Ask the Expert
Question 3—Hypertrophic Scars
Response by: Dr. Joseph
Rather than pitted or pock marks, my acne leaves reddish purple bumps behind. Are they also considered scars? What are the best options to speed up the healing process?
Yes—in general, acne scars are either pitted (holes or crater like valleys in the skin) or they can heal with raised scars (a bump rather than a hole). Raised scars are called hypertrophic scars or keloids, and are caused by a buildup of excess collagen and a decrease in collagenase (the enzyme that breaks up collagen). As you’ve noticed, they appear hard, raised, and as reddish, purple bumps or patches on the skin.
There are several treatment options, and each has its pros and cons. I’d recommend scheduling an appointment with your dermatologist, who can best provide you with a treatment recommendation that works for you. In the meantime, I’m happy to share a brief overview of some of the more common treatments:
- Intralesional (injected) steroids are able to improve the appearance of some hypertrophic acne scars because of the anti-inflammatory processes associated with the treatment that can decrease the creation of collagen in a scar.
- Cryosurgery uses liquid nitrogen to coat scars, causing direct physical damage and changeto the way scars appear.
- Radiation helps break down collagen in scar tissue. This is most commonly used as a companion treatment to prevent recurrence of hypertrophic and keloid scars and is usually reserved for severe cases based on the inherent risks of radiation therapy.
- Laser/PDL (pulse dye laser) is useful in breaking down the scar at deeper levels.
- Silicone dressing is simple a silicone bandage may be placed over the scar to help flatten it. This is usually most helpful in a freshly healing scar.
Prior to making an appointment with your dermatologist, please communicate when the scar began to form, whether it is increasing or decreasing in size over time and if you have a history of keloid or poor wound healing.
Always consult with a physician who is an expert in the above therapies to correct scarring before starting any treatment.