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Acne Scarring Can Be Prevented - and Treated


Acne has generally been viewed as a normal rite of passage from adolescence to adulthood. Because of its visibility and its occurrence during a difficult time of social development, acne may often have a devastating effect on a teenager's self-confidence and self-esteem.

When severe, untreated acne can result in disfiguring scars.

"Acne does not have to be an inevitable part of growing up," stated dermatologist Stephen Mandy, MD, Clinical Professor of Dermatology, University of Miami, in Florida.

"Acne is a treatable medical condition that, if left untreated, can last well beyond the teenage years. The only way to prevent the physical and emotional scarring from acne is to treat the condition before it becomes advanced."

Acne is a chronic inflammatory skin condition which affects 85% of all teenagers, more than 20 million teens nationwide. In approximately 30% of these individuals, acne will persist into adulthood. Lesions are often found on the face, but may also be present on the back and chest.

Acne is the result of a sequence of genetic and hormonal events that begin with the onset of puberty. As hormone levels associated with the development of secondary sexual characteristics rise, oil production in the sebaceous glands of the face, back, and chest increase.

Some people experience a thickening of the lining of the wall of the duct of the oil gland, a process called follicular hyperkeratosis. This thickening ultimately leads to a blockage of the duct and subsequent accumulation of oil beneath the skin in lesions called comedones, which are commonly referred to as blackheads.

Bacteria, known as corynebacterium acnes, proliferate within these comedones and produce free fatty acids which are very irritating to the skin.

This process can lead to pustular and cystic lesions which can rupture and leave scars.

"While there is no cure for acne, there are a variety of effective treatments which can control the sequence of events which cause acne," stated Dr. Mandy.

"A patient's dermatologist can determine the appropriate therapy depending on the severity of the problem and the sensitivity of the skin."

When acne treatment begins too late or is inadequate, scarring is often the outcome. Fortunately, dermatologic surgery provides more safe and effective treatments for acne scarring than ever before.

"Dermabrasion, the mechanical sanding of the upper layers of the skin, is quite effective in improving scars," stated Dr. Mandy. "With this procedure, a new layer of skin replaces the abraded skin during healing, resulting in a smoother appearance." Dermabrasion is usuallyyy performed once and most patients heal within 1 week.

The use of lasers has also had a significant impact in the treatment of acne scarring. The Erbium:YAG laser, which emits light through short bursts of energy that is absorbed by the water in the skin, allows for very precise sculpting of irregular scars. Patients usually recover from the procedure in 3 to 5 days and experience a short duration of postsurgery redness.

The CO2 laser works well for elevating depressed scars that give the skin a crater-like appearance. Since the CO2 laser produces more heat than the Erbium:YAG laser, it allows the energy emitted to penetrate deeper into the skin and tighten the skin's collagen fibers. By tightening the collagen fibers, the CO2 laser causes depressed scars to elevate and normalize in appearance. In most cases, only a single treatment is required to produce permanent results with either the Erbium:YAG or CO2 laser.

"It is important for teenagers and their parents to realize that both acne and acne scarring are treatable medical conditions," stated Dr. Mandy."