By: Dr. Oscar Hevia
Some adults, even those who never suffered from adolescent acne, may experience adult cystic acne, caused by an inflamed cyst that forms in the deeper layers of the skin. This type of acne does not respond well to drying creams, which don’t penetrate beyond the surface layer.
However, a very effective treatment for cystic acne, or a blemish that can linger for weeks or months after the cyst subsides, is an anti-inflammatory cortisone injection, which will reduce the inflammation and thereby shrink the cyst. While this may not be a desirable remedy for every outbreak, it certainly provides a viable treatment option prior to a special event. Typically, the cyst or the blemish will disappear within 24 hours after the injection.
Treating Acne Scarring
If you’ve suffered from the effects of long-term acne, scarring will likely be a telltale reminder that stares back at you in the mirror each day. A combination of the severity of the skin damage and skin’s genetic ability to repair itself will determine how the skin scars. These and several other factors will dictate the best course of treatment for scarring, but there are various treatment protocols to consider.
Fillers: I have had great success in treating acne scarring with fillers, and this is a protocol I often recommend for my patients. There is no wound, no wound care and no recovery time needed. And, since the scarring is permanent, injectable silicone is often a viable permanent solution versus temporary fillers, such as Rystelane®.
An exception to this course of treatment is ice pick scarring that may result from persistent acne. These scars look like someone poked holes in your skin with a needle or ice pick. This type of scarring does not respond to fillers because the bottom portion of the hole will not come back up to the surface. It is anchored deep in the tissue. Unfortunately, there is no effective treatment for this type of scarring.
Chemical Peels: Deep chemical peels may improve the appearance of acne scarring, but in most instances, they will not restore the skin to the pre-acne smoothness and texture. If you have darker skin, proceed with caution. Accessing a deeper layer of the skin may result in an uneven skin tone. Generally, peels are more effective in treating changes to the skin color, such as age spots or sun damage.
Lasers: As with chemical peels and bleaches or fading creams, lasers are most effective for treating skin discoloration. Although there are many lasers on the market that treat a multitude of the skin’s imperfectins, I have not experienced great overall results using lasers for the treatment of acne scars. As a result, this would not likely be a course of treatment I would recommend for my patients.