If acne is not treated on time or if one has the habit of picking at acne, one does develop scars which may be psychologically disturbing to the person. Everyone who has them wishes to get rid of these craters and pits on their face. 

At Skinfiniti, Dr Jaishree Sharad examines the types of scars and decided on a combination of treatments to reduce scars by almost 80%. A single treatment modality is never enough. Peels, Dermaroller, Fractional laser, Subcision, Cryotherapy, RF Microneedling and Dermapen are done as required to give you a smoother clearer scar free skin. Microneedling is usually combined with PRP – Platelet Rich Plasma ie your own blood is taken and after separation of different constituents the plasma platelets is reinjected into your skin.  The platelets in your blood are rich in several proteins as well as growth factors which release stem cells, increasing collagen formation, skin tightening and overall rejuvenation.

Acne scars may be in the form of: 

• Macules that are small oval flat dark skin discolorations
• Ice-pick scars that appear as small, sharp depressions that wider are the skin surface and narrow into
  a point as they reach down into the skin.
• Depressed fibrotic scars  
• Soft scars are gentle, scar-like depressions in the skin. They are usually small, and either circular or linear.
• Raised scars are called hypertrophic scars.

Various treatment modalities for acne scars:

1. Microdermabrasion is done for extremely superficial scars. The superficial layer of the skin is abraded with crystals of inert aluminum oxide which are ejected with force in a controlled manner. It needs to be repeated once in 3 weeks for about 6 sessions.

    

2. Chemical Peels – Glycolic/ TCA/ Mandelic/ yellow / pyruvic acid peels.
   Chemical peels are done for superficial scars, pigmented scars & soft scars. After properly studying the skin type and its sensitivity, the doctor decides on the type of peeling agent and its concentration. The skin is first cleaned & the peeling agent is then applied gently onto the lesion or on the full face till the ‘end point’ is achieved. During the procedure, the patient might experience warmth or stinging sensation. The peel is repeated every fortnight for 6-8 sessions. The different types of peels used are : alpha hydroxy peels such as glycolic acid- derived from sugarcane; lactic acid derived from milk ; kojic acid derived from a Japanese mushroom; mandelic acid derived from apples ; salicylic acid , a beta hydroxy acid derived from willow birch and TCA.

    

3. Fractional ResurFX LASER: Resurfx is a US FDA approved treatment modality for skin resurfacing both for traumatic and acne scars, stretch marks, chicken pox scars and for loose skin on the neck. This non-invasive fractional erbium fiber laser treatment allows you to discover the fresh skin underneath the scarred layers.
   Resurfx device works on laser energy to create multiple microscopic injuries over treated area. These miniscule injuries release multiple growth factors which causes new collagen formation along with remodelling of existing ones. As collagen remodels, skin tightens giving an anti-aging effect and scars improve. In this way, the body’s natural healing process creates new, healthy tissue to replace skin imperfections.
   There is redness and swelling on the face for about 24 to 48 hours after treatment which settles on its own. The procedure is repeated once a month or can be done once in two months if combined with microneedling. There is 60 – 80% improvement is acne scars.

    

4. RF Subcision : RF subcision is non-surgical, minimally invasive modality for the treatment of acne scars. In this technology, a special electrode is introduced under a scar or pit and radiofrequency energy is passed through. It is used to break fibrous strands, which pulls the skin downward to form a pit. Also, the radiofrequency energy stimulates new collagen formation, thus lifting the pits up. It a very safe procedure compared to mechanical subcision, in which there is minimal risk of complications associated with manual subcision such as trauma to the surrounding tissue, excessive bleeding, and large hematoma formation and fibrosis.

    

5. Microneedling with Dermaroller: Dr Jaishree is the pioneer of this treatment in India. This treatment which involves breaking of the fibrotic bands with a rolling instrument. This causes collagen remodeling in the next 2-3 months. It should be repeated once a month for 6-8 sessions. If you have rolling scars, depressed scars and do not have time for a surgery or if a laser treatment is expensive, this is an excellent treatment for you. The downtime is just 1-2 days.

    

6. Microneedling with Dermapen: It is an evolution of micro-needling. It is a motorized device with multiple fine medically approved stainless steel microneedles which pierce through the skin up to 2-3mm and stimulate new collagen formation with a very short downtime of about 24 hrs. This collagen remodeling leads to the tightening of the skin, thus improving acne scars, fine lines and open pores. It causes less damage to the epidermis (the surface of the skin and upper skin layers) as compared to other similar procedures leading to quicker healing and a higher rate of success. It also breaks through the fibrous bands that pull down the acne scars. It is one of the most innovative rejuvenation therapies by the technique of microneedling.

    

7. RF Microneedling: Topical numbing cream is applied to the area of treatment 1 hour before the treatment to minimize any discomfort during the procedure. Once the area is numbed, site is cleansed the with spirit, the doctor will then apply the device to the skin surface releasing the needles and delivering radiofrequency energy in short bursts as the head is moved across the area to be treated. Three passes of RF microneedling is done with decreasing depth. Immediately after the procedure, face is warm, red and swollen. If uncomfortable a cool pack is applied to the area.
   RF Microneedling delivers RF energy deep into the dermis by creating tiny punctures in the skin. This triggers the body to create new collagen and elastin resulting in: 

• Improved texture
• Filling up of the scars
• Firmness of the skin
• Pore size reduction
• Improvement in  stretch marks 
• Overall skin resurfacing
  
  It is a minimally invasive, short procedure with minimal downtime. There is mild redness and swelling may occur for a few hours and up to 24 hrs after treatment. Avoid sun exposure for 3days. The interval between RF microneedling is 4-6 weeks. However 6-8 treatments are required depending on the condition of patient’s skin.