Acnescars

Acnescars result from deep inflammation or unprofessional manipulation of acne lesions. If acne produces scars it is generally considered to be a severe acne. In this case a dermatologic consultation and treatment is highly recommended. It is much easier to prevent scars then to treat them.

The treatment of acne scars has to take into consideration the type of scarring.

Scars may disturb aesthetically, itch or be prone to discomfort. They consist of colour alterations, difference in level or skin texture. Depending on age, localisation and individual aspects they look differently and the treatment modalities vary.

Treatment options for scars
we primarily assess whether or not scar corrections make sense and will have promising results. A scar may improve on its own for a year or two. It may make sense to wait or, to treat early on.

Scars can rarely be improved to such an extent that they become invisible. Typically scar treatment will make scars look less visible but will not make them disappear completely.

Treatment of colour variations

Too red:
A scar appears red because it is still inflamed or intermingled with broken vessels. In this case an anti-inflammatory cream or laser-therapies are considered.

Too dark:
The inflammation of the scarring process may lead to the production of too much brown pigment; hence a hyperpigmentation is the result. This may happen spontaneously but is more often the result of sun- and other uv-exposure.
Therefore it makes sense to protect a scar from uv light in the first 1-2 years. Avoid sunlight and sun parlours, apply sunscreens and if possible also make up. Hyperpigmented scars may be treated with bleaching creams, peelings or medical laser-therapies. They may also be camouflaged with water resistant camouflage make ups.

Too light:
A scarring process may lead to hypopigmentation. Until this day there are no really satisfactory treatment options for this situation. Some people will profit from camouflage make ups, self tanning lotions or even fractionated laser-therapy. Having hypopigmented scars tattooed harbour considerable problems. We discourage you from this.

Treatment of level differences

Too high:
Typically these rare, so called hypertrophic scars, sometimes keloids, develop on the basis of an individual disposition. Hypertrophic scars may be treated with intralesional cortisone injections. The result consists of flatter scars, with a tendency to develop broken vessels within the scar, which in turn can easily be treated with medical lasers. Sometimes it is preferable to surgically remove a hypertrophic scar, immediately followed by a special X-ray treatment to prevent another hypertrophic scar from developing.

Too shallow:
These are called atrophic scars. they account for the most common acne scars. They exist in various forms:

• Saucer-shaped
  They can be recognised by pulling at the edges. In doing so, they get flat. The previously used treatments like dermabrasion, deep peelings and laser-skin-resurfacings, have mostly been replaced by fractionated laser-therapies. They "drill" little holes into the tissue and stimulate new collagen formation. New collagen is tighter than scar collagen: the scar gets flatter and skin texture smoother.
  
  Saucer-shaped scars may also be filled with biologically degradable Hyaluronic-acid-fillers.

  

• «Boxcar-scars»
  They have steep edges and a flat base. The treatment of first choice here is  ablative laser-therapy. The edges become flatter and the base gets rised.

  

• Ice-pick-scars
  They are deep and precipitous. Typically they are surgically removed.

  

Treatments of acne scars needs good planing, and is sometimes best performed in small steps. It always is a more lengthy process. It is important to us to give you clear ideas as to the social and professional down-time and the result that can be expected.

Examples