Press Release from the American Academy of Dermatology

ANAHEIM, CALIF. (July 31, 2001) – Acne is a common medical condition that affects up to 80 percent of people between 11 and 30 years of age. Even after the unsightly whiteheads, blackheads and pustules have been successfully treated, many people are left with disfiguring acne scars that serve as a cruel reminder of this difficult condition. Oftentimes, the scars can be just as devastating as the acne they replaced.

Speaking today at Academy 2001, the American Academy of Dermatology’s summer scientific meeting in Anaheim, Calif., dermatologist Mitchel Goldman, MD, Associate Clinical Professor, Department of Medicine, Division of Dermatology, University of California at San Diego, discussed results of his study on patients treated with a new laser surgery option for acne scarring, as well as other common treatments.

A new device known as the 1320 nm Nd: YAG laser with dynamic epidermal cooling shows promising results in treating acne scarring. The only infrared laser systems cleared by the Food and Drug Administration for treating wrinkles, this non-invasive laser technology works by stimulating collagen formation in the dermis – or deepest layer of the skin – which raises the acne scar.

In a study conducted by Drs. Goldman, Elizabeth Roston and Richard Fitzpatrick, 14 patients with depressed acne scars were treated with a 1320 nm Nd: YAG laser over four separate treatments spaced three weeks apart. By the end of the last treatment, seven patients experienced a 50 percent improvement in the appearance of their acne scars. Improvement was defined as how much the depressed acne scars were elevated following treatment. All patients showed an average 40 percent improvement in the appearance of their acne scars.

"The 1320 nm Nd: YAG laser is an excellent new method for treating acne scars because it works for all skin types – from very dark to very light – and with no downtime," explained Dr. Goldman. "Until now, many of the other acne scar treatments produced a wound that may have required weeks to heal. Since this new laser therapy is non-invasive, the patient does not require anesthesia and the procedure is not a painful one."

Other lasers, such as the pulse dye laser and intense pulse light, also work in elevating depressed acne scars by penetrating the dermis and producing new dermal collagen to elevate the depression. The pulse dye laser produces a bruise that can last one to two weeks. In addition, the Erbium:YAG laser allows for very precise sculpting of acne scars. With this laser, recovery times are faster – usually three to five days – with a shorter period of post-surgery redness than with the CO2 laser for acne scar correction.

Dermabrasion is another effective method to treat acne scars that involves the mechanical sanding of the upper layers of the scar. With this procedure, a new layer of skin replaces the abraded skin during healing, resulting in a smoother appearance. Although dermabrasion is an invasive procedure that requires anesthesia, most patients heal within one to two weeks.

For severely depressed scars, more invasive techniques are required. Subcision is a procedure that uses a surgical probe to lift up the skin that pulls away from the depressed scar tissue below. After the scar is released, the patient’s own fat or another substance like collagen can be used to elevate the scar.

"Acne scars that require surgical excision are usually followed by laser resurfacing or dermabrasion to erase the surgical excision line," added Dr. Goldman.

Another type of acne scarring is elevated scars, which are usually red in appearance. Lasers, such as the pulse dye laser and intense pulse light, work by eliminating the excessive blood vessels that give elevated scars their appearance. Elevated scars can also be treated with injections of intralesional 5% 5-FU, which works by breaking down the scar causing the acne scar to flatten. Intralesional 5% 5-FU is preferred over steroids because it does not cause a depression or the formation of new blood vessels that steroids can.

Patients with very mild acne scarring are also good candidates for microdermabrasion, a technique in which aluminum oxide, and silicon or salt crystals passing through a vacuum tube gently scrapes away the scarred skin. With this procedure, new cell growth is stimulated. While microdermabrasion is a quick procedure that leaves the patient with only minimal redness, patients will often require multiple treatments and the results are not as dramatic as other procedures.

"Today, patients have more options than ever to treat acne scars," said Dr. Goldman. "Dermatologists can help patients choose the best treatment options for their particular kind of acne scars. Acne scarring no longer has to be a constant reminder of the physical and emotional pain that accompanies acne."

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 13,000 dermatologists worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.