Acne can be mild, moderate or severe but no matter what type it is it can have a huge impact on self esteem. Acne can in some cases lead to lifelong scarring. Early intervention for acne is essential to help prevent permanent scarring. The board-certified dermatologists at Greenbrae Dermatology are experts in the management of acne and will tailor your treatment to your individual needs. Acne is a complex disease and treatments that offer long term cure are better than some techniques that improve your acne for a short period only.

How do we treat Acne?

Our dermatologists have many years experience in treating acne. To reduce spots and minimize the chances of scarring, options include:

• Non-prescription creams and lotions
• Oral antibiotics
• Hormonal Medications
• Oral retinoids/Vitamin A

Skin Color Changes

Skin color changes are extremely common. In patients with pale skin, this is usually characterized by flat pink/red areas that are left behind once the “bumpiness” has resolved. This is called post-inflammatory erythema. People with darker skin often get darker brown marks once the acne has resolved, this is commonly known as post-inflammatory hyperpigmentation. White marks can also occur once acne has resolved. Unfortunately, these post-inflammatory changes do not improve with oral antibiotics or topical anti-acne therapy.

Most of the color changes will improve naturally over time (6-18 months). Sun protection is important and some topical bleaching creams (e.g. Kojic and azelaic acid) can help with dark spots. Red spots may respond to laser (vascular laser). Scars develop over time and there is some evidence that early treatment of the post-inflammatory redness may reduce the development of scarring in the future.

Acne Scar Treatment

Up to 40% of acne suffers with moderate to severe acne will have some form of scarring. When acne scars bother you, safe and effective treatment is available.

The residual effects of acne can leave a wide variety of different types of scars that can develop following acne. The type of scar influences the way it is treated and often multiple treatment modalities are required. For example, deep pitted scars also called ice-pick scars will require more treatment sessions and stronger lasers than flat, thin scars. Some scars can be raised, also known as keloid scars, and they will often require injections of an anti-inflammatory to flatten them down. Most people with acne scars have a combination of different scar types and hence a range of approaches is required, which your dermatologist will discuss with you.

How do we treat Acne Scarring?

Many treatments are available and include laser treatments, minor skin surgeries, chemical peels, and soft tissue fillers. 

Before getting treatment for acne scars, it is important to clear your acne. New acne breakouts can lead to new acne scars. Having acne also means that your skin is inflamed which will reduce the effectiveness of acne scar treatment.

As skin loses collagen through aging, acne scars can often become more noticeable.

Techniques used to manage scars need to be individualized. The key to effective scar treatment is to have effective consultation which selects the best treatment for each scar type. For example, a patient who has some deep scars may benefit from having a soft tissue filler treatment to add volume to the skin and this may then be followed by laser treatments. Non-surgical treatment options for acne scarring include non-ablative fractionated laser therapy along with topical retinoids and chemical peels. Surgical treatment options are also available and are all designed to improve the appearance of scarring.

For best results, have a dermatologist examine your skin as there may be other underlying skin conditions which may further impact on the correct treatment plan.

Treatment for acne scarring include:

• Chemical Peel
• Fraxel laser
• Microneedling
• Punch grafting
• Subcision
• Soft filler injections