In clinical practice, acne scars can be categorized based on their appearance into: atrophic scars, hypertrophic scars, and keloid scars.
Atrophic scars are the most common, which are often referred to as acne pits.
Classification of Acne Pits
Acne pits, in clinical practice, can be divided into three major types: icepick, rolling, and boxcar. Once formed, they are very difficult to completely eliminate.
1. Icepick Type Acne Scar
Icepick acne pits are a difficult type of acne pit to treat, classified into deep and shallow types clinically. They generally result from a less severe inflammatory reaction, where a large comedone is expelled, leaving behind a vertical tunnel-like defect.
The main appearance is that of small skin deficits.
2. Rolling Type Acne Scars
Rolling acne pits are more common in males, with the temporal region and cheeks being the most affected areas. They are generally formed due to tissue destruction at deeper layers of the skin due to inflammation.
The main appearance is not severe skin atrophy but there is a larger area of collapse change.
3. Boxcar Type Acne Scars
Boxcar acne pits are the most common type, with many variations and atypical forms in clinical practice based on size, depth, and borders. They are generally formed due to full-thickness inflammation and destruction of the local skin.
The main appearance is of atrophic skin with a truncated-like depression.
Treatment Methods
01. Ablative Fractional Laser (Desquamative, representative: 10600nm Fractional CO2 laser)
Ablative fractional lasers are mainly used to treat acne pits (atrophic scars) and mild hypertrophic scars!
Ablative fractional lasers use the photothermal action of ablative lasers to damage specified skin sites and layers, stimulating the body’s own repair to produce collagen and elastin fibers, allowing the missing depressed parts to regrow.
With the adoption of super pulse technology, it can shorten and more precisely control the duration of thermal damage, reducing pain perception.
The device offers a rich selection of treatment modes, precisely controlling energy, depth, and range, which can solve more complex skin issues.
Treatment course: Usually requires 2-4 treatments, with intervals ranging from 4-12 weeks. The treated area will have dot-like scabs that fall off on their own after about 1-2 weeks.
Additionally, note the following post-operative care:
- The first 24 hours post-operation is the most significant stage of inflammation; mild exudation is normal. Ensure good skin surface cooling, avoid wearing masks, and avoid contact with raw water for 3-5 days post-operation; if contacted, dry promptly.
- From the first day after surgery, you can choose to apply a medical repair dressing for three consecutive days to accelerate epidermal repair.
- Avoid cosmetics within the first week, absolutely avoid makeup. Sun protection work must be done well, mainly by wearing hats and using sun umbrellas, which is effective, safe, and convenient!
02. Non-Ablative Fractional Laser (Non-desquamative, representative: 1550nm laser)
Non-ablative fractional laser is a minimally invasive treatment that sits between invasive and non-invasive methods, based on the principle of focal photothermal action.
This laser can create a series of micro-stimulation columns in the skin, keeping the stratum corneum intact, with coagulation and degeneration of the epidermis and dermis; column-shaped dermal collagen is also thermally stimulated and degenerated, prompting the stimulated collagen tissue to be replaced by new, orderly collagen during the repair process, thus achieving skin reconstruction.
Because the treatment only covers part of the skin tissue, with the rest of the normal skin preserved, recovery is expedited; normal life resumes quickly after treatment, requiring less downtime and being relatively safe, and can treat any part of the body.
Treatment course: Non-ablative fractional laser targets different treatment needs, with most requiring multiple treatments, with intervals of 3–6 weeks, and a total of 4–8 treatments needed for optimal results.
03. Gold Microneedling RF
Gold microneedling RF technology involves gold micro-needles coated with an insulating substance. The needle tips penetrate the epidermis, reaching directly into the dermis, while the epidermal layer is protected by the insulating substance and not subjected to thermal stimulation.
Radiofrequency and laser in the dermis act on dermal collagen, heating it, and relying on the body’s self-repair function, the collagen in the dermis layer is rapidly regenerated and rebuilt under the stimulation of radiofrequency energy, effectively resolving post-acne depressions, sagging skin, and other skin issues.
The application advantages of gold microneedling include:
- Rapidly breaking through the skin barrier
Dense micro-needles create absolutely uniform puncture channels in a short time, breaking through the epidermal barrier and precisely targeting the dermis, effectively stimulating new collagen reconstruction and regeneration, achieving tighter, finer, and more elastic skin.
- Accurate treatment positioning for different needs
Gold Radiofrequency Microneedle produces stable energy with high precision, achieving adjustable energy and depth. It is adjustable from 0.3mm-3.0mm in depth, freely adjusting to adapt to the thickness of the skin at different treatment sites, resulting in higher treatment accuracy.
- Minimal trauma, light pain, no risk of pigmentation
Gold microneedling treatment process involves slight pain, all within a tolerable range. After treatment, the skin may appear slightly red but will not have blood spots or scab, truly minimally invasive treatment.
Due to the protection of the epidermal gold insulation layer, stimulation to the epidermal layer is avoided, eliminating any risk of pigmentation, making it popular among white-collar women.
04. Picosecond Laser
Picosecond laser uses focal point technology (honeycomb mode) to concentrate 100% of the energy uniformly on the skin for deeper treatment.
At the same time, high-intensity dual-layer focal laser separately acts on the epidermal and dermal layers, stimulating the regeneration and rearrangement of collagen and elastin fibers, awakening the skin’s youthful vitality.
Repair Phase
In fact, photothermal procedures will leave some trauma on the skin, with small wounds appearing on the skin and barrier function compromised. If post-operative skin care is not attended to, the skin will face prolonged dryness and dehydration, making it very sensitive and vulnerable.
At this time, it is necessary to use post-operative repair products that are repairing, gentle, and non-irritating to promote wound healing, prevent inflammatory reactions from causing pigmentation, and maintain post-treatment effects.
