Many patients with acne heal with some degree of scarring. Although it is impossible to predict who will develop scarring, there are several factors that increase the risk:

• Ethnic background: acne patients of Asian, African American, and Hispanic descent tend to have more severe acne and more severe acne scarring

• Inflammatory acne: these lesions include cysts and nodules which penetrate the skin deeply, causing more skin damage than other types of acne lesions

• Untreated/delayed acne treatment: the longer inflammatory acne goes untreated, the greater the risk of scarring

• Picking, popping, and squeezing acne lesions increase inflammation and increase the risk of scarring

There are a few different types of acne scars that can form, depending on how your skin heals itself:

• Depressed acne scars: If the skin produces too little collagen during the healing process, pitted or depressed acne scars can occur:

• Rolling scars are shallow, round, smooth, and can be quite large, most commonly located on the cheeks, and the easiest type of acne scars to treat.

• Boxcar scars are deeper and often located on the temples

• Icepick scars are the deepest and also the narrowest type of acne scar, and therefore the hardest to treat, and can occur anywhere on the face that acne occurs

• Raised acne scars: If the skin produces too much collagen during the healing process, raised scars can occur (also known as keloid scars). This is more common in patients with skin of color.

Luckily, most of the time, acne scars are relatively mild and don’t need to be treated. But when scarring is more severe, treatment is required to smooth and even out the skin. There are many different treatment options for acne scarring, and not one treatment is suitable for every skin type and/or scar type. Acne scar treatment options include chemical peels, punch excision, microneedling with platelet rich plasma (PRP), microneedling with radiofrequency (RF), intense pulsed light (IPL), fractional laser resurfacing, and other laser treatments. The most successful results are often achieved by using more than one treatment modality. Your highly experienced ShanthiMD provider will do a thorough examination of your skin and work with you to choose the best acne scar treatment for your specific skin type, acne scar type, and cosmetic goals.

ShanthiMD Dermatology offers the MOST advanced treatment options for acne scarring:

Fractional laser resurfacing: fractional laser resurfacing is one of the gold standard treatments for acne scarring. Two wavelengths of light, one superficial and one deep (essentially Fraxel Dual®) are used to create microscopic columns of heat injury in the skin, stimulating collagen production and supporting the skin’s effort to heal itself. An advantage of this treatment is that it can be customized to skin type, depth of scarring, and amount of downtime tolerated.

IPL: Acne-prone skin very often heals with persistent redness in the form of tiny blood vessels at the surface of the skin called telangectasias. Intense pulsed light (IPL) is very useful to address this redness. IPL can be done alongside other acne scar treatments and in some cases, conveniently within the same treatment session like microneedling.

Eclipse Micropen Microneedling: The Eclipse experience is state-of-the-art microneedling treatment which can be combined with platelet-rich plasma (PRP) to revitalize your skin’s tone and texture and reduce the appearance of acne scars. Millions of microscopic pinpoint wounds are created by tiny microneedles, breaking up acne scars and other textural imperfections on the surface of your skin. These micro wounds stimulate your skin to produce new collagen and elastin, improving the appearance of acne scars in the process. Microneedling is safe and effective in all skin types and produces long-lasting results.

Genius Microneedling RF: The Genius™ takes microneedling one step further by delivering a flash of deep radiofrequency (RF) energy (heat) while gold-plated micro-needles are in the skin at three different depths. These tiny zones of heat injury amplify the level and depth of new collagen and elastin that is stimulated from microneedling alone. The resulting tissue tightening and remodeling deep within the skin becomes visible lifting, smoothening, and softening of acne scars at the skin’s surface. Another advantage of the Genius™ is that it is customizable for all skin types, including melanin rich skin.

Chemical Peels: Chemical peels exfoliate the outer damaged layers of skin to reveal smoother, more even skin underneath. This process can reduce acne scarring as well as unwanted hyperpigmentation (brown spots). There are many different types of formulas that can be used, depending on scar type and skin type and tolerance for downtime (peeling), including TCA (Cross procedure).

Subcision: Subcision is a very useful procedure that uses a needle (with anesthesia) to loosen scar tissue that is adhered to the tissue below, allowing indented scars to naturally rise toward the level of the normal skin.