Acne scars and facial scars often remain long after the initial breakout or injury has healed. Scars can be visible on the skin and they can also cause a rough texture. At Zormeier Cosmetic Surgery & Longevity Center, we serve patients from Noblesville, Shelbyville, Danville, Healdsburg and Ukiah who are looking for ways to improve the appearance of scarred skin.
We offer surgical and nonsurgical scar treatment options that can be used for different situations. Some of our treatments focus more on resurfacing the skin to smooth out any uneven texture. Others treat individual scars that are deep or stubborn. We can address both old and new scars to reduce their visibility on the face and improve the health of your skin.
Why Acne Scars and Facial Scars Develop
How Acne Causes Scarring
When acne becomes inflamed, the infection damages the underlying skin tissue. Your body is quick to respond by sending collagen to repair the area, but while effective, that repair process isn’t always precise. If too little collagen is produced, the skin can heal with a depression or indent. If too much is produced, raised scar tissue can form. The deeper and more inflamed a breakout is, the more likely it is to leave a lasting mark, which is why cystic and nodular acne tend to cause the most scarring.
Traumatic and Surgical Facial Scars
Not all facial scars come from acne. Cuts, burns, dog bites and surgical incisions can all leave visible scarring on the face. These scars vary widely depending on the size and depth of the wound, how it was treated at the time and how your body responded during healing. Facial skin is thinner than skin on most other parts of the body, which can make scars in this area more noticeable.
The Role of Collagen in Scar Formation
Collagen is the protein your body uses to rebuild damaged skin, and the acne scar healing process depends on how that collagen is deposited. In healthy skin, collagen fibers are arranged in an organized pattern. When the skin is repairing itself after a wound or breakout, collagen is often laid down unevenly or in excess. This disrupted structure is what gives scar tissue its different texture and appearance compared to the surrounding skin.
Factors That Affect Scar Severity
Genetics is a factor in how your skin heals, and some people are simply more prone to scarring than others. Certain skin tones are more likely to develop keloid or hypertrophic scars as well as post-inflammatory hyperpigmentation. Picking at or squeezing acne increases the chance of deeper tissue damage, and delaying treatment for active breakouts or wounds can also lead to worse scarring, since prolonged inflammation gives the skin more time to sustain damage.
Can Acne Scars & Facial Scars Be Fully Removed?
Most scars cannot be completely erased, but the right treatment can improve their texture and depth. The degree of improvement depends on the type of scar and how your skin responds to treatment. In many cases, a combination of approaches gives the best results by addressing different layers of the skin at the same time.
Common Types of Scarring
- Ice pick scars: These are narrow, deep indentations that extend into the lower layers of the skin. They are often the most difficult type of atrophic scar to treat because of how deep they go.
- Boxcar scars: These scars have wider, flat bases with defined edges. They are most often found on the cheeks and temples.
- Rolling scars: Rolling scars create a wave-like unevenness as bands of tissue pull the surface downward. They tend to become more noticeable as the skin loses elasticity with age.
- Hypertrophic and keloid scars: Both are raised, but keloid scars grow beyond the borders of the original wound while hypertrophic scars stay within them.
- Post-inflammatory hyperpigmentation: This is not technically a scar but a flat, discolored mark left behind after inflammation. It is more noticeable in darker skin tones and can take months to fade without treatment.
Acne Scars vs. Active Acne
It’s important to distinguish between active acne and the scars it leaves behind, since treating one while the other is still present can limit your results. Active breakouts involve clogged pores, bacteria and inflammation, while scars are the lasting texture or pigment changes that remain after the skin has healed. In most cases, we recommend getting active acne under control before starting scar therapy so that new breakouts don’t undo the progress of treatment.
Treatment Options for Acne Scars and Facial Scars
Morpheus8 RF Microneedling
Morpheus8 combines microneedling with radiofrequency energy to treat the skin where scar tissue forms. The tiny needles create microchannels while the radiofrequency heats the underlying tissue and triggers a robust collagen remodeling response. This treatment works well for atrophic acne scars and can also help tighten and smooth the surrounding skin.
Bellafill®
Bellafill is an injectable filler used specifically for the correction of atrophic acne scars. It contains collagen gel and polymethylmethacrylate (PMMA) microspheres, which provide immediate volume beneath the scar while also encouraging your body to build its own collagen. Bellafill is FDA-approved and lasts for up to five years.
Pearl Erbium Fractional Laser
The Pearl Erbium fractional laser is an acne scar removal option that creates tiny thermal columns in the skin. Your body gets to work to replace the damaged, scarred skin in response to this stimulation. It is effective for both texture irregularities and surface-level discoloration.
Laser Genesis
Laser Genesis uses non-ablative laser energy to heat the upper layers of the skin without breaking the surface. This stimulates collagen production over a series of sessions. There is no downtime with this treatment, so it is good for patients who want subtle and steady improvement without interruption to their routine.
Microdermabrasion, Facials and Peels
Surface-level treatments help exfoliate the outermost layer of skin to encourage cell turnover and a smoother texture. Chemical peels use acids at varying strengths to remove damaged skin, while microdermabrasion uses fine crystals or a diamond tip to physically buff the surface. These acne scar reduction treatments are best for mild scarring and post-inflammatory hyperpigmentation.
Injectable Medications
Corticosteroid injections can help soften and flatten hypertrophic and keloid scars and are often a first step before we recommend surgery. The medication is injected directly into the scar to reduce inflammation and slow excess collagen production.
Facial Scar Revision Surgery
When nonsurgical options are not enough, surgical scar revision is the next option. Methods like excision remove scar tissue and create a thinner and less noticeable result. This option can be used alongside nonsurgical methods to improve results.
Frequently Asked Questions
How many treatment sessions will I need?
The number of sessions depends on the type and severity of your scarring as well as the treatment being used. Surface-level treatments like microdermabrasion and chemical peels may require more frequent visits, while options like Bellafill may only need one appointment.
Can I combine multiple scar treatments?
Combining treatments is something we do regularly for patients with different types of scarring. For instance, a patient with both deep ice pick scars and surface-level discoloration may benefit from a combination of microneedling and chemical peels. We build treatment plans around what your skin needs.
When is surgical scar revision the more appropriate option?
Surgical scar revision is considered when a scar is too deep, wide or raised for nonsurgical methods to make a difference. It may also be recommended for traumatic or surgical scars that healed poorly or are positioned in a way that makes them especially visible.
Explore Your Treatment Options for Acne Scars and Facial Scars in Noblesville, IN
Acne scar treatment results depend on the type of scarring and the approach used, and working with an experienced provider can help you find the right path forward. At Zormeier Cosmetic Surgery & Longevity Center, Dr. Michele Zormeier is a double-board-certified facial plastic surgeon with over 20 years of surgical experience and an extensive background in laser and skin resurfacing treatments. To learn more about how we can help with your acne scars or facial scars in Noblesville, IN, call us at 317-699-8848 or fill out our online form.
