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Current treatment options in acne scars

Acne is a common skin disease that particularly affects the face, back and chest area. Although it is self-limiting, acne, which creates permanent scars and significant cosmetic problems when severe; Social adjustment disorder may be the cause of significant stress and anxiety in patients. Among the methods that can be used in the treatment of acne scars; There are options such as chemical peeling, microneedling methods (such as dermaroller, dermapen), needle radiofrequency treatments, laser and light treatments, filler injections, PRP and mesotherapy applications, plasma application. However, each scar and each patient should be evaluated individually, and the most appropriate treatment method should be planned according to the patient’s structure and the type and clinical severity of the acne scar. Various methods applied in the treatment of acne scars can be applied alone or in combinations.

Chemical peeling:

Chemical peeling; It can be defined as the controlled damage of the skin with the aim of removing superficial lesions and repairing the skin with some chemical agents. The aim here is to cause damage to the desired depth in the skin layers and to provide the treatment of various lesions by taking advantage of wound healing at the repair stage. The most used substances for this purpose are; glycolic acid (obtained from sugar cane), lactic acid (milk acid), malic acid (apple acid), tartaric acid (grape acid), trichloroacetic acid (TCA), salicylic acid.

Microneedling methods:

Skin needling methods have been used since 1995 to stimulate collagen. The procedure can be done with cylindrical apparatuses we call dermaroller, which contains microneedles with a length of 0.5-2.5 mm and a width of 0.1 mm, or with automatic apparatus called dermapen, where the needle length can be adjusted automatically and which enters and exits the skin very quickly. During the treatment, microchannels are formed in a controlled manner without damage to the surface layer of the skin. In this way, microneedling systems create a wound perception in the deep layers of the skin, trigger the wound healing process and cause the release of growth factors that stimulate elastin and new collagen production.

Fractional needle radiofrequency treatments (gold needle):

Fractional needle radiofrequency devices stimulate the regeneration of collagen and elastic structure in the dermis, which is the deep layer, without causing damage to the superficial layer of the skin, which we call the epidermis. With the microneedles at the tip of the device, small pores are opened in the epidermis, and the restructuring of the collagen is stimulated by the heat effect of the radiofrequency energy given from the insulated needle tips. The lengths of the needles are adjusted according to the desired depth, and after the application, redness and edema are gradually relieved in connection with the energy and resolve in 2-4 days. Since there is no crusting as in laser applications, the person can return to his social life in a short time. It can be applied in all seasons.

Fractional lasers:

Fractional CO2 and Er-YAG lasers are frequently preferred for this purpose. These systems damage the epidermis, which is the surface layer of the skin, and stimulate the collagen in the dermis with the heat energy reaching the dermis layer. Usually 4 sessions are required for skin rejuvenation and acne scarring. Its therapeutic effects last for 6 months to 1 year. It is applied with 3- to 4-week intervals. After the application, redness and crusting heal in an average of 1 week. Since sun protection is important, it is more correct to apply it in the winter months.

Plasma therapy:

It is a new form of treatment applied for the restructuring of the skin. The application stimulates new collagen production by damaging old collagen.

Filler applications:

It is a treatment method that provides filling and stretching of the collapsed area by injecting fillers under medium and deep scars.

PRP applications:

PRP is the separation of the blood taken from the person into its components after the centrifugation process and the injection of the obtained small amount of platelet-enriched plasma to the same person. PRP, which provides a brighter and more vibrant appearance by providing new collagen synthesis in the skin; It is an effective and natural treatment for reducing acne, acne scars and blemishes. Fractional laser can be used together with needle radiofrequency and microneedling methods, thus increasing the efficiency even more.