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Dear Patron

In view of the COVID lockdown we are offering Tele and Video consultation in line with the karnataka government issued circular HFW54 CGM 2020 dated 26/03/2020.
To book an appointment slot kindly call us at 9620638388 Or drop an email info@drdivyasharma.com
Let us all stay home and keep our loved ones and our country safe.

Stay indoors, stay safe
Team DSHS

Acne Scars

Acne scars is one of the commonest complaints these days. Acne scars not only make the skin look different but sometimes can be embarrassing for the patient. The only complication of acne is acne scarring. Most of the scars are found on the surface of skin but are actually sub dermal in origin. Acne scar requires a holistic approach and may involve multiple modalities. Dr. Divya Sharma examines your skin and advises acne scar treatment according to skin type and best suited to your skin type. Most of the patients seeking acne scar treatment in Bangalore have many questions which Dr. Divya Sharma has answered here. 

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FREQUENTLY ASKED QUESTIONS ABOUT ACNE SCAR TREATMENT

Q1) What are acne scars? How are the acne scars formed?
Ans- Acne scars are divided into two major types- Atrophic and hypertrophic scars. Most of the time patients complain of small open pores on the face which are actually types of acne scars. Whenever a pimple is formed, the underlying inflammation destroys the collagen fibers leading to formation of acne scar. Depending upon the healing response, scar can be atrophic or hypertrophic.

1) Atrophic scar – Scars formed due to lack of collagen formation. They are more common on the face. They can be further divided into three main types-

> Ice pick scars - These narrow, less-than-2mm, and V-shaped epithelial tracts have a sharp margin that extends vertically to the deep dermis or subcutaneous tissue. Their depth of involvement makes ice pick scars resistant to conventional skin resurfacing options.

> Boxcar scars- comprise 20 to 30 percent of atrophic scars. These scars are wider, 1.5-to 4.0mm, round-to-oval depressions with sharply demarcated vertical edges. 

  1. Shallow boxcar scars (0.1–0.5mm) are amenable to skin resurfacing treatments

  2. Deep boxcar scars (?0.5mm) are resistant. 

> Rolling scars comprise 15 to 25 percent of atrophic scars. These scars are the widest and may reach up to 5mm in diameter. They actually give a dimpling of the skin when a patient smiles or makes facial expressions.

2) Hypertrophic scars - They are formed due to excessive collagen formation. They are mostly found on the back of patients who have a long standing history of back acne. They look like red, raised lesions which give a cobblestone appearance sometimes.

3) Post Inflammatory erythema (PIE) - The red spots left behind by the pimples is termed as PIE. This is the easiest to respond to kind of scarring.

Q2) Can acne scars be prevented?
Ans- Acne scars can only be prevented by timely treatment and the right approach towards acne. Dr. Divya Sharma believes that acne is always skin deep. It is very important that not a single pimple goes without treatment. It is a myth that scars can be prevented by any home remedy except a good Dermatologist recommended treatment. Topical retinoids should be started early to prevent the underlying inflammation which is the cause of scarring..

Q3) How to remove the black spots left behind by the pimples? 
The black spots left behind by the pimples are known as post inflammatory hyperpigmentation. The inflammation caused by pimples activates melanin synthesis causing black spots or PIH. It is imperative that patients are advised to start applying sunscreen early in treatment along with a good topical retinoid as well. Agents like glycolic acid and Mandelic acid may be very helpful as well. Early treatment of pimples or acne is the key.

Chemical peels are very effective in managing the black spots or PIH. They can be started early along with the acne or pimples treatment. Spot chemical peels can be used for stubborn black marks or PIH. Blue light treatment is quite effective in preventing PIH.

The Carbon “Hollywood Peel” is a very effective treatment for inflammatory acne especially with the black spots Dr. Divya Sharma uses FDA approved Spectra Gold with patented Carbon from Lutronics , USA . Her centre is renowned for this procedure.

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Q4) Doc, I never had big pimples, still I see a lot of ice pick scars or open pores and pits? How is it possible?
It would be surprising to know that even blackheads or whiteheads keep the capacity to degrade collagen and cause scarring. All are forms of acne and need timely treatment by a Dermatologist.

Q5) How can the open pores or pit like scars (depressed) be treated?

As the atrophic scars are due to the defect in collagen which is found in the second layer of dermis. Hence the basic principle of treating atrophic scars is ‘Collagen Induction Technique’ or C. I. T.  The principle involves stimulation of collagen synthesis by creating micro injuries in the dermis. This induces growth factors which improve the collagen quantity and quality. There are differences in the techniques and protocols depending upon the skin type and sensitivity. 

Various procedures employ the same principle.

Q6) What procedures are used for which scar type? Is Laser treatment the only treatment for acne scars?
Ice pick scars which are mostly visible on the cheeks are located at greater depth. Microneedling radiofrequency utilizes both micro needling and radiofrequency or heat energy to stimulate collagen fibers. The benefit of using MNRF is that greater depths can be treated but minimal side effects. In patients with darker skin types, the risk of pigmentation is minimal with MNRF. The quality of the system used for MNRF is very important. At Dr. Divya’s Skin and Hair Solutions Clinic, we use the world's first FDA approved non insulated needles which are ‘single pass’ treatments unlike other brands where multiple passes are required. Fractional Sublative rejuvenation is also useful in these scars. Ablative Carbon dioxide laser is most effective for ice pick scars but carries a risk of hyperpigmentation and hence is not suitable for dark skin types.

Many non-ablative lasers like Fractional Carbon Dioxide and Erbium YAG employ laser beams to achieve collagen remodeling. 

Boxcar scars are fastest to respond and MNRF works best for them

Rolling scars may require subcision to disrupt the fibrous bands which tether the skin to the underlying skin. During subcision a beveled needle is used to release the scar and thereafter other modalities are effective. 

Q7) How many sessions are required for scar removal treatment in Bangalore?
Scars can always be improved and cannot be removed. It may require multiple sessions (up to 6 to 8) and the treatments are widely spaced apart to allow collagen remodeling. Dr. Divya Sharma has her signature style treatment which makes sure that minimal sessions give maximum results. 

Q8) Are there any side effects of acne scar treatment?
Most of the procedures are safe in expert hands. A proper priming is done by your Dermatologist to prevent hyperpigmentation. The choice of technology is also very important in deciding the safety of the procedure. 

Q9) Is there a quick remedy to improve scars?
The type of scar decides the efficacy. Black spots and red spots are quickest to respond. Carbon peel and FSR technology gives very fast results. Chemical spot peels are very effective in preventing the progression of scars. 

Q10) What is the cost of acne scar treatment in Bangalore?
The cost of acne scar treatment in Bangalore depends on the area to be treated and type of scarring. The number of sessions is evaluated by Dr. Divya Sharma and there is no compromise on the safety and efficacy of the procedure. The best possible and most cost effective procedure is done by the doctor. Acne scar treatment requires patience and persistence.

Dr. Divya Sharma is very holistic in her approach towards acne and acne scar treatment. At our clinic, we rely on our experience and your safety is our priority.

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