Raised acne scars

When acne clears, some people see raised scars on their skin. With time, these scars may become larger and more noticeable. Some raised scars itch. They can even be painful and tender. To ease the discomfort and diminish the appearance of these scars, dermatologists offer patients a number of treatment options.

Your dermatologist considers many things before deciding how to treat a raised scar. Considerations include where the scar appears on the body, the size of the scar, and how long the scar has been there. Your dermatologist will use this information to create a treatment plan. Often a treatment plan will include more than 1 treatment option. Raised scars, especially keloids, often respond better when treated this way.

Injections
These injections, which your dermatologist may call “intralesional injections,” help shrink raised scars. Injections of corticosteroids can soften and flatten thick, raised scars. Interferon can help soften a keloid and make it feel smoother. Dermatologists generally give a series of injections. Usually given every few weeks, the frequency will depend on the type of scar and many other considerations. Some patients receive an injection every 2 or 3 weeks. Others get an injection once every 3 to 6 weeks. If a scar does not respond (or stops responding) by the 4th injection, scar surgery may be recommended.

Acne Scar Surgery
When raised scars do not respond to injections, your dermatologist may recommend surgery to remove the scar. This surgery can be performed in a dermatologist’s office, and you can go home afterward. When treating a keloid, dermatologists do not recommend surgery alone. Most keloids have a high risk (between 45% and 100%) of returning when surgery is the only treatment. To prevent a keloid from returning, dermatologists use other treatments before and after surgery. Many people receive injections of corticosteroids before surgery.

Cryotherapy
This treatment freezes the scar tissue. Freezing the tissue causes it to die and gradually fall off. To improve the results, dermatologists may schedule a series of cryotherapy sessions and corticosteroid injections. This combination often produces the best results. It can effectively diminish hypertrophic scars and flatten some keloids. Cryotherapy, however, can leave the treated skin looking lighter than the surrounding skin. This limits its use in people with skin of color.

Gels, Creams, and Tapes
Many of these are available without a prescription and can be used at home to treat raised scars. Products containing silicone may help reduce the itch and discomfort of both hypertrophic scars and keloids. One study found that some (34%) keloids actually flattened a bit when patients applied a silicone gel continuously for 6 months.

To be effective, gels, creams, and tapes must be used continuously. This can be difficult, especially for scars on the face. Many people are willing to do this because these treatments have little risk of side effects. Even so, with continuous use, some people develop itchy, irritated skin. None of these gels, creams, or tapes is likely to eliminate a raised scar, but these can help reduce the discomfort and the size.