Service : Acne scars
Acne scars Acne scars

Difficult Acne

Acne scar features:

§         Distributed in different anatomical location of the face

§         Reflect variable appearance in different areas

§        Each area may have multiple types of scars

§        May have secondary features like erythematous and pigmented base

§        Coexisting active acne may be superimposed


Comedone extraction:

 Comedone removal is an importantadjunct to acne regimen to shorten the duration of lesion. The comedoneextraction facilitates further action of topically applied retinoids, resultingin complete resolution of the existing lesion and also prevents development ofnewer ones.


Intralesional injections:  

The intralesional steroids are helpful in resolving large and inflamedlesion and cystic acne lesion which have persisted for 2 weeks. Prioraspiration of the cystic contents for large lesions increases the efficacy ofthe injection intralesional steroid injection leads to rapid involution of nonpyogenic inflammatory sterile lesion in as early as 48 hours.



 Microdermabrasion is a usefuladjunct to other topical therapies and benefits comedogenic

Acne as well as improves the texture and quality of the skin in grade 1to 2 acne scars.

Microdermabrasion should proceed a week before the chemical peels.


Chemical peels:

Chemical peels are the most common interventional procedure undertaken toimprove the outcome in acne and scars. Peels are introduced at early stages ofanti acne therapy as they:

§  Improve coexisting comedonal and papular acne.

§  Alleviate post acne erythema.

§  Improve pigmentation at base of healed lesions.

§  Improve the depth, contour and cause softening of associated scars.

§  Added improvement in texture glow.

§  More youthful appearance of the skin.




Also called as collagen induction therapy this procedure employs arolling pin studded with rows of stainless steel needles.


Lasers and lights:

Photodynamic therapy are now reported to provide only fleeting benefitsdue to its anti P Acnes properties. The porphyrins built up in the sebaceousglands after 20% aminolevuilinic acid cream application are photoactivated andcauses self destruction of P acnes after a light source application. Many lightsources can be used like the red light, pulse dye excimer laser of a halogensource of light. Beneficial results are seen with this in inflammatory andcystic acne but not in comedonal acne. Side effects are transiet and includeerythema, and pigmentary changes. Photosensitivity may be seen by somepatients. Instead of ALA, indocyanine green dye can be used followed by diodelaser to achieve PDT.      



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