Scarring, particularly on the face, is a cause of consternation that can affect everyday life, self-confidence and self-esteem. One of the most distressful is acne scarring.
What is a scar?
Scarring occurs from an injury to the skin caused by an accident, a burn, cut or scape, after surgery or as part of a disease process like acne. When your skin is injured the body attempts to heal the damage by replacing the damaged tissues with scar tissue that is made from tissue that is thicker and less flexible than the rest of your skin. Genetics, age, skin color and medications can affect how you heal.
Once the scar is formed it goes through changes as it matures. At first the scar is pink to red. As the scar matures over months the redness fades and the scar may become lighter or darker than your skin and become depressed or raised.
Diagnosing your scars
Diagnosis is important because different types of scars need different treatments.
There are three types of scars:
- Atrophic scars result from a loss of collagen. They are flat or sunken. Typical sunken scars result from acne or chickenpox. These scars do not fade.
- Hypertrophic scars are raised and firm and stay within the borders of the original injury. Over time they tend to flatten. These scars typically form on the chest, back and shoulders. Stretch marks are this type of scar. They can be raised or slightly lower than the surface of the skin.
- Keloid scars are raised, deep reddish purple and extend beyond the borders of the original wound.
Dr. Kandula will examine your skin and determine the type of scar and rule out the possibility of skin cancer. She will then formulate a personalized treatment plan to address your needs.
Treatment for acne scars may include surgery, laser resurfacing, chemical peels, cryotherapy, dermabrasion and microdermabrasion. Sometimes a combination of treatments will produce the best results.
- Acne Scar Surgery is designed to make the scar less noticeable either by raising the scar or breaking up the scar tissue. It may be combined with injection therapy. This is an office procedure.
- CO2 Fractional Laser resurfacing produces high-energy light that vaporizes sections of the skin, layer by layer. It can treat surface skin and moderately deep lines and scars as well as sun damage. It also induces collagen formation which provides a smoother more even appearance. Fresh new skin grows over the treated area. Laser resurfacing can treat deep depressed and raised scars safely and effectively. Downtime required is about 2 weeks. This is an outpatient procedure.
- Non-ablative lasers such as the Nd:YAGâ laser and the Resurfxâ Laser refresh and rejuvenate the skin building collagen and smoothing the skin.
- Cryosurgery is the freezing of the scar which causes it to die and fall off. It may be combined with injection therapy. It is not recommended for people of color as it can cause hypopigmentation.
- Chemical peels, dermabrasion and microdermabrasion are all gentler types of skin resurfacing. They remove the top and middle layers of skin and induce formation of new skin. May require a series of treatments.
- Collagen Induction Therapies like microneedling produce controlled injury which stimulates collagen production to fill in depressed scars. It can take up to 9 months to see results and may require a series of treatments for the best results.
- Injection therapy for raised scars is intended to soften and flatten these scars. A series of treatments are usually necessary. Injections of corticosteroids or 5-FU (a chemotherapy drug) or both can improve scar appearance.
- Scar creams and gels can be used during the healing process to treat raised scars, shrink and flatten scars and reduce the appearance of the scar.
Contact Dr. Kandula in Parsippany, New Jersey to schedule an appointment for a complete evaluation of your skin concerns and discover all your treatment options.