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Is
there hope for acne scars?
Most people recover
completely from acne without any permanent scarring. Those with severe acne are
not as lucky. They are left with disfiguring acne scars of various types that
can leave them feeling self-conscious about their appearance.
Picking, pressing or rubbing of pimples or whiteheads
increases the possibility of scar formation.
When acne clears up, pink, red, or dark
spots often appear on the skin. The good news is that these are not scars and
will eventually fade. To be classified as scar, the skin defect has to persist
for at least a year. Topical products with lightening and exfoliating
ingredients like Retinol-C serum, NanoWhite cream, and AcneX soap can lighten these dark spots. Multiple
sessions of mild glycolic peel combined with diamond peel may provide faster
relief than topical medication.
Acne scars take several
shapes. The back and chest get the hypertrophic scar, which is thick and lumpy.
The face usually gets the depressed types of acne scars, named after their
shapes.  The first is an ice pick scar, which is deep pitted with steep
edges. The second is a boxcar scar, which has sharp, square sides to it. 
The third is a rolling scar, which has wide, shallow and curved indentation.
Most successful acne scar treatments may
take multiple sessions over a period of several months before significant
improvement can be seen. The basic steps of acne scar removal may include a
combination of the following procedures:
Dermal fillers: These are substance that can be injected into
depressed scars to plump them up to the level of the surrounding skin.
Hyaluronic acid injectable like Restylane and Juvederm are good fillers for
shallow to deep acne scars. They can last from 3 to 18 months, depending on the
material used. Your own fat, taken from another part of the body, can also be
used as dermal filler and can last from 1 to 3 years.
Ice pick scars may require dermal fillers.
Chemical peels: A chemical solution like trichloroacetic acid
(TCA) or glycolic acid is used to peel away the outer layers of skin. The
solutions are available in several strengths, and used according to the degree
of peeling desired. A series of 4 to 6 superficial peels are effective for
improving discoloration from acne, while medium depth peels or a deep peel can
improve the appearance of atrophic acne scars. Healing can take from 3 days to
3 weeks depending on the depth of peeling. Avoiding unnecessary sun exposure,
wearing sunscreen daily during the healing period and following post-care instructions
are important to prevent unwanted side effects.
Fractional laser is available
 at SkinStation. 

Fractional
lasers:
Excellent results can be
achieved for the boxcar and rolling acne scars with ablative fractional lasers
using CO2 or Er:YAG. These lasers are called “fractional” because they work by
resurfacing only a “fraction” of the skin at a time, leaving the surrounding
area intact for faster healing. These lasers poke tiny microscopic holes in the
skin down past the epidermis and into the dermis, causing new collagen to form,
which fills in the acne scars and smoothens skin. The same basic principle is
the basis for micro-needling procedure (dermaroller or auto stamping) which we call the COLLAGENESIS in SkinStation, but more sessions are needed to
approximate the same benefits one can get from fractional laser resurfacing.



Scar
surgery:
The
goal of scar surgery is to raise the scar to the level of the surrounding skin,
thereby creating a smooth appearance.  Sometimes the scar is actually cut
out and the edges of the remaining skin are brought together.  Fillers may
be used to raise the affected area. 



Before
committing to any medical treatment for acne scar, be sure you have all the
knowledge you need to make an educated decision.  Have your free
consultation with the doctors at SkinStation so that you fully understand the
risks and benefits of each treatment option.
__________________________________________________________________________
This was published in the July 17, 2012 issue of Manila Bulletin Lifestyle Section. The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission for his achievements in the field of cosmetic chemistry. He can be reached at fred.reyes@skinstation.ph.
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