Dermabrasion – This is a process where the doctor removes the top layer of the skin using an abrasive instrument that is similar to an electrical sander. This method would leave the skin red but upon healing, the skin surface appears much smoother and healthier. The “sander” machine uses a diamond plated wheel and actually “sands” the surface of the skin. It usually, takes an hour to perform dermabrasion. Some of the side effects of dermabrasion include scabbing and redness for a few weeks. Some say that this is the most effective treatment for acne scars. Superficial scars can be removed and deep scars may be reduced.
Microdermabrasion – This technique is related to dermabrasion. The only difference is that microdermabrasion uses aluminum oxide crystals that pass through a vacuum tube to remove the surface of the skin. In this method, the skin cells at the surface are only removed. There is no wound created compared to dermabrasion. It requires multiple procedures in order to have significant improvement.
Punch grafts – In this method, small portions of skin are taken from another part of the body and it is implanted on the location where deep scarring have occurred. The skin usually comes from the earlobe or the inner part of the thigh.
Chemical peels – This is good for acne scars that are not so severe. A chemical peeling agent is applied to the scar tissue and it is left there for a period of several minutes. The peel would remove the topmost layer of the skin allowing the regeneration of newer and healthier skin cells. The resulting redness from this procedure may last several weeks. Stronger chemical peels would produce “controlled skin injury” that promotes the growth of skin with improvement in appearance. Chemicals that are typically used are glycolic acid, trichloroacetic acid (TCA), salicylic acid, “Jessners” solution, and phenol. Chemical peels that generate controlled injury in the dermis can improve depressed acne scars.
Collagen injections – Collagen which is a natural substance of the body is injected under the skin to fill up superficial and deep scars. This treatment does not usually work for ice-pick scars and keloids. Collagen coming from cows is not used in people with autoimmune disorder. The cosmetic benefit that comes from collagen injection only last for 3 to 6 months.
Steroid injection – This is technique is usually performed on keloids and hypertrophic scars. Steroids inhibit the growth of fibroblast thereby reducing the quantity of collagen that is deposited into the scar. Side effects of steroid injection may include hypopigmentation, atrophy and telangiectasias.
Laser Resurfacing – This involves a CO2 or erbium laser beam destroying the outermost layer of the skin and heating the underlying layer of the skin. The treatment procedure can last from several minutes to several hours depending on the wavelength and power of the laser. This type of treatment is not recommended for dark skinned persons because it may cause uneven skin coloration. Side effects of this treatment include redness of the skin that may last for a few weeks to several months.
Subcision – The scar is detached from the underlying tissues allowing the formation of a blood clot under the skin. The blood clot will force the scar to the skin surface. The basic procedure involves the insertion of a needle under the scar and then it is gently maneuvered underneath the skin to release the scar tissue. This technique is typically used for deep rolling scars caused by acne and other skin problems.
Augmentation – This involves the use of skin filler which is similar to collagen. The skin filler is injected under the skin to raise the depressed scars. The results are only temporary and could last up to six months.
Autologous fat transfer – Fat is taken from other parts of your own body and is then prepared for injection to your skin. The fat is typically injected below the surface of the skin to “fill up” depressed scars caused by nodulocystic acne. Since fat is reabsorbed in the skin, this procedure must be repeated after 6 or 18 months.
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Surgery. Principles and Practice. New York: Marcel Dekker, Inc.; 1996: 1057-1160.
Jordan RE, Cummins CL, Burls AJ, Seukeran DC. Laser resurfacing of acne scars (Cochrane
review). Cochrane Database System Rev 2001; 1:CD001866.
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