Despite good hygiene and even despite good dermatologic care, people with acne sometimes still get acne scars and they ask me, "What can I do to get rid of them?" First and most importantly, we have to get your acne under control. There is no point in treating old acne scars if you are still getting breakouts of bad cysts which is what new scars usually come from. Assuming that your acne has come under control there are two types of acne scars that people get.
First is called an "Ice Pick Scar" because the shape of the scar almost looks like an ice pick has pierced the skin. As an example [Dr. Schultz holds up a cone-shaped disposable drinking cup] this drinking cup is very tapered and angular and deep compared to the width. So ice pick scars tend to be deep and angular and the only way to really get rid of them is by cutting them out. Two weeks ago a patient of mine with both types of scars came in to have twenty-two ice pick scars cut out. It was an hour procedure, a little bit of local anesthesia, one or two tiny plastic surgery stitches, and a week later they healed beautifully and he is very happy. Really, that is the only way to treat those types of scars.
When you have the more common shallow "Crater Scars", [Dr. Schultz holds up a dinner plate] they are much wider than they are deep, and these scars can be treated in several different ways. Temporarily, fillers can be injected under the skin to lift up the bottom of the scar to make it flat. The fillers can be permanent, or they can be temporary depending on what you and your doctor decide to use. If they are temporary, they probably need to be freshened up and retreated every three to twelve months. But there are also procedures that will get rid of these types of scars permanently. They are called ablated procedures. We used to do dermabrasion for that but today instead we usually use laser procedures that ablate or remove the upper layers of skin. It does cause about ten days of down time during which time the skin has to heal and reform and it looks like you have a really bad sunburn during that period. It is a time where you would not be going to work. After the procedure is done and the skin has healed (in about ten days to two weeks), you will have pinkness for about a month to two months which is easily covered by makeup. But, most importantly, you then have permanent improvement if not curing of the crater type scars.
So the good news is if your acne is finished, it is time to fix your scars and depending on the type of scars you have, there are procedures that will remove them and put a smile on your face.