Advances in Treating Acne Scars

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Dermatologist Dr. Judy Hu with Advanced Dermatology PC offers tips on the latest treatment options

Dr. Judy Hu

The good news is that dermatologists have more tools today than ever for treating acne scars. Patients wanting treatment should seek out a board certified dermatologist for advice on their specific case.

While it is the bane of many a teenager’s existence, acne is a part of life for people of all ages. It is the most common skin condition in the United States, affecting more than 50 million Americans, and it is increasingly common among women in their 30s, 40s and even 50s. And while many cases of acne are relatively mild—a few pimples scattered across the nose, chin and forehead—more severe cases can cause real problems, says Judy Hu, MD, a dermatologist with Advanced Dermatology PC. Serious acne, also known as cystic acne, creates swollen, painful lesions that can become infected, she says. These cysts destroy skin and other tissue, and even after they heal, can leave permanent scars behind.

Acne can create a few types of lasting damage to the skin, Dr. Hu explains. “Right after the lesions heal, many people see what’s known as post-inflammatory color changes—pink or purple areas are most common, but people with darker skin may see brownish patches,” she says. As the healing progresses, she says, some patients develop indentations, known as atrophic scars, ‘pockmarks’ or ‘ice-pick’ scars, as the body attempts to repair the wounds. Less common are hypertrophic, or raised scars, which develop when the body creates too much collagen in response to an injury.

“It’s important to remember that scarring is part of the body’s natural healing process,” Dr. Hu explains. In the case of a superficial injury—one that affects only the outermost layer of the skin—scarring is generally minimal. But cystic acne often creates deeper wounds, she says, which affect the deeper layers of the dermis. In those cases, the body must generate new collagen, which creates an irregularity in the skin.

And while scarring can occur in anyone, it varies widely from patient to patient, Dr. Hu says. “Scarring seems to be tied to a person’s genetics and his or her unique inflammation response. So two people with similar cases of acne can have very different long-term effects,” she explains, “with one person showing significant scarring and the other with virtually none.”

Tips on Treating Acne Scars
The most important part of treating acne scars is to get the original case of acne under control, which will prevent future scarring, Dr. Hu says. After that, she says, patients should consult with a dermatologist to determine the best options.

Skin Discoloration: While most post-inflammatory color changes will improve on their own, they can take months to disappear completely, Dr. Hu says. To help speed them on their way, she recommends a series of superficial chemical peels and a strict no-sun policy. “UV exposure exacerbates these pigmentation problems because it stimulates pigment-producing cells (known as melanocytes),” she says. Dr. Hu recommends applying a broad-spectrum, oil-free sunscreen every day.

Minor to Moderate Scarring: Some atrophic scars can be treated effectively with microneedling and chemical peels, which help resurface the epidermis. Laser resurfacing, which sends short, concentrated pulses of light that remove damaged skin and promote collagen growth, is another option.

Severe Scarring: More serious scarring can be treated with ablative lasers, which create a series of controlled injuries to the skin that triggers the healing process. “A fractional CO2 or Fraxel laser can reduce the appearance of both depressed and raised scars by removing the damaged surface skin cells and stimulating collagen production, which will help to fill in the depressed areas,” Dr. Hu says. If a scar is inflamed, she says, the erbium:YAG laser can also diminish the blood vessels that are causing the inflammation, thus making the scar less noticeable.

According to Dr. Hu, the good news is that dermatologists have more tools today than ever for treating acne scars. Patients wanting treatment should seek out a board certified dermatologist for advice on their specific case.

Judy Hu, M.D., F.A.A.D., a board certified dermatologist and fellow of the American Academy of Dermatology, specializes in medical, surgical, and cosmetic dermatology with extensive experience in skin rejuvenation utilizing injections and laser therapy.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation with 13 locations in New York and New Jersey, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

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