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Non Surgical Solutions : Acne and Acne Scaring
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There are numerous procedures that can be used to correct acne scars. Each procedure has its own risks and benefits, and several procedures are normally combined to create the smoothest appearing skin. Here is a brief discussion of the more effective acne treatment procedures.
Dermal Fillers
There are many types of dermal fillers that can be injected into acne scars to raise the surface of the skin and give a smoother look.
Hyaluronic acid derivatives are now the most popular artificial fillers. The injection of these materials does not permanently correct acne scars, so further injections are necessary. Fat injections are more permanent fillers.
Punch Excision
This method of surgically correcting acne scars is used on deep scars such as icepick and deep boxcar scars. This procedure uses a punch biopsy tool which is basically a round, sharp "cookie-cutter" tool that comes in diameters ranging from 1.5 mm to 3.5 mm. The size of the tool is matched to the size of the scar to include the walls of the scar. Under local anesthesia the scar is excised with the punch tool and the skin edges are sutured together. The newly produced scar eventually fades and may not be noticeable. If it is noticeable, it is more amenable now to resurfacing techniques.
Punch Excision with Skin Graft Replacement
With this method the scar is excised with the punch tool as above. Instead of suturing the skin edges together, the defect is filled with a punch skin graft usually taken from behind the ear. With this procedure a color and texture difference may be noticeable, but a skin resurfacing technique can be used 4-6 weeks after the grafting to correct this difference.
Punch Elevation
This method of surgically correcting acne scars is used on deep boxcar scars that have sharp edges and normal appearing bases. The same punch tool as above is used to excise the base of the scar leaving the walls of the scar intact. The excised base is then elevated to the surface of the skin and attached with sutures, steri-strips, or skin glue called Dermabond. This method lessens the risk of color or texture differences as can be seen with graft replacement, and lessens the risk of producing a visible scar as can be seen when wound edges are sutured.
Dermabrasion
This is one of the most effective treatments for acne scars although laser resurfacing has been more popular recently for treating acne scars. “Laser” sounds more advanced and more precise but when done by an expert dermabrasion gives frequently the best results. It does require general anesthesia and ten days to heal. The procedure involves using special mechanical rolling instrument to level the scars.
Microdermabrasion (Using crystals)
This treatment is popular because it requires no down time and is safe but has limited efficacy in treating acne scars. It is similar to gently using sand paper.
Chemical peels
Superficial chemical peels that are done by beauticians are not effective ion treating acne scars. Deeper TCA peels (a strong acid is applied to the scared skin so that new skin is forced out) are effective in treating permanent color changes seen in Asian and Middle Eastern skin. The face requires one week to heal.
Laser Resurfacing
Laser resurfacing is a popular treatment for many skin defects. The most popular laser types used for resurfacing of acne scars are the carbon dioxide (CO2). Erbium lasers are gentler but less effective. Lasers work by essentially burning the top layers of skin to a precise depth. The skin then heals replacing the burned layers with newer appearing skin. The correct post-operative care of skin that has undergone laser resurfacing is a very important factor in determining the success of the procedure. Healing time is ten days.
Fraxel Laser
Fractionated laser is the safest and latest method in treating acne scars. Done under local anesthesia (cream) - Requires one hour - Reddness for two to three days after procedure - Needs four to six sessions at least two weeks apart. Expect 50-60% lasting improvment. For more about fraxel click here
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