Learn about your options for treating acne scars and with laser and light therapies known as fractional photothermolysis (Fraxel Re:Store) and Erbium laser resurfacing.
Depressed scars are caused by tissue damage from the pustules of severe acne or other skin trauma and the body’s response to cell destruction. These scars are made of contracted strands of collagen that the body has developed to recover from acne or other skin trauma. The repairs aren’t usually as smooth as original skin as strands tend to pull in, leaving saucer-shaped indentations that are made even more visible by the shadows they cast. Though many scars caused by acne are relatively minor and heal quickly, if there is a deep beak in the wall of the pore infection can spread to surrounding skin, causing deeper damage.
Are there different kinds of scars?
There are two main kinds of depressed, or atrophic, acne scars.
- ‘Icepick’ type scars – small yet pronounced holes in the skin.
- ‘Boxcar’ scars – depressed areas similar to chickenpox cars that are usually round or oval shaped with deeply angled sides, often caused by tissue damage from the pustules of severe acne.
How can acne scars be treated with laser therapy?
Acne scars can be treated by a number of laser therapies. The goal of laser treatment for acne scars is to level out the surface of the skin so that the scarred skin and adjacent tissue can be made to look more alike, thus minimizing the appearance of scars. This is accomplished by stimulating additional collagen production, helping skin return to a more normal appearance. The type of treatment used will be determined by many issues, including type of scar, severity of damage and where scars are on the body.
Fraxel ReStore
A highly effective fractional laser treatment, Fraxel Restore, also known as fractional photothermolysis, treats a small percentage of the skin with a calibrated laser beam at each treatment session. Tiny columns of skin are treated, leaving adjacent skin undamaged. Each laser beam creates intense heat deep within the epidermis below the scarred tissue. The scarred skin responds to this controlled damage by growing new collagen, causing the tissue under the scar to rise, making the scar shallower and less noticeable. This fast-healing procedure has almost no risk of infection and can be used on face, chest, abdomen, neck, thighs, arms and hands.
Who is a candidate for this treatment?
Most patients tolerate Fraxel ReStore well, although if you have had problems with wound healing or keloid formation you should avoid the treatment. Patients with darker skin or those who have used Acutane within the past 12 months are also poor candidates.
What can I expect from treatment?
Fractional treatment can be scheduled aggressively or more mildly, providing minimal or even no disruption to your routine. It takes time for the body’s healing capabilities to form the collagen that smooths out the difference between normal and scarred skin.
What can I expect after treatment?
You may have redness or pinkness, swelling and mild to moderate sunburn-like pain for four to eight hours after the procedure. Though the discomfort only lasts a short time, use of cool packs or moist cloths should provide relief.
How many treatments are required?
Multiple sessions, each lasting about 30 minutes, are required for optimal effectiveness. The intensity and number of treatments will be determined by a number of factors, including:
- skin type
- size of area to be treated
- location of treatment area
Prior to treatment, you’ll have a complete skin evaluation, at which point you’ll have a better idea of your options.
Are there side effects?
Though most patients have little problem with the procedure, you may have pigmentation issues, scarring, pain, crusting, burning, acne-like breakouts or milia, small white bumps on the skin.
Erbium Laser Resurfacing
An excellent option for treating scars, erbium laser resurfacing uses radio frequency energy instead of CO2 energy to smooth skin. A series of pixels, or dots, are laid down in a calibrated pattern that causes minimal burning of surrounding tissue due to its use of cooler lights. Skin tightens, causing depressed scars to become less noticeable.
Who is a candidate for this treatment?
All skin types can benefit from erbium laser resurfacing, even patients with darker skin tones who often risk pigmentation problems with other types of laser scar therapy. This treatment can be effective for treating deep icepick and boxcar scars.
What can I expect after treatment?
Erbium treatment has the benefit of shorter downtime, more rapid healing and less post-operative swelling and redness. Patients are usually fully recovered and back to normal activities in a matter of seven to 10 days.