Deep Acne Scars

Acne is a common skin condition that affects millions of people worldwide. While acne itself can be frustrating, the scars it leaves behind, especially deep acne scars, can be even more distressing and long-lasting. These scars can significantly impact one’s self-esteem and quality of life. This comprehensive guide explores the types, causes, and treatments for deep acne scars, helping you understand how to manage and improve these persistent skin concerns.

Here at FMS Skin and Hair Clinics, after the thorough examination by the dermatologist, we offer a customized treatment depending on the extent and the severity of the scars. 

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Door No. 8-2-293/82/A/725/A, Beside FMS
Hitech City Rd, near Daspalla Hotel, CBI Colony,
Jubilee Hills, Hyderabad, Telangana 500033

Deep Scars Treatment

For MILD DEEP ACNE SCARS – For ice-pick scars/ rolling scars – multiple sessions of TCA CROSS is done followed by either MNRF and Fractional laser like Erbium YaG laser or Co2 laser is done. 

For MODERATE DEEP ACNE SCARS – For Deep scars like box car scars – multiple sessions of MNRF and fractional laser like Erbium laser/ Co2 laser is done

For SEVERE ACNE SCARS – for deeper boxcar/ rolling scars – few sessions of subscision is done followed by MNRF and Fractional lasers. If required, punch elevation or punch excision is done followed by fractional lasers or MNRF sessions for a better result.

What Are Deep Acne Scars?

Deep acne scars are the result of severe acne lesions that penetrate deeply into the skin, causing significant damage to the underlying tissue. When the skin attempts to heal itself, the process can lead to an overproduction or underproduction of collagen, the protein responsible for skin strength and elasticity. This imbalance in collagen production results in different types of scars.

Types of Deep Acne Scars

Deep acne scars can be categorized into three main types, each with distinct characteristics:

Ice Pick Scars:

Ice pick scars are narrow, deep, and sharply defined. They resemble small, deep holes or punctures in the skin, similar to marks made by an ice pick. These scars occur when a deep, inflamed blemish, destroys skin tissue. The skin’s attempt to heal leaves a deep, pitted scar.

Boxcar Scars:

Boxcar scars are also deep, but they are broad, box-like depressions with well-defined edges. They are wider than ice pick scars and have a rectangular or oval shape. These scars form when an inflammatory breakout destroys collagen and tissue, resulting in a loss of skin structure. 

Rolling Scars:

Rolling scars are broad depressions with rounded, sloping edges, giving the skin a wave-like or undulating appearance. Rolling scars develop due to damage beneath the skin’s surface. Fibrous bands of tissue is formed creating rolling or uneven texture. They are usually shallow but can be deep.

Causes of Deep Acne Scars

Several factors contribute to the formation of deep acne scars, including:

  1. Severity of Acne: Severe acne, such as cystic and nodular acne, is more likely to cause deep scars due to the significant inflammation and skin damage.
  2. Genetic Predisposition: Some individuals are more prone to scarring due to their genetic content.
  3. Delayed Treatment: Untreated or poorly managed acne increases the risk of scarring. Early, prompt and effective treatment minimizes the risk of deep scars forming.
  4. Inflammation: Chronic inflammation from severe acne can damage skin tissue and hinder the healing process, leading to scar formation.
  5. Skin Picking and Squeezing: Manipulating acne lesions can damage the skin and increase the likelihood of scarring. It is essential to avoid picking or squeezing pimples.

Treatments for Deep Acne Scars—At FMS Skin & Hair Clinics

Since the scar has already occurred, it is best to get treated at dermatologist clinic for better outcome. Effective treatment of deep acne scars often requires a combination of approaches tailored to the severity and the specific type of scar. At-home treatments can help in the prevention of the scar formation in future. 

At-Home Treatments

  • Topical Retinoids: They are derivatives of Vitamin A which promote cell turnover and collagen production, helping to improve skin texture and reduce scarring. Application of a pea sized amount of retinoid cream or gel once daily at night, will help in improvement of scars over a period of time.
  • Alpha Hydroxy Acids (AHAs): Chemical exfoliants usually help in removing dead skin cells and stimulate new cell growth. Glycolic acid (AHA), should be added into your skincare routine 2-3 times a week to improve skin texture and reduce the appearance of scars.
  • Vitamin C Serums: An antioxidant, which helps in brightening the skin, reduce hyperpigmentation and it also helps in boosting collagen production. Application of Vitamin C serum, helps to lighten PIH and improves overall skin tone.

At Clinic Professional Treatments

  1. Chemical Peels: Chemical solution is applied to exfoliate the top layers and promote the growth of new, smoother skin. Most common used Chemical Peels is the TCA CROSS, Glycolic acid peels etc. They help in re-surfacing scars and improving overall skin texture. 
  2. Laser Therapy: Usage of laser beam light to produced control damage in the deeper scar which helps in resurfacing of the skin and stimulation of collagen. Fractional laser like Erbium YaG laser, CO2 laser etc are used. Multiple sessions are often required.
  3. Subcision: This procedure involves inserting a 26G needle under the skin to break up fibrous bands causing the scar.  More used in rolling scars. Often combined with other treatments like fractional lasers or dermal fillers to fill up the gap for enhanced results. There might be mild bruising and swelling.
  4. Radiofrequency (RF) Treatments: Uses radiofrequency energy to heat the deeper layers of the skin, stimulating collagen production and skin tightening. Microneedling RF (MNRF), fractional RF reaches deeper layers.  Effective for resurfacing of the acne scars, texture improvement as well as helps in reducing pigmentation. Downtime is 1-3 days of redness and mild swelling.
  5. Punch Excision and Elevation: Surgical techniques to treat deep ice pick and boxcar scars. Punch excision removes the scar, and the wound is closed with sutures, while punch elevation lifts the base of the scar to the level of the surrounding skin. Highly effective for specific types of deep scars with very good result. Recovery involves a short period of redness and swelling.
  6. Fillers: Injectable substances which fill in deep and depressed scars. Most commonly used hyaluronic acid fillers, collagen stimulators etc. Results are almost immediate but they are temporary lasting from several months-year, depending on the filler used. Minimal downtime, with mild swelling or bruising.

Selecting the appropriate treatment for deep acne scars depends on several factors, including the type, severity, skin type, and individual preferences.  A consultation with a dermatologist is essential to develop a personalized treatment plan.  Different treatments target specific types of scars. Deep and extensive scars may require more intensive treatments, such as TCA CROSS, subcision, laser therapy etc. Deep acne scars can be a persistent reminder of past breakouts, but with the wide range of treatments available today, significant improvement is possible. Hence a combination approach is advised to achieve better results.