Dr. Truitt discusses the different type of acne scars and the newest treatment that is effective and safe for all skin colors.
Acne can be distressing but is often temporary. The potential acne scars can be permanent. It has been well documented in academic literature that acne scarring can significantly diminish patient quality of life where this loss of quality often begins in adolescence. Of the 80% of the population who get acne lesions (60 million in just the United States), 40% will be left with scars where studies have shown that those with acne scars are seen as less successful, less attractive, and were thought to be less confident.1,2 Thus, it is no wonder so much research has gone into treating acne scars over the last few decades to include the perplexing quandary of safely treating skin of color.
Acne can pose special challenges for people with darker skin. One pimple or breakout can cause dark marks, scars, or even keloids (scar tissue that continues to grow larger than the original scar) that last for months to years afterward. Patients are often frustrated when searching for a safe and effective treatment.
Evaluation of the skin is important as it will help to guide treatment. There are traditionally three types of acne scars based upon their clinical appearance: ice pick, box car, and rolling. Treatment of acne scars is based upon the type of scar and the color of the skin.
One of my favorite techniques for box car and rolling scars is subcision. With both box car and rolling scars, there are dermal fibrotic tethers pulling the skin downward creating the uneven and firm appearance of the scar. Subcision is making a small incision near the scar with the tip of a needle and gently sweeping the needle tip below the scar breaking those tethers and thus releasing the skin. The downside of subcision includes the need for local anesthetic injections, bruising that can last 1-2 weeks, and hyperpigmentation of darker skin types if not done in the correct plane.
While subcision is superb at releasing the scar tissue from the dermis, it does not improve the texture and tone of the epidermal portion of the scar. Using subcision in conjunction with microneedling with radiofrequency (RF) provides an excellent plan to treat both aspects of the scar and is especially effective at treating all three of the traditional scar types. Potenza by Cynosure Lasers is the latest in microneedling with RF, and it is a game-changer for improving this epidermal layer as it is effective and safe for all skin types.
Potenza delivers radiofrequency energy through fine needles at controllable depths, providing optimal reduction of acne scars, and it is color blind. Conventional treatments including lasers, chemical peels and dermabrasion can target melanin (pigment of the skin) causing hyperpigmentation and other issues, especially in darker skin types. Additionally, through the microscopic channels created by Potenza, dilute neuromodulator and dermal filler (for example, Botox and Sculptra) can then be applied topically to the skin to reduce redness and further smooth the skin to its natural glow.
Potenza has completely changed the landscape of acne scar treatment with its consistent efficacy and safety for all skin colors. There is no need to just live with your scars anymore.
References:
- Taub, AF. The treatment of acne scar, a 30-year journey. Am J Clin Derma. 2019; 20(5):683-690.
- Tan J, Kang S, Leyden J. Prevalence and risk factors of acne scarring among patients consulting dermatologists in the USA. J Drugs Dermatol. 2017; 16(2):97-102.