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Acne Scar (4)

暗瘡疤痕

If acne inflammation is not repaired properly, depressed scars may appear. This is a very common but difficult-to-treat type of scar, and today we will discuss the treatment of depressed scars.

Depressed scars belong to a structural skin problem and are more difficult to treat than pigmented acne marks or raised scars. There are three types: shallow boxcar, ice-pick, and rolling scars. Each type has different treatment options, and doctors will choose appropriate treatments based on the type of scar. To be honest, while doctors do their best to treat scars, patients must understand that scars are a permanent problem, and treatment can only improve them, but cannot restore them to normal skin.

For depressed scars, we can use non-surgical or surgical methods to treat them. Non-surgical methods generally include chemical peels, dermabrasion, fractional lasers, fractionated microneedle radiofrequency, sublative radiofrequency, and plasma technology. Surgical methods include filler injection, scar excision, subcision, skin grafting, and so on. It may seem very complicated, but the truth is that it mainly consists of three methods: excision/grafting, resurfacing, and filling. The success rate of treatment is affected by the depth and type of scar.

Resurfacing involves destroying the problem areas of the epidermis and then recreating them. Resurfacing includes chemical peels, dermabrasion, fractional lasers, fractionated microneedle radiofrequency, sublative radiofrequency, and plasma technology. Dermabrasion is the removal of the epidermis and part of the dermis, making the edges of the scar smooth, and then stimulating the production of collagen to smooth the scar.

The ingredients used in chemical peels for scars are different from those used in other types of peels. Regular fruit acid peels cannot effectively treat scars. So what should we do? We will use high concentrations of trichloroacetic acid (TCA) or phenol on the bottom of the scar to make it heal again. However, these methods have a higher risk and are prone to causing hyperpigmentation.

The purpose of fractional lasers, fractionated microneedle radiofrequency, sublative radiofrequency, and plasma technology is the same, which is to use high-energy lasers, radiofrequency, or plasma to damage the dermis and then produce new collagen to repair depressed scars. Among them, more people use fractional lasers (e.g. Fraxel® laser). Different instruments can improve scars, but the operation process must be careful because the high-energy output of the instruments may cause more severe side effects (such as skin darkening or blisters). Therefore, if you need any of the above treatments, be sure to find a doctor to handle them for safety!