Q. Is there anything that can be done to improve acne scars on the face. I am in my 30s and had terrible acne as a teenager. The active acne has finally gone away after seeing a dermatologist who was able to get it under control. Unfortunately, I am now left with many scars on both of my cheeks and some on my chin. Makeup does not hide the scars and sometimes seems to make them look worse. I am so embarrassed by my skin and am desperate to find something that will make my face look better.
A. I am sorry that you had to experience so many years with active acne and the unfortunate results: scarring. There are so many options now for the treatment of acne, and although it will not help you, you should keep in mind these options if you ever have children with the same problem. The options include topical antibiotics and Retinoids such as Retin-A®. Oral antibiotics, chemical peels, antibacterial cleansers, and as a last resort Accutane, which is a powerful anti-acne prescription medication are also excellent options. As for your scarring, this a much more difficult problem to fix. First, let me say that there are options that will improve the scars, but unfortunately, there is nothing that will make the scars go away completely. The three modalities for scar treatment of the face are dermabrasion, chemical peels, and fractionated CO2 laser resurfacing. Dermabrasion is essentially sanding the face, but this technique is rarely done anymore. Chemical peels do help but usually are not as aggressive as the laser and often require many peels over a long period of time. I favor using the laser because it is more aggressive in smoothening scars and is also more predictable in the results that can be expected. You should plan on more than one treatment for the scars, as each treatment will give additional improvement. The laser is usually performed with light oral sedation. It takes about a week for the face to heal such that you feel comfortable going back to a normal routine. The risks of laser resurfacing include prolonged redness of the face (looks like a sunburn), creation of new scarring due to the laser (rare), and overall disappointment due to not getting the result that you are seeking. I tell my patients that I can improve their situation in most instances but I will not be able to make your skin perfect. I recommend you see a board-certified plastic surgeon or dermatologist who performs laser on a regular basis.