After Acne, Treating The Scars

acne_scars_womanIt’s bad enough to have acne, which, if you’re lucky enough not to have the acne not hurt your skin when you have it, can be emotionally debilitating to those who struggle with it.  It’s even worse when acne literally leaves its mark after clearing away.

Acne scarring is the by-product of the inflamed lesion caused by acne, and its tendency to rupture or break the skin in the process of healing.  The degree of scarring depends on how severe the inflammation was and how deep below the surface the acne lesions were.

When the pimple is very close to the skin’s surface, a rupture can occur and healing can be very quick, causing minimal damage and scar.  When the lesion is bigger and deeper, the infected cells can infiltrate deeper tissue areas and destroy adjacent healthy skin tissue.


When more extensive damage occurs, your skin’s immune defenses come to the rescue to repair the damage by forming new collagen.  Because your body is trying to repair an injury and does not care what it looks like, the collagen patch does not look the same as the previous smooth skin, resulting in the look of pock mark or scar.

Discoloration is another aggravating and disfiguring aspect of acne scars.  Most commonly, acne scars can leave dark spots caused by the inflammation during the healing, especially in those individuals with darker skin tones.  Occasionally, acne scars can appear red due to accumulations of broken blood vessels and is most noticeable in very light skinned individuals.

Other factors that can aggravate scar color include sun exposure, which cause injured tissue to darken more than the uninjured skin.  Picking or squeezing acne lesions can also aggravate both the depth and color of the scar by creating more inflammation and spreading the infection into deeper and adjacent tissues.

What are the most effective treatments for acne scars?

melasma_laserLaser therapy– There are several forms of superficial laser therapies that will not treat the scars themselves, but can make them less visible by treating the color.  The dark or brown pigments left over in the darker-skinned person can be lightened to even out the skin tone with your normal skin.  The reddish color caused by broken blood vessels can also be lightened by using the laser to cause the blood vessels to collapse and get reabsorbed by the body.

Fraxel– Fraxel is the most well known brand name for a category of laser known as non-ablative fractional laser.  Over the course of 3-5 treatments depending on the depth of the scars, the treated skin surface will essentially be resurfaced.  The newer skin will be smoother, less discolored, and lessened in depth.

Because the treatment is much deeper than the superficial lasers, there is some mild pain that results.  Topical anesthesia is then applied to the treated skin that controls the pain.  Down time after anesthesia application usually lasts several days to one week of swelling and redness, which resolves as the skin heals.

microneedling_in_actionMicroneedling– This method is the newest for treating acne scars.  Using microneedles, the device I use here at Maine Laser Skin Care rapidly pulses the needles in and out of the skin, creating a controlled injury to the area of scarring.

This newly-induced injury triggers the body’s defense mechanism to form a new pattern of repair, which will smooth out pock marked areas and reduce pore size.  Similar to Fraxel, we use a topical anesthetic, although downtime is less with microneedling.  Three to four microneedling treatments, which are spaced out 4 to 6 weeks apart, will improve mild to moderate scars from acne.

Dermal Fillers– Sometimes, despite all the treatments above, some of the deeper scars will persist and appear deeper than the person will like.  Several dermal fillers that we typically use for lines in the lower face can also be used in the area of acne scars.  I have treated many acne scars that were exceptionally deep due to cystic acne with good success and patient satisfaction.

As with all of the other previous blog posts and newsletters, if you have any questions about the content or if you would like my opinion on how aesthetic treatments could help your individual condition, please don’t hesitate to call for a free and confidential consultation at (207) 873-2158

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About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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