but what causes it is unclear. Not every pimple will form an acne scar, but which ones do and which ones do not varies from person to person. In general, the larger deeper cystic lesions are the ones that result in the most noticeable acne scarring. These are the pimples that should be treated as early as possible with extraction or steroid injection.
These are some examples of cystic acne lesions that would probably result in acne scars.
Acne scars are very difficult to eliminate and the best method is prevention. Any existing acne should be eliminated before the process of scar removal begins. Elimination of acne should be done by a professional ONLY. Picking at your own acne lesions is the surest way to increase the chance of scarring. Picking worsens the inflammation by introducing more bacteria into the skin. The more inflamed the skin gets, the more chance that it will scar. Acne treatment is not always painful or difficult. Visit our acne pages to find out more information.
After existing acne has been treated we begin the scar removal process using one of two available methods.
The first and most effective method involves the use of the Active Fx fractional CO2 laser. When treating acne scars we usually perform a “Total Fx” treatment, using the Deep Fx head of the Active Fx device for part of the session. The Active Fx is a relatively new technology that provides the best results in improving acne scarred skin. The Active Fx is a fractional CO2 laser. Instead of the older, more destructive laser resurfacing procedures, the Active Fx affects only 15% to 20% of the skin at a time, permitting faster healing and more effective acne scar elimination. The Active Fx laser has become the standard of care around the world for the elimination of acne scars. It is effective not only in smoothing out the pitted texture of the skin, but it will also lighten the discoloration that accompanies some acne scarring. After the treatment, you will have about three days of mild swelling and about a week of sunburn-like redness with some peeling. Most people take about five to seven days off from work for recovery. One to three treatments are usually enough to solve most acne scarring problems. The treatments are performed about three to four months apart so that we can see the gradual improvement associated with the collagen stimulation effect of the laser. Significant improvements are visible after each treatment.
We also treat acne scars with the Fraxel SR1500 laser. This is a fractional laser as well, but it is an Erbium laser instead of CO2. The Fraxel is not as intense as the Active Fx, so results are more gradual and more sessions are necessary for significant improvement in a patient’s acne scars. Typically, we recommend five to seven sessions of Fraxel to see the best results. The sessions are spaced about three to four weeks apart. The reason that patients sometimes choose Fraxel over Active Fx is that Fraxel is less expensive and the downtime after Fraxel treatment is significantly less than what is experienced after Active Fx. Two to three days is usually sufficient to recover from a Fraxel treatment, as opposed to the five to seven days that are necessary for recovery after Active Fx.
You can read frequently asked questions about acne here.
You can read frequently asked questions about light based acne treatment here.
You can read frequently asked questions about Fraxel here.
During your free acne scar removal consultation, Dr. Rivkin will evaluate your skin, discuss your desired results, and explain the procedure in detail. You will have the opportunity to view before and after photos, so that you will know exactly what to expect from the treatment.
Dr. Rivkin’s patients know that they can get in touch with him at any time. He is always in the office at Westside Aesthetics, and is personally involved in every treatment.