A common question that we receive at the Advanced Acne Institute is whether Accutane can treat acne scars.  At first this seems like a pretty straightforward question.  However, it is actually more complicated than you may think.

First of all, acne sufferers think of acne scars in different ways.  For example, some refer to marks and spots that are left over from prior acne breakouts as “scars.”  However, this is not technically true.

The discoloration left by pimples is technically referred to as post inflammatory hyperpigmentation or post inflammatory pigment alteration, in which the discoloration can be darker than the normal skin color or appear persistently reddish even after the initial pimple has healed.

So discoloration is not the same as a true acne “scar” which is a permanent imperfection within the skin structure.  For example, a depression in the skin or a deep hole in the skin or a raised bump on the skin surface are all forms of actual acne “scars.”

In the field of acne treatment, we typically refer to these different types of acne scars as boxcar scars which have a rectangular depression with fairly defined borders, and ice-pick scars which are small, deep holes in the skin or rolling scars which are areas of uneven skin surface.  Hypertrophic scars are acne scars that are raised above the skin surface.  A comprehensive discussion of the different types of acne scars can be found here.

One of the important considerations in answering the question whether Accutane can treat acne scars must take into consideration how each acne sufferer defines the term.  Only then can this question be answered appropriately for each individual.

Furthermore, understanding the particular concern of an individual acne sufferer is the first step in addressing whether Accutane can treat the type of “scar” that is of concern to a particular patient.  For example, is it the skin imperfection that is bothering them or is it the discoloration?

Furthermore, red or dark discoloration often accompanies the actual physical scars.  Therefore it is often necessary to tease apart the feature that is most unsettling for each patient.  Is it the scar itself or is it the discoloration within the scar?

So the first objective is to develop a mutual understanding of what is meant by a scar.  And then it is vital to understand whether the patient is bothered by the redness or discoloration within the scar or if it is only the skin depression or the hole within the surface of the skin or the unevenness of the skin surface.

Only after achieving common ground as to what the real concern is can a treatment plan be effectively formulated and the role of Accutane considered.

To be more clear, if an acne sufferer is concerned mostly about how visible the scar is, this can often be addressed by targeting the discoloration without having to actually treat the actual scar itself.

In other words, if we use Accutane treatment to prevent new breakouts from erupting, this will prevent new spots of discoloration and allow the old marks to simply fade away with time.  The effectiveness of waiting for discoloration to fade should not be under-appreciated. In reality, the fading can occur relatively quickly and the patient can be very happy with the results.  In this way, Accutane can be a very effective treatment to gain control over the troubling appearance of redness or discoloration that so often occurs within acne scars.

Stopping Further Acne Scarring

Another important consideration is that Accutane is the most effective way to prevent further acne scarring.  That is, by preventing more breakouts, Accutane is a very effective treatment which can limit the risk of additional scars forming.  This is a vital part of any treatment or discussion regarding acne scar treatment.

Once this is explained and once an acne sufferer understands that the persistent discoloration will disappear completely over time as long as we can prevent new breakouts from forming, expectations are better managed and hopefulness can be achieved once again.

So in this scenario, a patient who is seeking treatment for acne scars may be best helped by explaining the difference between scars and discoloration and by further targeting what is actually the source of their frustration.

So to recap, Accutane can be a vary effective way to help treat acne “scars.”  If, on the other hand, an acne sufferer is bothered mostly by actual acne scars that are permanent imperfections of the skin, other treatments will be necessary for effective treatment.

The Advanced Acne Institute is a unique dermatology practice located in Miami, Florida specializing only in the treatment of acne.   We focus solely on providing the most effective treatments to help our patients achieve clear skin.  We are pleased to share our insights and perspectives in acne treatment as an educational service, however this information is provided strictly for educational purposes only and should not be considered medical advice and is not a substitute for seeking the advice and treatment by an appropriate medical professional.