Acne Scar Treatment

Date Modify : 2015-07-14 15:10:39

Is there anything I can do about my acne?

 To get rid of acne, we have to kill bacteria (P.Acne) in the inflame acne and decrease sebum production from sebaceous gland such as Acne Clear Laser (ACL).

 Nowadays we have a wide range of treatments available to combat acne and acne scars. To achieve best results, you are advised to go through your dermatologist.


NSLC 4Cs Acne Treatment Program

his NSLC 4Cs Acne Treatment Programme consists of:

 1. Clearance - Active acne must first be cleared with the appropriate washes, medicinal creams, skin care routine, and/or oral medication, and in serious cases of active acne, we can use more drastic treatments such as laser and light therapies.

 2. Control - Once clearance is achieved, continuous control with the appropriate products and skin care routine are essential to prevent or minimize future relapse.

 3. Camouflage - While the acne problem is being treated, the results will take. Meanwhile our customized camouflage cream will help you face each day with necessary confidence. 

 4. Correction - Red marks, brown marks, raised scars and depressed scars left behind by acne can be treated with a wide range of clinic procedures without unnecessary downtime:

 - Red marks can be treated with IPL (Intense Pulsed Light), V Beam (V Perfecta), PDL, PTR Laser, etc. IPL works by constricting the tiny congested blood vessels and therefore clears up the red marks, flush and blush of acne.

 - Brown marks can be treated with lightening creams, microdermabrasion, or IPL and pigment lasers such as Luminis I, Medlite, SPM, DFHL Laser in resistant cases.

 - Raised lumpy scars benefit from injections of cortisone to soften and flatten them.

 - Deep depressed scars and ice pick scars may benefit from Fraxel, E-Matrix or Golden SEM.

 - Very superficial uneven scars can be softened with chemical peels or Booster Microdermabrasion treatment.

 - Superficial depressed scars can be smoothened out with Fractional Laser treatment, Fractional Sublative RF treatment or Golden SEM.


What else do I need to know about managing acne?

 - Do not squeeze or scratch pimples. Avoid facials, scrubs, masks and exfoliants when your acne is inflamed.

 - Do not attempt to cover pimples on the forehead with a cap or fringe.

 - Do not wash with hard soaps. Wash away the surface oil with quality gentle soap.

 - Use reliable water-based, oil-free cosmetics.

 - Stick close to your doctor's prescription. Feel free to check with your doctor if you have any doubts about the treatment or side effects or for some reasons you are not improving.

 - Certain birth control pills and hormone medications can worsen acne. Do discuss with your doctor.

 - Stress and lack of sleep may aggravate acne.


Take-Home Messages

 - Acne is treatable! 

 - Acne scar is preventable by seeking treatments early 

 - Sometime your acne may worsen initially before it gets better. 

 - Occasionally it may take a few months to see definite result 

 Discuss with your doctor or dermatologist if certain treatment are seemingly not working for you, or you are not comfortable with the medications prescribed for you, because other alternatives are available that would help.

 

Acne Scars

 Acne can affect people from ages 10 through 40 and up. Acne can show up as any of the following; congested pores, whiteheads, blackheads, pimples, pustules, or cysts (deep pimples). These blemishes occur wherever there are many oil (sebaceous) glands, mainly on the face, chest, and back. It is important to seek medical advice early since medical treatment can improve your appearance and prevent the treatment depending on the type and severity. 


Acne scars treatment

includes oral medications like antibiotics as well as creams and lotions for application on affected areas.

 If you are suffering from acne, it is important that you remove surface oil from the face by washing with soap and water or with medicated cleansers. Remember to wash frequently when the face is oily, about three times a day. Continue washing even when you acne is cured. And always remember not to squeeze or scratch pimples. 

 "The important thing to have when it comes to treating acne is patience. Most of the treatment options for acne may take 2 or 3 months to start working. It is therefore important to give each regimen or drug enough time to work before giving up on it and moving on to other treatments."


Who can have it?

 Usually, acne begins at puberty and is gone by the early 20s. In some cases, acne may persist into adulthood. Such types of acne include severe forms that affect the body as well as the face (which afflict males more than females) and acne associated with the menstrual cycle in women. In other cases, acne may not present itself until adulthood. Such acne is more likely to affect females than males.

 There are several reasons for this. As females get older, the pattern of changes in hormones may itself change, disposing sebaceous glands to develop acne. Ovarian cysts and pregnancy may also cause hormonal changes that lead to acne. Some women get acne when they discontinue birth control pills that have been keeping acne at bay. Sometimes young women may wear cosmetics that are comedogenic i.e. they can set up conditions that cause comedones to form.


What role does diet play in acne?

 Acne is not caused by food. Following a strict diet will not, clear your skin. While some people feel that their acne is aggravated by certain foods, particularly chocolate, colas, peanuts, shellfish and some fatty foods, there is no scientific evidence that suggests food causes or influences acne. Avoid any foods which seem to worsen your acne and, for your overall health, eat a balanced diet--but diet shouldn't really matter if the acne is being appropriately treated.

 In general, acne lesions should not be picked or squeezed by the patient. In particular, inflammatory acne lesions should never be squeezed. Squeezing forces infected material deeper into the skin, causing additional inflammation and possible scarring.


How to treat?

 At our clinics, various treatment protocols can be considered e.g or light therapy (I Clear or Multiclear) or various chemical peels and lasers.

Prescription Medications

Topical (applied to the skin) Antibiotics

Topical retinoids

Oral antibiotics

Oral contraceptives

 C. Severe acne is characterized by deep cysts, inflammation, extensive damage to the skin and scarring. It requires an aggressive treatment regimen and should be treated by a dermatologist. Severe, disfiguring forms of acne can require years of treatment and may experience one or more treatment failures. However, almost every case of acne can be successfully treated.

Severe acne with cysts

Physical methods and prescription medications that can be used to treat severe acne include:

- Drainage

- Interlesional corticosteroid injection

- Isotretinoin e.g. Roaccutane

- Oral antibiotics

- Oral contraceptives

- Combination of various treatment modalities e.g. lasers, Multiclear.


How to treat Acne Scars and marks?

Depressed acne scars are generally divided into 3 categories:

 Rolling scars - Rolling scars occur as a result of tethering of otherwise normal-appearing skin to the subcutaneous tissue below. This process gives the skin a rolling or undulating appearance. To differentiate from the other acne scars, one can put the index and thumb and stretch the skin of the rolling scar and the rolling scar 'disappear'. Conventional skin resurfacing techniques do not work on rolling scars. They must be corrected by breaking up the subcutaneous fibrous bands.

 Boxcar scars - Boxcar scars are round to oval depressions that have sharp vertical edges. Unlike icepick scars they do not taper to a point at the base. Shallow boxcar scars are 0.1-0.5 mm in depth and can usually be treated with conventional skin resurfacing techniques. Deep boxcar scars are >0.5 mm in depth and require full-thickness treatment techniques.

 Ice Pick scars - Icepick scars are narrow, sharp scars that make the skin appear it has been punctured with an icepick. They are usually narrower than 2 mm and extend into the deep dermis or subcutaneous layer. Icepick scars are usually too deep to correct with skin resurfacing treatments such as dermabrasion or laser resurfacing. Surgery can be attempted to correct this.


Hypertrophic scars 

These are mainly keloids and treatment is same as keloid treatment.

Occlusion therapy -

 Silicone gel or sheets are used in the 1980s. This has to be worn with pressure up to 24 months for at least 12 hours per day. However, the improvement can be excellent.

 Non silicone sheets or polyurethane dressing again have to be worn for long period e.g. at least 12 hours per day and for about 8 weeks. The result however is variable.

 Scarguard is a topical cream containing silicone, hydrocortisone and Vitamin E. Study done showed that scarguard stimulates the release inactive collagenase precursors that may inhibit new scars from forming and reduce existing scars. It is usually used for at least 2 months.

 Injection - Injection can be done with corticosteroids with 4 to 6 week intervals. Injections with 5 flurouracil can be done. This can be mixed with corticosteroids. However with this mixture, pain, hyperpigmentation and tissue sloughing can be a problem. 

 Surgery - This can be done to remove the keloid or hypertrophic scar but there is a higher risk that the keloid may recur. Cryotherapy (with liquid nitrogen) can also be used.

 laser or IPL - It is reported that certain lasers can help and IPL has been used for a while to improve the texture and colour of the keloid. Laser like CO2 can be used to ablate the keloid but the recurrence rate is high. This can be reduced if used together with injection of corticosteroids. Other lasers that have been used are pulsed dyed lasers (585 nm), Nd Yag (1064 nm) and IPL (flashlamps).

Others - Intralesional botox has been reported to have shrinking effect on hypertrophic scars.