To understand how to treat scars, we need to know how they form in the first place. Many depressed scars are formed due to previous inflammation and infection during healing (e.g. a big pimple with pus). Fibrous bands form below these scars in the dermis layer of the skin as a result, and thus distort the surface of the skin, resulting in a depression.
In order to successfully treat these scars, it is not enough to have surface treatments like scrubs and dermabrasion, or acid peels, although these are useful to a certain extent. To really treat these scars, we need to get below the surface of the skin and break up these fibrous scar tissue, as well as build new collagen to fill up the depressions, hence making the surface smoother and more even.
Our experience with treating acne scars has been that almost all patients see some improvement after just one session of fractional CO2 laser treatment
. Multiple repeated sessions are necessary in order to achieve the optimal result depending on your expectations. Generally, rolling and box scars tend to show the most improvement, and pitted scars take longer to respond.
In some patients with stubborn scars, further treatment options could include needle subcision, or the use of dermal fillers under the scar. We are seeing very good results with dermal fillers because they do not just reduce the appearance of the scar immediately. In addition, due to the lifting effect of the filler, we manage to see that the fibrous bands holding the scars down are broken and the final result after the filler has worn off is much better than before.