Over my life, I’ve done three rounds of Accutane: at 13, 27, and 33. Somehow I escaped cystic acne without any scars. I know not everyone is so lucky. My mom had terrible acne scars and I know it affected her self-esteem. She tried doing some intense laser treatments and strong chemical peels (this was about 20 years ago), but nothing ever made much of a difference.
These days there are some pretty effective options for treating acne scarring. The easiest and least expensive way is a retinoid. While prescription strength retinoids like Retin-A are used to treat active acne, they are also used to improve skin texture and elasticity, diminish appearance of pore size and lessen fine lines. They stimulate cell turnover and increase collagen production…so if you have acne scarring, the retinoid, with consistent use, WILL improve the texture of the scars. Will they all disappear? No. But they will improve. Skin Better’s Alpha Ret, and prescription strength, are options from us.
Before moving on from products to procedures that can treat acne, let’s discuss the three main types of acne scars:
Ice pick scars: small, deep holes which can have the appearance of enlarged pores.
Box car scars: Skin indentations or craters and can be shallow or deep.
Rolling scars: broader indentations due to atrophy or loss of the underlying collagen or fat. Rolling scars tend to look better when the skin is stretched tight.
It is common to have more than one type, and each type of scar is treated differently.
My favorite treatment for acne scars is microneedling with Skin Pen. Skin Pen is effective at treating all types of acne scars.
We recently upgraded to Skin Pen from MicroPen, and we are seeing much more effective results with fewer treatments. The purpose of microneedling is to stimulate the production of new collagen, using the body’s ability to heal itself. The tiny needles used in microneedling make microscopic channels in the skin, creating controlled wounds and triggering the body’s healing response: it stimulates the skin to regenerate and repair itself naturally. You will need to commit to AT LEAST 3 treatments, and maybe up to 6 treatments to see optimal results.
Lasers are an option too, although they will have more downtown than Skin Pen, and you will also need more than one treatment. Lasers effectively treat box car and rolling scars. All of these skin resurfacing treatments (including Skin Pen) work by the same general principle: creating controlled injuries to the skin and encouraging the body to heal itself through cell turnover and collagen stimulation.
We offer the Nano Laser Peel and the Halo. The Nano Laser is ablative, meaning it will remove the outer layer of skin. The Halo works in two ways: it has an ablative portion just like the Nano, but it also has a non-ablative portion which targets the deeper layers of skin, encouraging collage stimulation without having to damage all the outerlying tissue around those areas (think what a yard looks like when it is aerated). You see results faster with the ablative procedures; non-ablative results take several months to see as those treated areas are deep within the tissue.
Works well with rolling scars. There are several fillers that can be used for acne scarring, one of which is Bellafill. It is a semi-permanent filler with an FDA-approval to treat acne scars. It has been proven to last up to 5 years. For larger areas of scarring, subcision can be done before the filler is injected, to help lift the indentations. Other fillers that can be used will last 6 months to about 1 year.
Honestly the best results I’ve seen for improving acne scars are with microneedling. It doesn’t provide that instant result like fillers do, but in my opinion, it is the most effective in the long term.