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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. This is why the best way to avoid acne scars is to treat acne.

Sometimes, however, preventing acne scars is hopeless 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.

How to Choose the Best Scar Treatment Option for You

The best way to treat extensive scarring is through surgery. The most common types of surgical interventions include punch excision, punch elevation, and subcision. These procedures are usually followed-up by using dermal fillers or laser resurfacing.

Ice Pick Scars & Punch Excision

Cystic acne usually leaves behind a scar that makes the skin look as if it has been pierced by a pin or needle. This type of acne scar is what specialists call an ice pick scar. It is usually deep and extends into the dermis.

Punch excision or punch excision with grafting 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 then sutured together, forming a straight scar that is level with the surrounding skin.

Sometimes, the extent of the excised skin is too large to suture. In this case, it would be necessary to use grafted skin to close the wound. Once again, a straight scar will appear, but much less noticeable than the original ice pick scar.

Boxcar Scars & Punch Elevation

Boxcar scars are wider than icepick scars and are usually oval or round. They are caused by a loss of tissue during a particularly severe inflammatory reaction. The treatment for acne scars of this type is usually punch elevation and dermal fillers or laser treatment.

Punch elevation is similar to punch excision. However, in this case the walls of the scar are left untouched. The base of the scar is brought up to skin level using fillers or sutures. Finally, grafted skin is used to close the wound.

Subcutaneous Incision for Rolling Scars

Rolling scars are formed when fibrous bands of tissue develop in between the layers of skin. These bands pull down the epidermis making the skin take on a wave-like appearance. The best treatment option is subcision.

A small needle or scalpel is used to separate the epidermis from the deeper scar tissue. The epidermis will become more level once the blood accumulates in the space between these two layers. In some cases dermal fillers may be required if the scar tissue is too deep.