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Dr Ravindra Dargainya

Dr. Ravindra Dargainya

Dermatologist, Cosmetologist, Trichologist, Allergy Specialist, STI/AIDS Consultant

Dr Prachi Dargainya

Dr. Prachi Dargainya

Physiotherapist & Nutritionist

Skilled in Orthopaedic injuries, Aches and Pain, Bell's Palsy, Paralysis, Ante/Post natal Consultation.

Acne and Acne Scars

Even with the most careful and conscientious treatment, acne scars may still occur.

Causes

Severe nodular and cystic acne as well as pricking of acne may result in acne scarring. Each acne lesion has the natural ability to heal itself. Every pimple results in loss or formation of tissues. The loss of tissue results in milder scars, while formation of new, thicker tissue can result in more severe scars.

Types of Acne Scars

Ice-pick scars : The skin appears to have been pierced by a needle. They result from a deep blemish or may be caused from cystic acne.

Rolling scars: This type causes rolling or "wave-like" undulations across otherwise normal-appearing skin.

Boxcar scars : They are round or oval depressions wider than ice-pick scars. They develop as a result of tissue loss from a severe breakout. They give the skin a pitted appearance.

Hypertrophic scars: They appear as firm, raised masses of tissue and are usually larger than the original acne in size.

Treatments For Acne Scars

Specific treatment procedures to minimize acne scars will be determined by your dermatologist based on -

  • Your age, overall health, and medical history
  • Severity of the scar
  • Type of scar
  • Your tolerance for specific medications, procedures, or therapies
  • Your opinion or preference
  • RF pixel (Laser resurfacing) – Laser resurfacing with a pixel is a method of treating acne scarring. Based on Unipolar RF-based technology, the Pixel tips with Micro Plasma Technology create multiple controlled, micro perforations (small holes) within small zones of thermal injury. During the procedure, just a small portion of the tissue is ablated (vaporized). The remaining tissue supplies the healing that leads to the elimination of irregular superficial pigmentation, tightening of dermal collagen and the smoothing that results from the generation of new collagen leading to scar filling.

    Creams and Lotions - Various creams or lotions containing retinol, vitamin C and alpha and beta hydroxy acids help in resurfacing of the scars. They are more effective in superficial scarring. These topical creams are often used as a combination with various other procedures done for scarring.

    Chemical Peels - They are also effective in treating acne scars. They result in a smooth, even surface along with improving the texture of the skin.

    Microdermabrasion – It is a procedure that removes the superficial layer of skin helping in resurfacing of the scars, but only for superficial ones. It uses a gentle vacuum along with crystals and gently abrades the top layer of dead skin. This also stimulates collagen production and helps heal the scars. As the skin heals from the procedure, the surface appears smoother and fresher.

    Mesotherapy – It is a non-surgical, relatively painless procedure wherein multiple microinjections deliver vitamins, amino acids, hyaluronic acid, etc into the skin stimulating collagen production and help in scar resurfacing. Significant improvement in the scar surface has been noticed with this procedure.

    Dermaroller – A medical micro-needling procedure that releases new collagen and elastin in the scar tissue. Thus effective in scar filling as well as rejuvenation.Mostly useful in indented or rolling scars.

    Filler injections – A cross-linked hyaluronic acid is injected beneath the skin to replace the body's natural collagen that has been lost. It is mostly useful for depressed scars like boxcars or rolling scars. Procedure can last for up to 8 – 12 months. When done in combination with other treatments, the results can be good.

    What is Acne?

    Acne, commonly known as pimples or zits, is a disorder of the sebaceous glands (oil glands)

    What causes acne?

    Whenever there is excessive sebum production (sebum is the oil produced by the sebaceous glands), there is clogging of the glands, which stops the normal exfoliation of dead cells. These dead cells along with excessive sebum forms a plug called a “comed” or blackhead/whitehead”.The stagnant fluid inside a plug is a fertile media for bacteria called Corynebacterium to grow which them progresses to form Pimples / Acne.

    Is there a difference in acne in men and women ?

    The cause is same for both sexes. However the severity of acne & scarring is more in men.

    Is Acne hereditary?

    No the cause of acne is not hereditary,its hormonal. But the severity of acne is. For example, if the father has had deep acne scars in his youth, there is a good chance that if the son does not take prompt treatment, he can progress to deep scars as well.

    Is stress a cause of acne?

    Stress is among the most common causes for exacerbating of acne. Stress causes specific hormone secretion, which stimulates sebaceous glands and eventually leads to acne.

    Is it true that oily skin is more prone to acne?

    No. That is a myth. Oily skin and dry skin are equally predisposed to acne. In fact, most women with adult acne have dry sensitive skin.

    Does Diet have a role in Acne?

    As far as scientific research is concerned, carbohydrates with a high glycemic index, which cause glucose and insulin levels to spike, may influence the development and severity of acne. Conversely, a diet high in protein and carbohydrates with a low glycemic index seemed to improve acne breakouts.

    Is Acne related to body heat?

    There is no relation between body heat and acne. Acne is severe in summers because, the humidity causes swelling of the lining of sebaceous glands that hampers normal exfoliation and hence clogs the sebaceous glands.

    How are hormones related to acne?

    In adolescence, the hormonal changes in the body are a normal variation and hence acne is self-limiting. But if one has severe acne and associated irregular menses, excessive facial hair or hairloss form scalp, it generally suggests a hormonal imbalance. Adult acne almost always has a underlying hormonal defect. Your dermatologist can help you identify the defect precisely.

    Which Cosmetics are suitable for acne prone skin?

    Cosmetics have to be chosen with great care. I generally tell my patients that cosmetics for acne should be avoided as much as possible. Emulsion based, non oily, non comedogenic ones are preferable, if you must go for one.

    Does fullers earth / multanimitti pack help?

    A product who’s purity can not be ascertained should not be used for treatment, for it can cause more harm than good. Fuller’s Earth / MultaniMittireduces the sebum secretion and has certain anti-inflammatory properties, but the OTC products purity needs to be established.

    Does squeezing pimples aggravate acne?

    This condition is called acne excoriee. It is the worst thing to be done to pimples. The marks thus formed can sometimes be permanent. Therefore, it is never advisable to squeeze your acne or blemishes. Even Clean-ups done by beauticians, if the entire comedo is not evacuated, it can cause larger acne and risk of scarring.

    What Causes Adult Acne?

    Adult acne is different from adolescent acne in that it is almost always associated with hormonal problems. The use of Cosmetics and Stress are major contributors to Adult Acne. Adult acne also requires different line of treatment and the response is also slower than adolescent acne.

    What are Scars?

    Scars result from a wound or injury. Scars, however unwelcome, are part of the skin's normal healing process. Generally, superficial wounds heal without scarring. It is when the dermis is damaged that scars form on the skin.

    What are the types of Acne Scars?

    Acne scars fall into two main categories - atrophic / sunken scars, which is due to tissues loss within the skin, and hypertrophic where there is excess tissue. Atrophic scars have three sub categories - icepick, boxcar & rolling scars.

    How can one get rid of acne scars?

    Early scars are responsible to medium depth peels lik 50 % glycolic acid peels. But long standing scars need more invasive procedures such as Dermaroller (Micro-needling) and Ablative lasers ( Co2 / Erbium yag )

    Does microdermabrasion help in reducing acne scars ?

    No. Microdermabrasion can, at the most by virtue of the suction, prevent forming tough scar tissue in very early scars.

    Is treatment of Scars painful?

    A numbing cream applied prior to the treatment procedure makes the procedure painless.

    Can Acne scars go completely?

    No. But they can be reduced in depth by up to 50 %.

    Can Scars be prevented?

    Early treatment of acne by a qualified dermatologist can prevent scarring in most cases. Don't squeeze, pop, or pick at pimples.

    What are acne marks ?

    Acne marks are the marks blemishes which are left post acne.

    Do they vanish completely on their own?

    Rarely do acne marks go on their own, they do lighten with time.

    How can one prevent oneself from the acne marks ?

    Timely management of active acne will reduce the number of acne marks. Not picking or squeezing your acne will reduce the chances of acne marks.

    How can one get rid of the acne marks?

    Acne marks can be managed with tretinoin creams, chemical peels or laser depending on the severity of acne. While creams can be of use if started early on, most patients need peels to see desired response. Laser is generally required when the marks do not respond to peels. This generally happens in those patients who are used to squeezing their pimples.

    Do acne marks recur once they are removed by peels?

    No. Unless, you get new acne, you cant develop new acne marks.

    How many sessions of peels are required to get rid of acne marks?

    It will take anywhere between 6 – 12 sessions for getting rid of acne marks.

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