Raised Acne Scars

Itching, pain and discomfort are often part and parcel of the raised acne scars that linger after acne lesions have vanished. The American Academy of Dermatology states that some raised scars (keloids) may even increase in size. When deciding on the correct method to use in treating raised acne scars, your dermatologist will consider how long you've had the scar, as well as its size and placement on your body.

The AAD notes that there are two types of raised acne scars, keloids and hypertrophic scars. Keloids, which are usually large with a thick, banded texture, usually form on the chest, shoulders, upper back and earlobes and may grow past their boundaries. The American Osteopathic College of Dermatology states that hypertrophic scars resemble keloids but are more common, remain the same size and can go away in time. Keloids are more common in darker-skinned individuals of African, Asian and Latino descent. Hypertrophic scars can affect anyone, regardless of racial group.

Intralesional Injections
The AAD indicates that the first treatment method for raised acne scars is to inject them with corticosteroids or interferon. A series of injections is usually given at two- or three-week intervals. The AOCD indicates that while hypertrophic scars usually respond to this treatment, keloids are far more challenging, and have a high rate of return in individuals with a family history of keloids. According to the AAD, if the scar doesn't show signs of improvement after four injections, another treatment method may be considered: acne scar surgery.

Surgical Treatment
An in-office surgical procedure in conjunction with follow-up treatments may be advised for raised scars. The AAD indicates that subsequent to excising the scar, various methods may be used to prevent the scar from coming back, such as application of a pressure dressing, corticosteroid or interferon injections and, in the most severe cases, X-ray treatments. Because between 45 and 100 percent of keloids return after surgery, the AAD indicates that injections of corticosteroids prior to surgery is often used to prevent keloid regrowth.

Other Medical Treatments
The AAD states that an increasing number of dermatologists use pulsed-dye laser (PDL) or intense pulsed light (IPL) treatment to address raised acne scars. Again, to prevent keloids from returning, injections of corticosteroids or application of a pressure garment may be advised. Cryotherapy employs the application of liquid nitrogen to "freeze" scars. The AAD indicates that a combination of cryotherapy in conjunction with corticosteroid injections often gives the most marked results. Prescription topical corticosteroid and trentinoin may also be applied to the scar to reduce its size and appearance.

Over-the-Counter Treatments
Silicone creams, gels and strips are available at most drugstores and pharmacies. The AAD indicates that these can slightly flatten raised scars if used daily over a long period of time. Silicone may also assuage the itching and tenderness associated with hypertrophic scars and keloids. The AAD states that many patients prefer applying topical creams rather than risk undesirable side effects of more invasive medical scar treatments. However, over-the-counter products won't get rid of the scars entirely.