Acne can leave behind more than active breakouts. Many patients struggle with acne scars, uneven skin texture, discoloration, and long-term skin damage even after their acne is under control. Because acne scarring can take many different forms, from deep ice-pick scars to broad depressed scars, effective treatment often requires a customized approach.
At the Maloney Center for Facial Plastic Surgery, Dr. Brian Maloney works closely with patients to develop individualized treatment plans that address both active acne and acne scarring. Using a combination of medical skincare, injectable treatments, laser resurfacing, scar revision techniques, and advanced skin rejuvenation procedures, Dr. Maloney helps patients achieve smoother, healthier-looking skin.
Understanding Acne and Acne Scarring
The skin has two layers, an outer protective layer (epidermis) and the deeper, supporting layer (dermis). The main part of the oil gland is located in the dermis, with a small tube extending up through the outer layer to open on the surface. When the oil glands become blocked, they continue to secrete their oils (sebum).
Eventually the gland bursts, exposing the oils to the surrounding cells. These oils are very irritating; therefore, the body sends clean-up cells to remove all the damaged tissue. The end-result is a weakening, or loss of, the supporting layer of the skin, causing the outer layer to fall in, thus creating a depressed scar. Scarring from acne can be narrow and deep, commonly referred to as ice pick scars, or broad and flat.
Preventing Acne Flare-Ups
Our skin has millions of oil glands that help protect it. Oil glands become blocked for many reasons: inadequate cleansing of the skin, failure to remove makeup at bedtime, sensitivity to fragrance, high-fat diet, and/or excessive, or the thickening of, gland secretions due to changes in hormones. Dr. Brian Maloney commonly recommends working closely with your dermatologist to control active acne, especially deep cystic acne. Some of the basic acne recommendations do not involve medication.
- Always wash the face before going to bed. Remove any makeup with a makeup remover and then wash again. Choose a cleanser that have little fragrance and that are not too harsh.
- Change your pillowcase at least twice a week. Oils and dirt from the hair can accumulate on your pillowcase pillow and can irritate the face.
- Avoid fragrance (perfume, fabric softener, etc.) as the acne-prone skin can be sensitive.
- Watch what you eat. Avoid colored drinks, fried foods, milk, peanuts, and chocolate.
- Choose hypoallergenic, non-comedogenic moisturizers, sunscreens, and makeup.
- Try not to touch the face repeatedly with the hands.
Dr. Maloney offers the following minimally invasive Acne Treatments to his patients.
- Tretinoin
- Fillers
- Punch Grafts
- W-plasty, Geometric Broken Line, and Z-plasty Scar Revisions
- Wire Brush Dermabrasion
- Carbon Dioxide (CO2) Laser
Acne Treatment Options
Tretinoin
Tretinoin (Retin-A®, Retin-A Micro®, Atralin®, Avita®, and Renova®) is one of the most effective prescription skincare treatments available for both acne management and long-term skin health. Unlike over-the-counter retinol products, tretinoin is a prescription-strength medication that helps accelerate skin cell turnover and improve the overall quality of the skin.
Benefits of tretinoin include:
- Exfoliating and smoothing the skin’s surface
- Improving skin tone and texture
- Stimulating blood flow to the skin
- Lightening certain dark spots and discoloration
- Helping reduce the development of precancerous skin changes
Because tretinoin promotes healthier skin cell growth, it remains one of the most valuable long-term treatments for patients dealing with acne, sun damage, and early signs of aging.
Facial Fillers
The hyaluronic acid fillers such as Juvederm® and Restylane® are the latest in-office treatments for some acne scars. The fillers can be injected into certain acne scars to help level the skin surface. Deep ice pick scars, in general, do not lend themselves to this type of treatment. Broader scars typically respond better.
Punch Grafts
Since the depressed acne scar represents a loss of the supporting layer, one treatment is to remove the damaged dermis and bring in healthy dermis. Punch grafts involve removing the depressed scar with a circular punch. Healthy skin, most commonly from behind the ear, is removed using a slightly larger punch. The healthy skin is placed in what used to be the scar hole. The graft is either taped or sutured in place. The tape or sutures are removed at the one week appointment. Depending on the number and nature of the scars, several sessions of punch grafting may be performed. This procedure is most often followed by wire brush dermabrasion or ablative CO2 laser resurfacing to help smooth out any “circles” created from the punch graft.
W-plasty, Geometric Broken Line, and Z-plasty Scar Revisions
When a lot of scars are present, larger scar revision procedures such as the W-plasty, Geometric Broken Line, or Z-plasty may be helpful in creating a smoother skin surface.
Wire Brush Dermabrasion
Wire Brush Dermabrasion has been a valuable tool in the treatment of acne for over fifty years. It is not to be confused with microdermabrasion. Microdermabrasion is a procedure performed by aestheticians which works by removing some of the outer protective layer of the skin. Microdermabrasion is a nice tool to help “refresh” the complexion, but it does not provide improvement in the appearance of the acne scars because it does not reach the deeper, supporting layer of skin.
Wire Brush Dermabrasion is generally performed in the operating room by a surgeon. The skin is numbed with a local anesthetic. The spinning wire brush is used to remove the outer layer of the skin and a portion of the supporting layer. The end result is something that looks like a carpet burn. Postoperative instructions follow a moist-healing protocol. Studies have shown that skin wounds heal faster when the surface is kept moist. The skin edges begin growing together, following a path of moisture. If the skin edges hit a crust they have to go under it, slowing the healing process. Patients are instructed to spray the dermabraded areas for fifteen minutes with a kitchen sink sprayer or shower, six times a day. After each spraying, the areas are gently dried, and Aquaphor® is applied. This protocol is followed daily for the first week. Generally by the end of the week, the new skin has matured enough to stop the spraying. A gentle moisturizer may now be used as needed.
Carbon Dioxide (CO2) Laser
The CO2 Laser is a focused beam of energy that removes the outer surface of the skin. It is a very controlled way to remove the outer scarred layers of the skin. Sometimes, a challenge with the CO2 Laser is the patient who has deep scarring, especially around the nose area. These patients may benefit from a combination of Wire Brush Dermabrasion around the nose and CO2 Laser on the rest of the face.
Candidates for Acne Treatment
Dr. Maloney believes that every face is different and finds it important to customize a treatment program specific to each patient’s concerns and issues. If you are tired of trying over-the-counter and prescription products that do not help with your acne, schedule a consultation appointment with Dr. Maloney to find out what skin rejuvenation procedures are right for you.
The Benefits of Acne Treatment
Modern acne scar treatments can significantly improve the appearance of damaged skin and restore smoother, healthier-looking contours.
Benefits may include:
- Reduction of acne scarring and skin irregularities
- Improved skin texture and tone
- Smoother skin contours
- Reduction of discoloration caused by previous breakouts
- Increased confidence and self-esteem
- Customized treatment options for different scar types and severities
Additional Skin Rejuvenation Procedures Include:
Why Choose Dr. Brian Maloney for Acne Scar Treatment?
Acne scar treatment requires a thorough understanding of both skin healing and facial aesthetics. Because no two patients have the same scarring pattern, successful treatment often involves combining multiple techniques to achieve the best result.
Dr. Brian Maloney is a double board-certified facial plastic surgeon with extensive experience in laser resurfacing, scar revision surgery, facial fillers, and skin rejuvenation procedures. He develops customized treatment plans based on the type, severity, and location of each patient’s acne scars rather than relying on a one-size-fits-all approach.
Achieve Clearer, Healthier-Looking Skin in Atlanta, GA
Acne and acne scarring can affect patients long after breakouts have resolved, but modern treatment options offer significant improvement for many forms of acne damage. Dr. Brian Maloney and the team at the Maloney Center for Facial Plastic Surgery provide customized treatment plans designed to improve skin quality, texture, and overall appearance.
To learn more about acne scar treatment and skin rejuvenation options, schedule a consultation today by calling 470.207.1367.
