Useful Acne Scarring Treatments
Offered in the Cosmetic Medical/Aesthetic Medical Sector
This is by far the most popular treatment used to treat acne scars. It is effective but only mildly so. Treatments are multiple in nature and do go some way to produce new collagen and remodel collagen in sunken acne scars. One of the reasons why this treatment is popular is because recovery time is quick. Usually the patient can go to work the next day with only some mild redness as a consequence. The redness usually will last a maximum of 2 days. Even though tangible benefits are only very mild in each treatment the trade-off is quick recovery. it is a good way of improving one’s acne scarring without having to take time off work. There are multiple devices. Dermapen is a electronic needle stamping device in which needles can be repeatedly stamped to a controlled depth (eg 1.5mm) at a speed of 100 times per second! Less state-of-the-art in the world of microneedling are simple roller devices that needle the skin using a rolling motion. Often local anaesthetic cream is used prior to the procedure as it is uncomfortable despite a quick recovery.
This is also a proven technique in the treatment of acne scars. A caustic agent such as Trichloracetic Acid (TCA) is applied to the skin and causes the outer layers of skin to be removed by a process of controlled chemical burn. This helps acne scarring in two ways. There is an element of surface remodelling through regrowth of a new superficial dermal and epidermal layer. The inflammatory process causes an increase in the production of new collagen as part of the healing process. By the nature of chemical peels this remodelling and collagen formation is limited to the upper layers of the skin.
Improvement is mild but if a good medically qualified provider is used a typical TCA 25%/Jessners combination peel or TCA 35% peel can achieve a better result equivalent to multiple microneedling treatments.
The downside is that recovery time is in the region of 7-9 days. As a result more technically advanced treatment providers are offering fractional laser resurfacing as the benefits are greater for a similar amount of downtime. Therefore chemical peels although effective are seen as somewhat old-fashioned.
This is a type of microneedling that combines radiofrequency energy via the needles. The idea behind this concept is that with the thermal energy created by radiofrequency greater collagen stimulation is created than needling alone. There is limited evidence to support this claim. At present results appear to be more device, technique and operator dependent. Fractional laser treatment with CO2 laser is a more powerful modality with a much larger evidence base.