Zits Scars: Sorts & Most Efficient Remedy Choices

By Dr. Thomas Griffin

Zits is an especially frequent pores and skin drawback. Affecting about 80% of individuals ages 11-30, zits impacts greater than the visible, and beauty look of the pores and skin, however the psychological well-being of these affected as nicely. Whereas not each individual affected by zits could have indicators of the zits left on their pores and skin, about 1 in 5 who’ve had zits could have some extent of scarring. Zits scars are everlasting marks left on the pores and skin. 


Basically, zits is an inflammatory pores and skin situation. The oil-making glands of the pores and skin, sebaceous glands, get clogged and the elevated oil manufacturing backs up. The physique’s immune system reacts to this build-up and creates a pimple. In zits scarring, this irritation and the wound therapeutic that outcomes is the basis of the issue. Those that are predisposed to zits scarring have a extra sturdy inflammatory response that not solely assaults the zits lesion however the surrounding pores and skin as nicely. 

Forms of Zits Scars

There are 3 kinds of zits scars; icepick, boxcar, and rolling.

Icepick scars are deep, slim, scars that seem like giant pores.Boxcar scars are shallow depressions within the pores and skin with pretty sharp, vertical, borders.Rolling scars are deeper, wider, and fewer outlined.

Most sufferers could have a mixture of a number of kinds of these scars. 

Remedy of zits scarring begins with its prevention.

Early, aggressive, therapy of lively zits with a dermatologist is necessary.

There are a variety of various topical and oral medicines which may be prescribed to assist management zits early. A superb prescription therapy routine usually entails a number of medicines to focus on the clogged pore, scale back oil manufacturing and assist management the irritation. I’m an enormous advocate of chemical peels and laser remedies to assist additional enhance the outcomes of prescription medicines.

Chemical peels, of which there are a number of varieties, might help straight break down the clogs within the pores and exfoliate the superficial pores and skin. They assist to scale back the variety of zits micro organism on the pores and skin. Within the lively zits stage, laser vitality may be very useful as nicely. Gadgets like BBL, clear silk, aerolase, and genesis warmth the pores and skin gently and assist to scale back the irritation and blood vessel dilation that causes collagen injury. Though these gadgets take a number of remedies and maintenance, they’re non-invasive, haven’t any downtime required, and are very tolerable. 

1 therapy session with mixture of TRL full subject ablative resurfacing and Profractional.

Along with prescription and laser prevention of zits scarring, it’s necessary that these individuals affected by zits don’t make their threat of getting scarring any worse. Choosing and popping zits solely makes issues worse. I like to make use of the analogy of an iceberg. The whitehead we see on prime of the pores and skin is simply about 10% of the particular pimple. After we pop that whitehead we really burst the puss underneath the pores and skin as nicely. The physique responds very strongly to that and tries to wash it up with a stronger inflammatory response. This makes the pimple last more and will increase the chance of scarring. As a substitute, of popping, use a pimple sticker. The duvet will assist to maintain your fingers off of them and helps to dry the lesions out quicker. 

As soon as an individual has scars and their lively zits is managed therapy of zits scarring relies on the kind of scars that an individual has. As acknowledged earlier, there are 3 primary kinds of scars and most sufferers have a mixture of scar varieties.

Remedy ought to goal the totally different scar varieties and due to this fact a mixture of various remedies is sort of at all times employed. 

Boxcar Scars: Probably the most treatable scar sort.

boxer scarEarly intervention, put up accutane with BBL to enhance the crimson element. Scars handled with RF micro needling and professional fractional 4 classes. 

This type of scar is shallow and has sharp vertical borders. Laser resurfacing is the very best strategy to boxcar scars. There are a variety of various lasers that are able to bettering boxcar scars. A number of remedies with non-ablative fractionated lasers like halo and Fraxel do a high quality job with out sacrificing a lot in therapeutic time. Ablative fractionated lasers like a CO2 or erbium-based professional fractional will add some extra restoration time however are a bit simpler than a non-ablative laser. The last word therapy for boxcar scars, if therapeutic time will not be a problem, is absolutely ablative resurfacing. This therapy is aggressive, the laser removes full layers of pores and skin like a managed burn, however the outcomes are wonderful usually in a single therapy.

Icepick scars: Slender, vertical, and deep scars.

icepickIcepick scars handled with 2 classes of RF micro needling 

These lesions are typically fairly troublesome to deal with. There are a number of approaches to icepick scars. The primary is a modified chemical peel known as TCA cross. On this methodology, a really high-strength acid is utilized on to the scar with a slim sharp device like a toothpick. The thought is to injure the perimeters of the scar throughout the melancholy and get the outlet to fill in. It typically takes 6-8 classes however doesn’t damage. Every session has some therapeutic across the websites. Some physicians will do small surgical procedures known as punch excisions to take away and sew the ice decide scars. As soon as both the TCA cross or punch excisions are full the pores and skin may be resurfaced with a laser to mix all of it in. I’ve discovered these strategies to be extraordinarily efficient for ice decide scars, nonetheless lots of my sufferers will not be enthusiastic about having a surgical process on their scars. On this case,

“I discover radio frequency micro-needling together with superficial laser resurfacing to be an efficient technique of bettering ice decide scars.” Dr. Thomas Griffin is a board-certified dermatologist in Philadelphia the place he focuses on beauty dermatology. In line with him, “Radio frequency is principally warmth utilized to the deep ranges of the pores and skin. This warmth is launched from the guidelines of the microneedle. Warmth capabilities to spice up collagen manufacturing and tighten the pores and skin. The advantage of RF micro needling is that microneedles can get very deep, millimeters, within the pores and skin with nearly no therapeutic time.” Making an attempt to get a laser millimeter into the pores and skin would end in a large restoration. This depth is necessary in icepick and rolling scars to enhance the boring depth of collagen injury. I like to mix RF micro needing with a superficial CO2 resurfacing in order that not solely are we treating the depth of the scars, however the prime layers of the pores and skin as nicely. The C02 improves the superficial texture irregularities and is great for pore enchancment. 

Atrophic or Rolling Scars: consequence from large-scale, deep, degradation of collagen.

boxcarRolling, atrophic and boxcar scars handled with 6-8 classes of discovery pico 1064nm fractionated and RF microneedling.

The superficial pores and skin is, for probably the most half, regular in look and texture however the dermal collagen is thinner and typically sure down. As with all zits scarring, a mixture of remedies is important to enhance rolling scars. “Sure down” refers to small, fibrous bands that tether the pores and skin down. These bands may be freed up with a course of known as subscission the place the doctor takes a small needle and makes use of it underneath the pores and skin to chop the bands. Subscission is usually mixed with laser and vitality methods. Due to the depth of the injury to the collagen in rolling scars, superficial resurfacing methods are often not very efficient. Lasers that safely penetrate into the deep dermis are most well-liked. For any such scar, I want to make use of picosecond lasers. Versus ablative or non-ablative fractionated lasers which basically bore a gap by way of the highest of the pores and skin, picosecond lasers focus their vitality underneath the pores and skin the place they make tiny burst accidents. Fractionated picosecond gadgets may be very efficient for rolling scars whereas minimizing restoration time.

Treating Zits Scars: Be Affected person

Most remedies heal fully in just some days and they’re protected for all pores and skin varieties. Whereas boxcar and icepick scars will not be typically amenable to injectables, rolling scars may be successfully injected with fillers and collagen-boosting merchandise like sculptra. Whereas fillers will not be everlasting, they will make a big impact rapidly and simply. Basically, fillers can be the final step within the course of after lasers. 

Remedy of zits scarring is a fancy course of. Whereas it’s necessary to notice that having an expectation of 100% pristine pores and skin is usually not a actuality, a educated aesthetic doctor could make a big impact on scarred pores and skin. As with every sort of scar, early intervention is the important thing and offers the very best outcomes. Nevertheless, if a affected person has had scars for a lot of years all will not be misplaced.

Perceive that therapy is a course of, be affected person.  A number of remedies with varied instruments over time is the very best strategy. Search for a supplier who focuses on laser medication. This supplier ought to have a lot of lasers and may supply a number of therapy choices and approaches to suit your particular wants. 

In regards to the Writer:


Dr. Thomas Griffin is a board-certified dermatologist specializing in beauty, medical, and surgical dermatology. He’s the Division Chair of the Laser and Aesthetics Surgical procedure Heart at Dermatology Associates of Plymouth Assembly the place he treats sufferers from all through the tri-state space. Dr. Griffin believes in a patient-centered strategy to dermatologic care.  

The Content material will not be supposed to be an alternative choice to skilled medical recommendation, prognosis, or therapy. At all times search the recommendation of your doctor or different certified well being supplier with any questions you will have relating to a medical situation.

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