Introduction and background
Post-acne scarring or scarring after acne may be a physically disabling and psychologically devastating disease. Unfortunately it is not particularly well treated. The more morbid resurfacing procedures are becoming less popular and are being challenged by new and innovative procedures and treatments that require less costs and time for healing. New techniques and supplements have been added and older ones modified in attempts to improve risk benefit profiles.
Classification or grading of acne scarring
The following system attempts to classify acne sufferers according to the severity of their scarring and thus their burden of disease:
Macular Acne Scarring and Marking (Grade 1 Acne Scarring)
The first grade of scarring is macular changes visible irrespective of distance and represents not a problem of contour like other scar grades but of colour. This colour may be red, white, or various shades of brown to black. In this grade of stage of acne scarring, red hyper- or hypopigmented flat marks visible to patient or observer at any distance. Likely treatment options for this grade of acne scarring include time, optimized home skin care, light strength peels, microdermabrasion, vascular or pigmented lasers, or intense pulsed light.
Mild Atrophy or Hypertrophy (Grade 2 Acne Scarring)
This grade of scarring includes those scars that may not be obvious at social distances of 50 cm or greater and may be covered adequately by makeup or the normal shadow of shaved beard hair in men or normal body hair if extrafacial (other than face). This group is in danger of both exaggerating their problem and being over treated by physicians with traditional resurfacing procedures, especially if the treating physician is not skilled with a wide variety of procedures. Frequently practiced methods to treat this grade of accruing include non-ablative lasers, blood transfer, skin needling or rolling, microdermabrasion, dermal fillers.
Moderate Atrophy or Hypertrophy (Grade 3 Acne Scarring)
This level of scarring is obvious at social distances of 50 cm or greater and is not covered easily by makeup or the normal shadow of shaved beard hair in men or body hair if extra-facial, but is still able to be flattened by manual stretching of the skin. This type of scarring is mot likely treated by Ablative lasers, dermabrasion, and medical skin rolling, fractionated resurfacing, dermal fillers if focal, subcision and blood transfer. Intra-lesional corticosteroids steroids or fluorouracil. and/or vascular laser.
Severe Atrophy or Hypertrophy (Grade 4 Acne Scarring)
This is represented by severe atrophic or hypertrophic scarring that is obvious at social distances of 50 cm or greater and is not covered easily by makeup or the normal shadow of shaved beard hair in men or body hair if extra-facial and is not able to be flattened by manual stretching of the skin. Treatment options may include punch techniques (float, excision grafting), focal trichloroacetic acid (CROSS technique) with or without resurfacing techniques (including fractionated resurfacing), fat transfer, occasionally rhytidectomy, Intralesional corticosteroids steroids or fluorouracil and/or vascular laser.
Is there any therapy suitable for all grades or stages of acne scarring?
All of the above-mentioned treatments are either surgical or medical (clinical) and can only be performed by a doctor or professional. In addition, they are not only expensive but almost all of these therapies have an associated risk of serious side effects, complications and also involve high costs (and are usually not covered by health insurance).
Quite recently, there have been some news regarding the entry of some quality and safe anti-acne combination therapy kits or systems that have been successfully used by a millions of users and withing the comfort of their homes. Several products may be used to help prevent pimples, pustules or blackheads. These kits of systems usually consist of herbal products and use 100% natural active ingredients to effectively address all acne lesions including acne spots, scars and pimples including blackheads, whiteheads and red spots. There are no added chemicals or drugs that promise immediate relief such as products that use benzoyl peroxide which dries skin of excess oil and kills bacteria instantly. Compared with such chemical-based products, these kits or systems may require more time for results to show but the results are durable, long lasting and more prominent. Therefore, more and more dermatologists are now of the belief that these kits can act as the best defences against the formation of embarrassing scars, pimples, pustules, and boils as they also help fight off bacteria that cause scars in the first place.
Post-acne scarring remains a very difficult task to correct. Great strides may be made in this condition only with attention to a greater understanding of its progression, the reasons why certain people scar and others do not, the inflammatory mediators, and the study of the scarring process. The variety of scars mirroring the variety of acne lesions means that no simple single process is likely to provide an answer to all acne scars. However, fortunately, there have been some quality and safe home-based solutions to the prevention and treatment of acne scarring.