Meet
Dr. Prashant Murugkar

Acne and acne scars can give people nightmares. Acne scars are common and occur due to skin pores that are blocked with excess oil, bacteria, and dead skin cells.  The skin pore usually swells and breaks the wall of the follicle and paves way for the formation of pimples and scars. Usually, if the lesion is minor it heals quickly but if the wall of the pimple breaks it can cause severe acne and scars.

Why one must consider treating their acne scars?

Acne scars can affect the confidence of people and have effects on mental and physical health. They must be treated for the following reasons:

• Improved skin health
• Enhanced appearance
• To improve self-esteem

Types of acne or pimples:

• Blackheads, these are formed when the oily secretions get blocked at the opening of the skin pore and appear as black bumps
• White heads, these are formed exactly as the blackheads, but they appear white as the oily plug is not exposed to air.
• Pustule, this describes a pimple filled with pus
• Papule, this describes a pimple that is inflamed, red and painful, but does not present a pus-filled appearance
• Papulo-Pustular, when a pimple is a combination of the above types

Types of acne scars

• Hypertrophic or Keloid scars, these are scars forming after a pimple that become raised, itchy, bumpy and can sometimes involve the adjoining normal skin
• Atrophic scars, these are further classified into Rolling, Box or Ice Pick scars, and as their name suggest these are depressions that take on various shapes. These are by far the commoner aftermath of acne.

Treating Acne

Thankfully the common teenage acne, naturally go away around 26 – 28 years of age as the harmonal milieu stabilises and the skin becomes less oily. However, a significant population of acne sufferers, start having harmonal or PCOD related acne in their late twenties, these can persist through adult hood.

The management of acne is three-fold process, the first is good skin routines that combine sunscreens, Salicylic Acid cleansers, Vitamin A creams to reduce the oil production and regulate the exfoliation, preventing oil build up and therefore acne. The second step is to treat established or emerging acne by the use of topical or oral antibiotics, topical Benzoyl Peroxide or other products. The final step is the prevention of scars, the simplest method is not to touch the facial skin or pop the pimples, and the use of regular skin rejuvenation treatments like Salicylic acid peels or Medical Microneedling.

Treating Acne Scars

There are many modalities that can be used in treating established acne scars, but none is magic and none gives a 100 % result. As with all scars we can improve their appearance significantly but can’t make them disappear. The following methods are commonly used

• Medical Microneedling or Dermaroller is a process of treating the skin with a needle bearing roller that will punch tiny holes in the skin, stimulating collagen formation and plumping of the skin and scars
• Dermapen, this is a variation of the above technique
• Fractional CO2 lasers, here a laser is used in a grid pattern punching out thousands of little holes causing both mechanical and thermal damage, that stimulates exfoliation of skin and remodelling of collagen and scar.
• MNRF, this is a technique similar to fractional CO2 but uses Radio-Frequency energy instead of lasers
• Subscision, in this technique a needle is used to break the scar holding down the skin
• Cross TCA, a very strong peeling agent TCA is used to cause a controlled destruction of an ice pick acne scar
• Scar excision, were the scar is surgically removed and sutured
• PRP injections, the use of Platelet Rich Plasma to stimulate collagen formation and remodelling along with Dermaroller or Dermapen
• Nano Fat injection, uses liquidized fat from under patients’ skin to supply stem cells to the scarred skin, in the hope that there will be new collagen, and elastin formation plumping out the scar
• Fat Transfer, here intact fat cells are transferred to the under surface of the scar to plump it out
• Dermal Filler injection, here hyaluronic acid-based filler gels are used to plump the scar out instead of Fat

Authored by Dr. Prashant Murugkar