• People experience different types of scarring from acne, and every person is left with different facial topography. Therefore, acne scar treatment must be addressed on a case by case basis. No single treatment is right for everyone. You and your dermatologist or cosmetic surgeon will have to decide what is right for your type of acne scarring. Acne scar type is a major factor to decide which treatment option is most suitable. Treatment of atrophic acne scar may not be the same as treatment for hypertrophic acne scars, rarly seen with acne. Depressed acne scars which are associated with atrophic changes in fat and connective tissue in dermal layer are most frequently seen with following acne.
• Since getting rid of acne scars is a complex process, often several of the treatments will have to be combined to produce the best results. For example, punch techniques followed by laser acne treatments is common. Ice pick acne scars might require undermining the acne scars (subcision) followed by injections (augmentation) . It is not uncommon to see more than two procedures combined as well.
• Basic research into how acne scars are formed and treated is very limited. It has not been a well treated condition in the past. However, new treatments are helping.
• Make sure you see before and after pictures of your doctor's previous patients, and be realistic about results.

As we understand more about skin damage from free-radicals, it seems that using an antioxidant would help treat post-inflammatory changes or even permanent scars. Unfortunately no good scientific studies have shown that any oral or topical antioxidant prevents or heals skin damage. As a matter of fact, Vitamin E, when applied topically to healing wounds, has been shown to cause more harm than good. As antioxidant research continues, scientists may find a formulation that effectively reverses skin damage, but until then any claims of skin rejuvenation through the use of antioxidants are merely hype.

It is common to have stains/discoloration and superficial scars from acne. These hyperpigmentation spots will generally improve with time and can be helped to improve more quickly with skin care treatments such as topical retinoids, alpha-hydroxy acids and therapeutic exfoliating facials. For many of those with mild scars, they may not even be aware of it — some of these may improve over time. However, severe scarring may be more difficult to treat.

Peels are another option to treat acne scars. TCA, glycolic peels and salicylic acid peels are more known available treatments. 10-40% improvements could be seen. Results vary according to types of scarring. This acne scar treatment improves overall skin tone and lustre and appears to help superficial mild acne scars. It also works best if you get a series of at least 6 peels, having one every 1-2 weeks. It uses very fine aluminum crystals to create a micro dermabrasion effect on the skin. Although the face is the most common area, other sun damaged areas such as the neck, chest, arms and hands may be treated. The effects may be more pronounced than glycolic acid peels, and should be used for those patients who do not yet require laser skin resurfacing or who do not want to deal with the longer healing time.

Treatment with fillers. Injections with Collagen, Cymetra™, Dermalogen™, Restylane™, and Hylaform™ are good treatments for shallow and deep acne scars. Fillers can be injected into the area of the scar, smoothing depressions. Results are immediately apparent. Patients usually require touch-up treatments every six months to two years. Injection of lactic acid for severe acne followed by dermal fat atrophy is another example that one study suggests its success in treatment of acne scars.

Treatment with dermabrasion is often recommended for severe acne scars and works well on both raised and grooved areas of the skin. The skin is first treated with an anesthetic, and the top layer of the skin is then "sanded down" with a wire brush or diamond burr. Seven to ten days later, the skin forms a new, smoother layer. Patients can expect full recovery in about six weeks.

Micro-Dermabrasion can be likened to a superficial "skin polishing,, using micro-crystals vacuumed over your skin's surface to remove damaged skin cells. These gentle treatments can provide noticeable improvement to acne scars. These dermabrasion treatments are progressive and are applied through a course of weekly sessions.

Treatment with laser has been around for more than 15 years now to improve skin scars. There are several types that could be used for acne scars. Among them co2 laser, YAG have become more well know for their effectivenss in skin resurfacing. Non ablative laser is another modality for treatment of acne scars with more effectiveness on dermis layer.

| American Academy of Dermatology | Plastic Surgery and Laser Treatments | Stretch Marks in Pregnancy | Aging Skin | Free radical inhibition by Metronidazole in treatment of acne | Mechanism of cytokines activation by Propanium Acnes | Oxidative Stress |