Acne: Scars And Overpigmentation

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Acne: Scars And Overpigmentation
Acne: Scars And Overpigmentation
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Acne: scars and overpigmentation

The skin inflammation in acne can cause scars and overpigmentation (hyperpigmentation). It should be taken into account that in many cases the complexion can improve by itself over the years.

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  • What to do about acne scars
  • What can be done about overpigmentation
  • Whom can I ask?
  • How are the costs going to be covered?

What to do about acne scars

As with other scars, acne scars cannot completely recover. In many cases, however, an improvement in the condition of the skin can be achieved. Depending on the type of scar, different methods are used with varying degrees of success (*):

  • surgical methods with which either the edges of the scar are flattened or the scar valleys are undermined and thus lifted: this is done using a punch (punch excision and elevation), scalpel (subcision) or high-speed grinding and milling of the skin (dermabrasion),
  • Laser,
  • Flash lamp / Intense Pulsed Light (IPL) technology,
  • chemical scar treatment with highly concentrated trichloroacetic acid (TCA),
  • Dermatofiller (e.g. hyaluronic acid, collagen, poly-L-lactic acid, calcium hydroxylapatite or fatty tissue),
  • Microdermabrasion and microneedling (the skin is scratched on the surface with microfine needles under local anesthesia and thus stimulated for repair),
  • Injection of glucocorticosteroids directly into the acne scar,
  • Cold therapy,
  • Pressure treatment (a slight pressure is continuously exerted on the scar via bandages. The reduced blood flow slows the metabolism in the scar tissue. This should reduce the scar tissue and make the scar smooth and elastic)

What can be done about overpigmentation

Inflammation-related overpigmentation (post-inflammatory hyperpigementation, PIH) is caused by pigment deposits in the context of skin inflammation. Treatment includes avoiding UV light and consistent light protection with a broad-spectrum light protection preparation. PIH are usually difficult to treat. In practice, combinations with active ingredients from different points of attack have proven successful.

Topical therapies can influence pigment formation in a number of ways. Various substances with different effects and tolerability are used for this, eg azelaic acid, retinoids, N-acetyl-glucosamine (NAG), niacinamide, kojic acid and various plant substances such as soy. The effectiveness of lasers or flash lamps cannot yet be conclusively assessed. Better results are achieved using so-called non-ablative fractional photothermolysis. A laser is used to specifically and controlled heating of microscopic skin areas while protecting the epidermis. The aim of this stimulus is to stimulate the skin's ability to regenerate.

Chemical peels have also proven their worth. They remove the top layer of skin (stratum corneum) and accelerate the penetration of the bleach. Very superficial or superficial glycolic acid peels can be used as an additional treatment with little risk. However, their effect on dark skin types and deeply located pigment is minimal. The use of salicylic acid peels should be considered here.

Whom can I ask?

The treatment of acne scars and inflammation-related overpigmentation is carried out by dermatologists.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Medical aids & aids
  • Health Professions AZ
  • and via the online guide to reimbursement of social insurance costs.

The patients themselves have to pay for the costs of cosmetic treatments.

(*) German Dermatological Society: S2k guidelines for the treatment of acne, AWMF register no. 013/017.

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