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The result of severe acne is acne scarring. When severe acne is left untreated it will be more than likely develop into unsightly scars. For this reason, the best way to avoid acne scars is to treat acne.

However, there are times when preventing acne scars is near impossible due to the severity of the acne breakout. In these cases, scar removal becomes a reality. Scar treatment will depend on the type of scarring you have and the extent of the scar tissue.

How to Choose the Best Scar Treatment Option for You

Surgery is the best option for treating extensive scarring. The most common types of surgical interventions include punch excision, punch elevation, and subcision. These procedures are usually followed by laser resurfacing or dermal fillers.

Punch Excision & Ice Pick Scars

Cystic acne can leave behind a scar that makes the skin appear as if it has been pierced by a pin or needle. This type of acne scar is commonly known as an ice pick scar. It is usually deep and extends into the dermis.

Punch excision is the best option for ice pick scars.

A cookie cutter like instrument is used in this procedure to remove scar tissue. The remaining skin is then sutured together, forming a straight scar that is level with the surrounding skin.

Oftentimes, the extent of the excised skin is too large to suture, in which case, grafted skin is used to close the open wound. Once again, there will be a straight scar, but much less noticeable than the ice pick scar that it will ultimately replace.

Punch Elevation & Boxcar Scars

Boxcar scars are wider than icepick scars and are oval or round-shaped. The main cause is a loss of tissue that has resulted during a particularly severe inflammatory reaction. The treatment for acne scars of this type is generally punch elevation followed by dermal fillers or laser treatment.

Punch elevation is similar to punch excision, the only difference is that the walls of the scar are left untouched. The base of the scar is brought up to skin level using fillers or sutures. Grafted skin is used to close the wound.

Subcutaneous Incision for Rolling Scars

When fibrous bands of tissue develop between the skin layers the result is a rolling scar. These bands begin pulling down on the epidermis making the skin take on a wave-like appearance. In cases such as this, the best treatment option is subcision.

A small needle or scalpel is used to separate the epidermis from the deeper scar tissue. Blood will then accumulate in the space left between these two layers. This will help the epidermis become more level. In some cases dermal fillers may be required if the scar tissue is too deep.