When acne is cured or considerably improved, unsightly scars may still remain. The scarring varies from superficial irregularities to deep grooves and "punched" depressions.
A CO2 laser beam can abrade a thin layer of skin. Sharp edges of retracted scars can be flattened out to some extent into less visible margins. An increase in collagen synthesis may improve the overall result over the course of several months. Several treatments are necessary to obtain a maximal result.
Dermabrasion means shaving the surface of the skin with a grindstone. For small lesions it can be performed under local anaesthesia. When the whole face is treated general anaesthesia is usually required. Bij grinding evenly the skin surface may be smoothened. By grinding deeper locally, the sharp edges of the punched skin depressions may be made flattened out.
The skin is coverd with an alginate dressing, that forms a dark crust on its outer surface and a gel on the wound, thus promoting the healing. After five to twelve days the crust separates and the pink skin becomes apparent. Normal activities can be resumed at that stage. The pink colour takes several months to fade away.
The facial skin recovers well after this kind of treatment because many skin cells remain in the sweat glands and the hair bulbs. These cells grow out of the pores to form a new epidermal layer in five to twelve days. The skin on the back, the neck and other parts of the body does not recover that well and it cannot be treated by dermabrasion.
There is still a limit to the regeneration capacity of the facial skin. Deep scarring will require several operations in order to avoid scar formation by too deep a single treatment.
After serious acne, the subcutaneous fat may be replaced by scar tissue. This causes skin retraction and makes the skin feel hard. Fat transfer (lipostructure) can improve this condition.
Acne is a skin disease and it is therefore treated by dermatologists. Scar improvement by operations can only be attempted once the disease is cured or at least well under control.