Acne scars can be difficult to get rid of. We spoke to Dermatologist Dr Nick Lowe about the treatment options.

For some people, acne is way beyond just the odd pimple or two. Inflamed spots that cover the cheeks and jaw line – not to mention the back or chest, can be distressing. And, just to add insult to injury, it can in some instances lead to scarring.

Obviously, prevention is better than cure so if you’re worried about your acne its best to speak to a GP as soon as it starts to flare up and get yourself some good products such as a salicylic acid  cleanser and an oil free moisturiser and a vitamin A cream.

Dermatologist, Dr Nick Lowe, of the Cranley Clinic on Harley Street says this is especially important if you have darker skin as you are particularly susceptible to hypertrophic (scars that are raised in a confined area) or keloid scars (scars that are raised by spread beyond the damaged or injured area).

Types of scarring

There are a lot of different types of scars associated with acne.

According to Dr Lowe, an acne expert who has formulated his own brand of anti-acne skin care products called  acclenz™, the most common scars that result from acne are:

• Ice pick
• Box punch
• Rolling
• Contracted atrophic
• Erythematous
• Hyperpigmented (dark coloured scarring)
• Hypopigmented (the scar turns white)

In addition there are the hypertrophic and keloid scars.

In some instances, some patients may have a combination of different types of scarring.

Acne and scarring can have a serious emotional and psychological effect, and it’s not just women who are affected. As Dr Lowe says, acne scarring on men can be just as devastating as it often makes people judge them in a different way.

“It can make men look more aggressive, so there’s not just a physical cost but also a psychological one as it can affect the way they present to the world”, he says.

What can be done?

Fortunately, there is a lot that can be done to help reduce or get rid of acne scars even when the acne is still active. In the first instance there are various topical creams that a doctor can prescribe. These include retinoid (Vitamin A) and cortisone creams and tape.

The cortisone can help get the inflammation under control and prevent scarring while the vitamin A cream can help control oil production and prevent future outbreaks.

Once the scarring is there, there are a number of options including:

• Fillers for volume
• Fillers for collagen stimulation
• Anti-wrinkle treatments like Botox
• PRP-platelet-rich plasma

For pitted or dented scars like the ice pick, box and rolling scars fillers – usually the domain of lips and facial sculpting, can make a considerable difference by plumping up the indented area to make it smooth again.

As indented scars are often the result of damaged collagen in the area, fillers that have a collagen stimulating effect, like Ellanse, can make a significant difference. Ellanse contains microcapsules containing ingredients that are broken down over time to release collagen stimulating ingredients. The result improves over time and can last up 1-4 years depending on which Ellanse product is used.

Dr Lowe says the anti-wrinkle injections can be really useful in areas of movement such as around the mouth where repeated movement can make the scars appear thicker or hypertrophic. The PRP, he adds, can be useful in promoting collagen growth and wound healing.

Sometimes a treatment called subcision is used. Often indented scars are held down by damaged fibrous tissue underneath, but severing those ties can help produce a smoother end result.

In some instances removing the whole scar may be the best course of action.

More severe scarring

Stepping up to the next level involves radiofrequency or laser treatments.

Dr Lowe says fractional laser can be used effectively on superficial acne scars but if there is deeper damage, the Fractional CO2 laser or Fractional RF are the best options.

While they are different treatments they function in a similar manner by penetrating the skin and causing micro-damage that boosts collagen production. The laser also ablates the surface of the skin so there can be downtime of a few days to a week if the CO2 is used.

For scars that have lost their pigment alexandrite or thalium 1927 mn lasers can be used while a vascular laser is more appropriate for red or darkened scars (erythematous scars).

Acne is not the easiest of conditions to treat and scars are complicated things, but the skin smoothing results with these treatments can be impressive.

If you are concerned about scarring and want to know more about your options to treat them, contact Dr Lowe or speak to your GP about options in your local area.