Severe acne will usually develop into acne scarring. This occurs when this type of acne is left untreated and becomes more likely to develop unsightly scars. For this reason, the best way to avoid acne scars is to treat acne.

However, sometimes preventing acne scars is almost impossible due to the severity of the acne. 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.

Finding Your Best Scar Treatment Option

Surgery is usually the best option for extensive scarring. The most common types of surgery include punch excision, punch elevation and subcision (or subcutaneous incision). These procedures are usually followed-up by using dermal fillers or laser resurfacing.

Punch Excision for 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 known as an ice pick scar. It is usually a deep scar that extends into the dermis.

Punch excision is the best option for ice pick scars.

This procedure entails the removal of scar tissue by using a cookie cutter like instrument. The remaining skin is sutured together resulting in 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, a straight scar will appear, but much less noticeable than the original ice pick scar.

Punch Elevation & Boxcar Scars

Boxcar scars are usually oval or round-shaped and wider than icepick scars. These types of scars are caused by a loss of tissue during a particularly severe inflammatory reaction. The treatment for acne scars of this type generally involves punch elevation that is later followed by dermal fillers or laser treatment.

Punch elevation is similar to punch excision, however, in this case of punch elevation the walls of the scar are left untouched. Fillers or sutures are used to bring the base of the scar to skin level. Grafted skin is used to close the wound.

Subcutaneous Incision for Rolling Scars

Rolling scars are caused when fibrous bands of tissue develop between the skin layers. These fibrous bands pull down the epidermis making the skin resemble a wave-like surface. Subcision is the best treatment option for this type of scar.

In this procedure a small needle or scalpel is used to separate the epidermis from the deeper scar tissue. Blood accumulates in the space between these two layers and helps the epidermis become more level. Dermal fillers may be required if the scar tissue is too deep.