The skin's own healing ability is the key to eliminating or reducing the unsightliness of acne scars. There are three types of scars:
1. Pits: Ranging from tiny dents (sometimes indistinguishable from pores) to deep, ragged craters.
2. Hypertrophic: Fibrous, discolored thicknesses.
3. Atrophic: Thin, slightly depressed patches.
Such scars can be caused by any acne lesion, such as blackheads, pimples or red, boil-like inflammations. None pose a health threat, but the scars cause some individuals to live with a private, unnecessary anguish about their looks.
Treatment is most effective after the acne-prone years, which occur from the mid-teens to the mid-twenties. Usually only a few visits to the dermatologist's office are needed. The three favored treatments at present are:
Dermabrasion. The most widely used technique, it sands the afflicted area down to the level of most scars. Following a consultation and a photographic session (for a before-and after record), the patient is given a general painkiller (usually Demerol), and then a local anesthetic (a skin refrigerant). The abrasion is performed with a wire brush or a diamond dust stone, which is attached to a device resembling a dentist's drill. Scarred tissue and surrounding areas are abraded to ensure uniformity of skin color and tone afterward. Upon healing, the skin will return to its normal texture, minus the scars and some superficial wrinkles.
Once scraped, the face is a raw, draining lymph until the scab forms about two days later. There may be initial pain and itchiness. The scab falls off in about two weeks (plan to take a two-week vacation during the scabbing period), followed by a couple of months when the skin is slightly pink and tender. It's essential to avoid the sun during this period. The healing process goes on, unnoticeably, for about a year.
From dermabrasion, expect elimination of most superficial pits and 50% to 80% improvement of deeper scars. Cost: $500 to $1,500. Risks: Infection, gouging (during the abrasion), hyper pigmentation (discoloration) if the skin is exposed prematurely to the sun.
Dermabrasion is not recommended for: Hemophiliacs or individuals allergic to anesthetics or metals. The treatment must be used with extreme caution on dark-skinned people, including blacks, Orientals, and Latins, because of the increased likelihood of hyper pigmentation.
In severe cases, dermabrasion may be repeated, but no more frequently than once a year. Or it may be combined with one of the localized scar-removal methods (such as excision or pit incision).
Excision. This procedure surgically removes the entire scar, including the depression, after which the wound is sewn up along skin lines. The fine stitches are removed five to seven days later: Cost $50 to $250. Risk: Minimal.
Pit incision. It removes the base of the acne pit with a tubular surgical instrument. As the wound heals, the pit floor moves upward and into plane with the skin surface. Cost: $50 to $250. Risk: Minimal.
Limitation: Antiscarring treatment is usually confined to the face and is far less effective on other acne-vulnerable areas, such as the neck back, torso, or buttocks. These areas heal less easily than facial tissue, and treatment can lead to additional scarring.
Acne And Women Athletes: Medical evidence shows that women who exercise heavily develop more severe acne than those who do not. Reason: Vigorous exercise produces increased amounts of male hormones for at least 30 minutes following a workout. The hormones cause the oil glands to produce increased amounts of oil. Some ducts carrying this oil to the skin surface are blocked. Bacteria in the pores convert the oil to free fatty acids. They cause redness and swelling in the skin. Recommended: Remove blackheads. Wash thoroughly twice a day with bland soaps.
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