Acne is a common condition that affects up to 85% of individuals between the ages of 11 and 30, and up to 5% of older adults. Unfortunately, in some cases, the severe inflammatory response during the healing process of active acne results in permanent, disfiguring scars.

There are two main types of acne scars, which are differentiated by whether there is a net loss or gain of collagen. About 80%-90% of individuals with acne scars have scars associated with a loss of collagen (atrophic scars), while a minority show hypertrophic scars and keloids. It's unclear why some acne patients develop scars while others do not, as the degree of acne does not always correlate with the incidence or severity of scarring.

Atrophic acne scars can be divided into three sub-categories:

Boxcar Scars: These have sharp, cliff-like vertical margins and a larger, flatter base. They usually appear on the temples and the cheeks, resembling chicken pox scars.
Rolling Scars: These are wide and shallow, creating a wave-like appearance. They become visible when the tissue beneath the skin is damaged and resemble rolling hillsides.
Ice Pick Scars: These are deep and narrow, forming pits in the skin. They are usually caused by a deep pimple or cyst that has destroyed the follicle.

Unlike the more common atrophic scars, hypertrophic or keloid scars show extra tissue at the scar site, forming a bump. Hypertrophic scars stay within the site of the original acne lesion, while keloid scars grow beyond the boundary of the original wound. Both are more commonly found on the chest and back, but they can also occur on the face.

When it comes to treating acne scars, it's crucial for the clinician to select a modality that can effectively reach the appropriate depth of both superficial and deep scars. Acne scar treatments range from surgical solutions such as punch excision, subcision, chemical reconstruction, and laser resurfacing, to combinations of these modalities. Non-surgical options, such as dermal fillers, chemical peels, and dermabrasion, are also available. Ablative procedures are associated with long recovery times and side effects like post-inflammatory hyperpigmentation, especially in darker skin types. In contrast, non-ablative and fractional laser devices have fewer side effects, but multiple treatments are typically required to achieve satisfactory results. At Dr. Supranee Laser Clinic, we use a targeted e Two treatment approach for effective and efficient management of acne scars.