Acne Scarring: OVERVIEW

Acne scars are the complication of severe acne (pimples).  Acne scars are formed during healing of active acne as a natural process of wound healing but in scars normal collagen tissue is replaced by scarred fibrous tissue.
There are multiple safe and effective surgical or non-surgical acne scar treatments in Jaipur that can reduce the scars. All the treatments induce new collagen formation that is called neocollagenosis and improve appearance of acne scars. Qualified dermatologist performs all the treatments only.
The best results are usually obtained from combination of acne scar treatments when the Dr. Sunil Kothiwala Dermatologist in Jaipur examines your skin first to know the kind of scar you have.

AcneScarring CAUSES

Why does Acne Scar?

Acne has different stages. When acne is in its initial stage, there is no scarring. As it advances to inflammatory stage and the inflammation reaches deep into skin, chances of scar formation start. During healing of active acne there is either loss of healthy collagen tissue or excess formation of collagen due to severe persistent inflammation. Hence controlling inflammation early is probably the key to prevent or reduce scarring in acne. However in some patients scars at early stage of acne with minimal inflammation have also been noted, but these scars show good improvement with treatment.

Who is Prone to Getting Acne Scars?

It depends on multiple factors:

1. No treatment for active acne or who left acne to resolve on their own.
2. Delayed Starting of treatment for active acne.
3. Picking, popping or squeezing acne increases inflammation hence results in scarring.
4. Having severe acne (nodulo cystic )
5. Family history of severe acne.

Acne Scarring Symptoms

What are the types of Acne scars?

Acne scars are polymorphic and have different shapes, sizes, depth and surface texture. Multiple types usually co-exist in the same patient. Acne scars can be broadly divided into three categories.

• Macular (flat) acne scars: Erythematous, Hyperpigmented
• Atrophic (depressed)acne scars: Ice pick, Boxcar—shallow and deep, Rolling, Linear—narrow and wide
• Hypertrophic (Raised) acne scars: Hypertrophic, Keloidal, and Papularscars.

Put a graphic image of type of acne scars

Acne Scarring Treatment in Jaipur

Why You Should Treat Your Acne Scar?

As acne scars are permanent end consequence of acne, it is not necessary to treat acne scars. It is more of cosmetic concern that causes psychosocial impact on individual’s daily life. Reduced self-esteem, limiting social or professional interactions, affecting career and personal life and desire of improvement in look are main reason for getting treatment for acne scars.

How are acne scars treated?

At Dr Kothiwala’s SkinEva Clinic various modalities of treatment in Jaipur are available for acne scars. For acne scars Dr Kothiwala SkinEva Clinic is one of most advanced skin clinic in jaipur as it is equipped with all possible treatments of acne scars and Dr Sunil Kothiwala Dermatologist in Jaipur </a> is highly experienced in performing these treatments. Treatments are chosen and customized according to individual patients. Acne scars remain a therapeutic challenge andhence,combination treatments are the only key to treating them well. Following modalities are used:

Topical therapy

Topical therapy can play a crucial role in the management of acne scars. There is no anti acne scar cream which can treat acne scars to a good extent. Sunscreen & moisturiser are the most important part of acne scar treatment for post procedure skin care. Tretino in creams as anti acne scar creams is useful for initial treatment in mild superficial scars, as primingagents to reduce incidence of complications and as maintenance therapy between surgical techniques.

Microneedling and PRP therapy

Microneedling is a minimally invasive treatment for acne scars. It is mainly useful for rolling, linear and shallow boxcar scars. The instrument with fine needles is used to create microinjuries over the skin. Microneedling causes dermal stimulation with increased dermal collagenization. It is safe for all skin types. Dr Kothiwala SkinEva Clinic is best skin clinic in Jaipur for microneedling treatment for acne scars because clinic have Dermapen world’s best microneedling device that provide most uniform and effective results.
For enhanced results, it is often used in combination with PRP therapy. Platelet-rich plasma (PRP) is a concentrate of platelet-rich protein that has been harvested from the patient’s own blood by using the centrifugation technique. Platelets are cells present in blood that help in tissue repair and growth of new cells. When skin is treated with PRP, it promotes tissue regeneration and collagen growth. This leads to skin tightening, smoothing and brightening. It improves the skin tone and texture and refines pore size and gives an overall healthy and rejuvenated look. At SkinEva Clinic, PRP is formed by automated PRP plus machine which gives high concentration of platelets under uniform temperature. Dr Sunil Kothiwala Acne Scar Specialist Jaipur himself perform the whole treatment.

Fractional CO2 Laser

Fractional CO2 laser is the most effective treatment for acne scars. Results of fractional CO2 laser are best among all non surgical treatments for acne scars. Dr Kothiwala SkinEva Clinic is equipped with world’s best CO2 laser that is Alma’s Pixel CO2 Laser for acne scar laser treatments in Jaipur. It is highly versatile and precise and promises excellent results while minimizing unnecessary tissue damage. The Pixel CO2 laser is used to resurface the skin on the face and body and is an optimal solution for reducing the appearance of scars. It targets the water content of soft tissue of skin and remove scarred tissue in fractional pattern. Its thermal effect induces new collagen formation which helps in improving texture of acne scar. Dr Sunil Kothiwala has delivered many lectures about CO2 laser treatment for scars and conducted training workshop for younger dermatologists in national conferences. He is expert in providing laser treatments for acne scars.

Fillers

Fillers are best used for shallow depressed acne scars. Fillers are of various types but are usually based on Hyaluronic Acid (HA) that naturally hydrates and lubricates our skin and joints. HA binds with water increasing hydration and gives plump appearance. Dermal fillers are clinically proven to hydrate the skin and stimulate collagen production thus restoring and adding volume to the treated area. They give instant elevation of scar but results obtained from many types of filler are temporary and can last for 12-18 months.

TCA CROSS

TCA CROSS treatment is best suitable for ice pick acne scars. In this treatment TCA is applied in the centre of ice pick acne scar which results in denaturation of scar tissue. New collagen formation results in elevation of scar. It can be combined with fractional CO2 laser orpercutaneous collagen induction technique with microneedling to enhance and improve the results.

Subcision

Subcision is basically indicated for depressed acne scars. It’s a process of elevation of depressed acne scars bythe introduction of a sharp needle beneath the scar that breaks the fibrous adhesions tethering the scar. Combining subcision with a resurfacing procedure such asfractional laser resurfacing yields good outcome.

Punch excision technique

Punch excision technique is utilized for deep depressed and boxcar scars and is generally combined with laser resurfacing for optimal result. It is good combination when patient have fewer acne scars.

Chemical peels

Peels ablate epidermis (topmost layer of skin), which is followed by epidermal regeneration and collagen formation. Salicylic acid, mandelic acid, glycolic acid, Jessners solution and TCA are most frequently used in indian skin. They are generally used in combination with other procedures such as subcision, microneedling and CROSS technique. These are indicated for macular, hyperpigmented and atrophic scars.

Microdermabrasion

Microdermabrasion is an effective modality for treatment of superficial acne scars. It can be done using crystals or diamond tips. It is a safe, non-invasive office procedure with minimal or no downtime.

Treatment for raised hypertrophic acne scars

• Scar creams: Silicon based creams and dressing are useful to depress te elevated scars. They are slowly acting and useful in combination to other treartments. They make the scars shrink, flatten and lose their colors.
• Intralesional injection: It is injection to diminish growth of fibrous tissue. It is given once in 3 weeks and usually from first injections results start appearing. Dr Sunil Kothiwala Dermatologist assess the hypertrophic scar and inject medicine into scar itself. It makes scar soft and flatten.
• Laser treatment: CO2 Laser ablate the raised scar tissue and it can be followed by injection on same day to prevent recurrence. IPL treatments can be ien to reduce size of hypertrophic acne scars.
• Intralesional cryotherapy for raised acne scars: In this treatment liquid nitroen gas delivered into the lesion through specific device which freez the tissue. Scar tissue dies and shed off but this treatment can lead white spots on skin.

What are the useful combination of treatment for best results in acne scars?

Dr Sunil Kothiwala Dermatologist Jaipur has developed own protocols to perform all acne scar treatments in Vaishali Nagar that give best results in acne scars.

• CO2 Laser plus
• Microneedling with PRP therapy (any acne scar )plus
• If ice pick acne scars – TCA CROSS
• Deep Box scar (Few in number)- Punch excision
• Deep box scar (multiple)- subscion
• If patient want quick results – Fillers (but results are temporary)
• Superficial atrophic acne scars- chemical peels or microdermabrasion
• Macular scars- Chemical peels or microdermabrasion

Factors to Consider Before Starting the Acne Scar Treatment

Selection of best acne scar treatments depends on various factors. Dr Sunil Kothiwala discusses these factors in detail in first consultation. These factors are:

• What is treatment result expectation?
• As multiple sessions are required so affordability is also important to consider.
• Post treatment Downtime. Can you afford downtime?
• How much time you can give for treatment and post procedure skin care?

Outcomes of the treatments of acne scars

In most of acne scar patients we expect average 50-60% improvement in apprearance of acne scars. Multiple sessions of these treatments are required for best results. Still end results depends on selection of treatment, knowledge to perform the treatment and type of scars. Patient need to follow all postr procedure skin care instructions sincerely to avoid side effects. All acne scar treatments are safe and effective, but the best solution to the problem of acne is prevention.

How can acne scarring be prevented?

Following can be helpful:

• Never go for self-medication.
• See a Doctor as soon as acne develops, so that correct treatment can be started. Treat acne early as soon as it develops.
• Follow the treatment regime meticulously.
• Do not pick or squeeze acne lesions.

ACNE SCARS TIPS

1. Discuss with dermatologist about your concerns related to acne scars.
2. Check for affordability, number of sessions, down time and then decide nature of acne scar treatments.
3. Follow all the pre procedure instructions to avoid post procedure side effects.
4. Pre procedure sunsceen application for 3-4 weeks is mandatory.
5. After acne scar treatment understand day to day skin care regime.
6. Post procedure moisturiser and sun protection are most important.

Acne Scarring FAQs

• Q.I don’t have time of 3-4 weeks before acne scars treatment for sunscreen application. Is it necessary to apply sunscreen before acne scar treatments?
• A. Yes, specially in Indian skin it is necessary. It is called priming. Skin type III-V need priming to avoid post procedure pigmentation changes.

• Q.what is most effective non surgical acne scar treatment?
• A. Fractional CO2 laser

• Q.what is average down time post Co2 laser for acne scars?
• A. 5-7 days. Post CO2 laser there is scab formation of treatment area which shed off in 5-7 days. Redness may persist for 2-3 weeks as per skin type for that sunscreen application is must.

• Q.is it necessary to get combination of acne scar treatment?
• A. For best results yes. Because there is no any single modality which can work on all type of scars with same efficacy so most of the time dermatologist combine 2-3 treatments according to acne scar type and skin type.

• Q.How frequently I will need co2 laser ?
• A. Post CO2 laser epithelisation starts in 4th week which is followed by new collagen formation. 2-3 months is ideal time to repeat CO2 laser. Sometimes this gap can be more.

• Q.Can acne scars recur?
• A. A. the changes in scars with treatments which are inducing new collagen formation are long lasting and usually scars don’t appear again. Results of fillers are temporary.

• Q.what is the cost for laser treatment of acne scars?
• A. Laser treatment for acne scars is very much affordable at Dr Kothiwala SkinEva Clinic Jaipur and cost of one session range from 4000-6000 INR according to areas and extent of acne scars.

For more information on Acne Scarring treatment in Jaipur located at Vaishali Nagar & Sitabadi Tonk Road Branches or to inquire about other services please contact us on 7669571405.