Emerging Trends In Acne Scar Management

 

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On an average 80% of Indian population suffers from acne between the age group of 12 to 28 yrs of age. Almost 50% of these patients have acne scars later in life which serve as a terrible reminder of this disease.
What Causes Acne scars:
Everyone who has acne does not scar to the same extent. Reasons of scarring are multi-factorial and there is no single identifiable cause.
1) Scars develop whenever there is dermal injury which is 0.56+/- 0.03 mm
2) People who tend to pick or squeeze their acne blemishes are more likely to scar
3) Delayed treatment of Acne resulting in more infection and increase breakouts also contributes to scarring
Types Of Acne scars:
All acne scars are not the same and each type requires a different treatment.
1) Consist of pigmentation like brown patches in darker skin or red patches in lighter skin tones
2) Depressions such as ice pick, rolling, and box varieties of scars
Best time to treat acne scars is there when there are no breakouts.
Treatment Of Acne Scars:
There are many treatment options today but there is no one size fits all approach as each scar is different. This is where a Plastic Surgeon who has good experience in various types of scarring and expertise in their various treatment modalities is required.
Treatment has to be individualised depending on the type of scarring, downtime required, frequency of treatment, cost and finally the most important factor the potential of the treatment to improve the condition.
1) Brown patches:
Topical bleaching cream with Vit.C application. It may require 4 to 6 sittings spaced 14 days to 21 days apart. This is a low cost treatment with minimal downtime.
Chemical peels: They are more aggressive form of treatment and vary from medium to superficial depth. They require more downtime and additional precautions from sun in a tropical country like India.
2) Red or Hyperaemic patches:
These are managed by giving oral and topical antibiotics which reduces the inflammation. Lasers can be used in cases where increased vascularity is a cause secondary to rosacea. Lasers increase the cost and the downtime in the treatment.
3) Scars with depression like ice pick scars:
These scars are the most difficult to improve and may require a combination of procedures to achieve significant levels of improvement. Various surgical methods as described below can be used.

Current Trends In Management of Depressed Acne Scars:
1)Micro needling: This is the technique in vogue these days. It involves multiple punctures in the scarred skin with the help of a Dermaroller or Dermapen. After this various various types of medications or solutions like PRP can be applied over the treated area. This treatment may require 4 to 5 sessions every 14 days. In my experience this has shown promising results when done properly in combination with the proper solutions.
2) Dermabrasion: This is a time tested procedure which gives the best results in experienced hands. This procedure is entirely operator dependent and requires the maximum downtime. This involves buffing down the scarred skin upto the entire depth of the pit scar. Quality of the dermabrader, protecting the surrounding normal skin followed by proper after care in the form of sun protection creams and other medications gives the optimum results.
3) Laser Resurfacing: This is the fad nowadays .With ever evolving technological advances there various types of lasers available for clinical use . They vary from superficial to deep or more aggressive lasers. More aggressive the laser, more the downtime required and less number of sessions are required. However, availability and cost are major limiting factors in the treatment. CO2 lasers with fraxel technology are quite effective for skin resurfacing.
4) Others: Punch excision, subcision, fillers and chemical peels are older methods used as indicated.

Dr. Arunesh Gupta is a renowned Plastic And Cosmetic Surgeon based in Mumbai,India. He has trained in Plastic, Reconstructive and Cosmetic Surgery in India and U.S.A.
Dr. Arunesh Gupta has published extensively in Plastic Surgery Journals, written book chapters, and has presented his work nationally and internationally at Plastic Surgery scientific meetings. He is also actively involved in organizing continuing medical education and workshops for the benefit of other doctors and medical students.
His areas of interest are
1. Cosmetic Surgery of face, breast and body
2. Microvascular Surgery for Onco-reconstruction
3. Stem cell therapy for Hair and Facial rejuvenation
4. Cosmetic Gynecology
For any queries regarding Cosmetic Surgery
contact Dr.Gupta :
Email : aruneshgupta@gmail.com
Whatsapp : +91-9594066503
Website: http://www.piaaesthetics.com/