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ACNE SCARRING AND MARKINGS

Acne scarring is predominantly a concern for patient who during their puberty have suffered from deep cystic acme. These scars tends to be located on the face, but on several occasions may appear on other parts of the body, particularly the back.

A necessary prerequisite for a patient to begin the correcting procedure is for the acne to not be in its active stage, to have stopped occurring at least for the most part, and for the scarring to have stabilized. In addition, one must be aware that completely erasing the scarring is impracticable and that the only thing that can be achieved is their improvement up to a point, depending on the procedure employed and the type of scarring.
There are several methods of correction that a plastic surgeon may employ here, such as healing, surgical removal, or the use of injectable materials. 


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PEELING TO IMPROVE ACNE SCARRING

The most basic method of improving acne scarring is peeling. As has been explained in the relevant chapters on peelings, these are divided into three variations, depending on the way in which they are performed; variation also exists depending on the depth of the operation upon the skin.


PEELING METHODS

Peelings, depending on how they are employed, can be labelled as:

•    CHEMICAL PEELING: The skin is smoothed via a chemical means. Oxides are usually employed to clear the skin and allow new skin of better texture to grow. The scar tissue becomes smoother and the scars themselves become less deep, and therefore less visible.

•    MECHANICAL PEELING: These are performed via the method of dermabrasion with a diamond wheel when a deep peeling is required, or using crystals for lighter peelings.

•    LASER PEELING: These are two types of lasers that may be used on acne: carbon dioxide lasers (CO2 Laser) and Laser Erbium. Both aim to smoothen the scars and reduce their depth.

As far as depth is concerned, as mentioned before, the deeper the plastic surgeon digs into the skin, the better the results he can achieve. Of course, even deeper peelings cannot achieve a complete erasure of the scars, but can allow for a percentage of improvement in the 40%-70% margin.




AFTER PEELING

The length of the recovery period is dependent on the type of peeling method used and the depth of penetration. Deeper peelings tend to require a recovery period between 10 and 15 days.

Peelings are only performed during the winter months, and require the patient to be particularly cautious about exposure to the sun for a few months after their completion.

This method may be combined with others to further improve the result.


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OTHER METHODS OF IMPROVING ACNE SCARRING

Apart from peelings, the following methods of correcting acne scarring are also available:

•    SURGICAL REMOVAL:

This is typically employed only on very deep and vivid scars, wherein one can simply remove them and perform a suture. The marking left by the suture will of course be preferable to the deeper scarring. It is not a preferred methods, but is often used to compliment other methods when dealing with very vivid scars.

•    FILLING MATERIALS:

This is most often employed to deal with very particular types of scars and is not suited to general use. The plastic surgeon will employ a certain filling material, usually hyaluronic acid, to fill the scar and make it appear more level. In any case, the essential aesthetic issue of scars and acme is not the scar tissue itself but the lack of evenness in the surface of the skin. Once the scar has been brought to a level with the rest of the skin following the use of filling materials, the general image is vastly improved. The disadvantage of this method is that it does not provide a permanent solution. The duration of the result, however, is quite lengthy (1-3 years). Of course, the most important advantage is that it is a very easy procedure that may only take approximately five minutes.

The issue of acne scarring can be particularly detrimental to the psychology of the patients, who tend to be young in age. Improving the problem tends to aid in the improvement of the psychology, particularly at an age where the latter is fairly sensitive.