There are different types of acne scar. Color is an important characteristic of scarring. Some scars are red, brown (dark), while some are light in color. Others are skin color.
Acne scarring is not level. The elevated ones can be nodular usually located on the chin, but some are hypertrophic, thickened, and are keloidal. Most, however, are depressed being very narrow often called ice pick scars. Some are boxcar scars or rolled scars. Boxcar acne scars usually have an acute angle at the base and are several millimeters in diameter and can be as deep as 2 mm. They appear like a crater. Rolled acne scars are characterized rounded edges and tend to be larger.
Each property of the acne scar needs to be treated so multiple technologies are often used. For the redness, limelight laser IPL or laser Genesis are very effective in reducing the redness. If there are dilated blood vessels, then a ND: YAG laser would be effective.
Hyper pigmented or Brown scars are very common in patients who have the dark skin. Laser Genesis with its microsecond – pulse ND: YAG laser is an excellent choice along with IPL treatments using specialized cooling technology. Ablative lasers such as the YSGG [Pearl fractional] can be very effective in treating the Brown spots. Patients with darker skin in which an ablative laser is not recommended, laser Genesis becomes a very effective tool making the skin more level and returning the natural color to the skin. Hyperpigmentations can also be improved with medical skin care home products with ZO Skin Health.
Ice pick scars are narrow and deep acne scars that can be excised and sutured together. Sometimes the diameter of the ice pick scar is wide and is better to put a full thickness skin graft after the excision. Later and ablative laser the necessary to make the surface is smooth as possible
Nodular scarring usually on the chin can be treated with radio frequency of each individual module to flatten that. Thick hypertrophic or keloid scars need to be treated with a combination of injection of strong steroid plus laser Genesis.
Depressed scars that are boxcar or rolled shape our best treated with an ablative laser such as of fractional CO2 laser or of fractional YSGG laser. Multiple sessions are usually used because patients want their skin as smooth as possible. Other less severe technologies can be used such as laser Genesis and PRP. Rolled scars can sometimes be excised.
Depressed scars caused by subcutaneous atrophy are corrected quite easily with an acne scar treatment that will last a long time such as Volift or Voluma.