Adapalene and tazarotene are new topical treatments similar in action to tretinoin. Adapalene may be less irritating for many individuals.
Ask your doctor if switching medications might be right for you. Another new acne treatment is azelaic acid cream, a prescription medication which helps to suppress acne bacteria and appears similar to benzoyl peroxide in its efficacy.
After active acne has been treated effectively, patients may want to think about pursuing scar revision. Their options have improved in recent years. Acne scars can never be entirely removed, but minimizing their appearance may be a realistic goal.
Deep pitted scars, sometimes known as “ice pick scars,” may be removed with an instrument called a punch, which acts like a miniature cookie cutter. Once the scar is “punched out,” the skin is either sewn up or replaced with a tiny skin graft. Shallow acne scars may be sanded using dermabrasion or laser resurfacing.
After local or general anesthesia is administered, the skin is superficially abraded with an spinning wheel in a treatment called dermabrasion, or a pulsed laser. Like a piece of wood that has been lightly sanded, the skin does not show as many irregularities after it has healed. Risks of resurfacing include worsening of scarring, persistent redness or persistent pigmentary changes. Patients who have previously taken isotretinoin, however, should wait one to two years before pursuing any scar revision because of the risk of worsening the scars.
Deeper knotted scars may be surgically removed, leaving behind a flatter and less obvious scar. However, individuals with oily skin-which is common in those with acne resulting in scars-often do not heal as well as those with non-oily skin.
Therefore, there’s a risk that the scarring may not be reduced. Doctors are also refining implant techniques. Depressions in the skin can be lifted with various collagen preparations or even fat removed from other parts of the patient’s body in a procedure known as liposuction.
Artificial Gore-Tex implants also are a consideration. Most scar revision procedures are considered cosmetic surgery, which usually means insurance will not cover payment. The best scar treatment of all is prevention. By promptly treating teenage and adult acne, you and your doctor can work together to improve acne lesions before they worsen and cause scarring.