Scar Treatment Options: From Dermabrasion to Chemical Peels

What can you do if you have scars? If your acne is still active, your main concern should be to stop the condition from progressing and causing further scarring. Implement a highly aggressive topical treatment program and adhere to it diligently. Strive to gain control quickly, and if you encounter any difficulties, consult a doctor. It's crucial to halt scarring acne since it is much easier and more cost-effective to prevent scars than to treat them once they have formed. By pursuing aggressive treatment, you also benefit from simultaneously addressing your scars while bringing your condition under control through peeling. Regardless of the method used, surface peeling visibly reduces scarring.

Keep in mind that time alone can act as a treatment for scarring. Scars become less noticeable with the passage of time. When using DP agents and undergoing peeling, these changes occur more rapidly.

Nevertheless, the improvement achieved with time or superficial peeling is not particularly dramatic or fast, and you may desire more significant results. There are various professional treatments available for scarring. The only limitations are the availability of professional services and your financial resources. Doctors are constantly improving their approaches to scar treatment. Ask your doctor to discuss the different methods that can be used to treat your scars, as the treatment needs to be tailored to your specific needs based on the type of scarring. Inquire about the expected level of improvement, potential risks, and associated costs.


The traditional method for treating acne scars is dermabrasion. This technique involves freezing the skin and then abrading it with a wire brush or a diamond fraise mounted on an instrument similar to a dentist's drill. The follow-up care varies, but the abraded area may ooze and bleed, and significant swelling can occur. A crust or scab may form, and when it falls off, the skin remains raw and tender until it is fully healed, which typically takes about three weeks. During the healing process, and even for a few weeks afterward, the skin is more sensitive to topical applications and sunlight.

In theory, dermabrasion should result in perfectly smooth skin after healing, but this is often not the case. Some scars are too deep and cannot be eliminated with this procedure. Individuals with numerous ice-pick scars, for example, should not expect those scars to disappear.

On the other hand, if all the scars are relatively superficial, they can be completely eliminated. In cases of partial improvement, the procedure can be repeated to achieve further enhancement. It is essential to allow sufficient time for complete healing before undergoing another dermabrasion session.

The risks associated with dermabrasion include infection, hyperpigmentation, hypopigmentation (changes in skin coloration), and the development of small cysts called milia. The main drawback is that the results are often disappointing for those who require the most significant improvement, particularly individuals with deep scarring. Immediately after healing, the appearance can be misleading due to swelling within the skin. This swelling persists for weeks to months, making the skin appear smoother than it actually is. The initial appearance is better than the final outcome.

Dermabrasion can be highly effective for some individuals, but the results may be disappointing for others. Your doctor can provide you with information about the level of improvement you can expect based on your specific type of scarring.

Chemical Peeling

Chemical peeling is quite similar to dermabrasion, but instead of mechanical sanding, a caustic chemical like trichloroacetic acid is used. The chemical is applied, causing a severe peeling process similar to dermabrasion. The results and risks associated with chemical peeling are also similar to dermabrasion.

When the term "chemical peel" is used, it usually refers to a one-time application of a high-concentration caustic chemical, such as 50 percent trichloroacetic acid. Another form of chemical peeling, which is less intense, involves applying a lower concentration of the chemical repeatedly. For example, applying 20 to 30 percent trichloroacetic acid twice a week.

This approach produces a milder peel, but the results can be gratifying if the applications are continued for several weeks. There are fewer complications associated with this method of scar removal. Moreover, this type of chemical peeling, often referred to as chemical exfoliation or chemo-exfoliation, has the added advantage of being capable of treating both active acne and scarring.


Chemabrasion is a combination of chemical peeling and dermabrasion. The combination of these 2 methods may lead to improved results.


Superficial freezing of the skin using liquid nitrogen, either rolled or sprayed on, causes peeling similar to chemical exfoliation. Dry ice can also be used instead of liquid nitrogen. This method is used to treat both active acne and scarring.


Some scars appear more prominent due to their sharply defined edges. When the scar walls are almost perpendicular to the surface, they cast a shadow within the scar, making it more noticeable. Strong solutions, such as 100 percent trichloroacetic acid, can be applied carefully to the edges of such scars. This causes the scar wall to bevel. With a more gradual incline, the shadow is reduced, making the scar less noticeable.

Surgical Excision

Certain scars are so deep or extensive that the best approach is to surgically remove them and stitch the skin back together.

Excision and Elevation

Depressed scars can be incised using a scalpel or a biopsy punch to bring them to the surface. Sometimes, a filler material is placed beneath the scar to help elevate it.

As mentioned earlier, the patient's financial situation can be a limiting factor in scar treatment. Some of these procedures are time-consuming and costly. While advancements are continually being made, much can be done for scarring. However, preventing scars is still far superior and more cost-effective than attempting to eliminate them once they have formed.

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