Acne scar formation: Acne scarring is the most dreaded outcome for acne patients. The formation of scarring is related to the degree of inflammation and the patient’s mishandling. Acne scarring may manifest as increased collagen tissue (proliferative scarring and keloids) or be associated with collagen destruction (e.g., icepick-like scarring, atrophic fibrotic tracts, atrophic blotches, and degradation of elastic tissue around hair follicles).
Male patients, those with a family history of acne scarring, and those with more severe acne are more likely to develop acne scarring. Another problem that plagues patients with acne is post-inflammatory hyperpigmentation, some of which persists for a considerable period of time, especially in people with darker skin tones, and is sometimes more bothersome than primary lesions.
Treatment of acne scarring: In the past, the common method of treating acne scarring was grinding. Mechanical grinding was used for heavier acne scarring and microdermabrasion was used for lighter acne scarring. Since the introduction of fractional lasers, especially with plasma, there is a safer and more effective weapon to treat acne scarring. Mechanical grinding has been abandoned because it is too damaging and microdermabrasion because it is too weak.
However, the situation of acne scarring is very different. In some people’s acne scarring, there is both an increase in collagen tissue and collagen tissue destruction, and a single photoelectric treatment can only solve the problems of the general area and not all of them, therefore, the treatment effect is still unsatisfactory. There are also acne scars such as, for example, ice pick-like scars, where no matter whether fractional laser or plasma is used, satisfactory treatment results cannot be achieved.
After years of clinical practice and research, a comprehensive scar treatment program was developed, which means that in the process of treating acne scars with plasma and fractional laser, different types of scars are further enhanced by peeling, fat filling, surgical incision, and drug closure, and other means, which have achieved significant results.
For example, in the aforementioned ice pick-like scar, after peeling, the adhesions between the scar and the subcutis are loosened, followed by ion beam and monopolar radiofrequency treatment, the former initiating the epidermal trauma repair, and the latter continuing to heat the deeper layers of the scar to remodel the collagen below the scar. Then there is the atrophic fibrotic tract, which can be filled with fat to restore the skin to its fullness and luster, or of course surgical incision can be chosen for severe cases.
There are many other means and methods of comprehensive treatment, so I won’t elaborate on them all here, but one key point is to choose the right method for different scars. In short, only through comprehensive treatment can we solve the troubles of acne scar patients more perfectly and restore the original youthful appearance.