This is one of the most frequently asked questions I receive. I realize that many of my patients want beautiful, smooth skin, and they want it now! What I always end up telling them is that the choice of treatment and subsequent amount of downtime will significantly depend on the type and severity the acne scarring.
Below, I’ve outlined two general types of acne scars, and respective treatment options. While downtime can vary, I’ve also noted the general amount of time each procedure requires.
Deep acne scars
Deep acne scarring is usually in reference to wider, non-pitted scars, and is commonly seen after severe acne. One treatment that offers the least amount of downtime would be the use of dermal fillers. Dermal fillers are synthetic or harvested substances that are placed under the scars via an injection to raise the depressed skin. The goal is to make the scarred skin to match the surrounding area. For patients in U.S., Bellafill® is a dermal filler recently approved by the FDA for treating acne scars. It has been clinically tested and proven to safely and significantly reduce the appearance of atrophic acne scars. Bellafill® works by adding volume to the skin to lift and smooth out the pitted acne scar to the level of the surrounding skin.
The dermal filler is injected into individual scars during an office visit, with the ability to treat multiple scars at once. In most cases, results can be almost instantaneous, and your dermatologist may recommend several treatments a few weeks apart. There can be some bruising, swelling and redness for several days but overall downtime is minimal. Individuals may apply makeup directly after the treatment. Areas can be retreated as often as needed.
Pitted acne scars
These types of scars are usually much deeper than they are wide, and are often referred to as “ice pick” scars. Pitted scars can be best treated using a technique called “punch excision” or “punch grafting.” During this procedure, a small “punch”—usually one to two mm in diameter—is used to remove the pitted area. The skin is then sewn back together with a very small suture, or a tiny piece of skin, often taken from behind the ear, is put in place of the “punch.” While this may sound a bit aggressive or involved, it’s actually a fairly simple procedure. What’s ideal about this procedure is that several scars can be treated in one office visit, and the treated areas may begin to heal within one or two weeks. Occasionally, there is some bruising and redness but the overall downtime is modest.
It’s important that you consult with a physician to determine what treatment option is best for you. Your dermatologist will be able to diagnose what type of treatment is ideal for your lifestyle and help you understand the risks and benefits of each procedure.