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How Does Acne Cause Acne Scars?

Acne Scar Treatment Sydney Consumer GuideAcne results from blocked and infected hair follicles on the face, neck, chest or back. If the acne isn't treated effectively it can leave scars behind. An acne scar treatment option that is FDA approved for the treatment of acne scars is the eTwo SublativeTM Radio Frequency (RF) Treatment System, is providing excellent results in reducing the appearance of acne scars, but with none of the complications of similar treatments.

This article explains how acne scars are formed and what options are available to reduce their appearance.


What Are Acne Scars?

When acne breakouts penetrate the skin deeply, they damage the top layer (the epidermis) of the skin and the deeper layer (the dermis) beneath it. Collagen fibres are produced as part of the healing process, which gives the skin a firm texture. Too little or too much collagen in the wrong place will create a scar. We don't really know why some people get scars and others don't, but if your parents or other family members have acne scars, it is likely that you will scar too.


The type of scar depends on how much collagen your body makes.

  • Raised (Hypertrophic) acne scars: firm raised bumps caused by too much collagen and are more common on the shoulders, upper back and chest, and in people with darker skin types.
  • Depressed (Atrophic) acne scars: the most common type of scar, and caused when too little collagen is produced. Atrophic scars are further subdivided into narrow ('icepick') or wide ('rolling' or 'boxcar').

The type of scar determines which treatment option is appropriate.


Treatment options

  1. Surgery can be used for deep 'icepick' scars. This method can also cause scarring, although it is generally not as pronounced as the original scar.
  1. Ablative techniques (chemical peels, laser resurfacing) remove some of the epidermis, encouraging new skin cells to grow in place of the scar tissue. Ablative techniques are better for wide, shallow scars.

Ablative treatments take longer to recover from and have high rates of complications (pain, swelling, redness and infection). These methods have limitations on the type of acne scar they can treat. If the scar is deep and oddly shaped, removing the top epidermal layer won't reduce the appearance of the scar effectively. Ablative techniques also often cause areas of uneven skin colouration (hypopigmentation) lasting up to two years after treatment, particularly in darker skin types. 


  1. Non-ablative techniques and 'fractional' lasers are more gentle and have fewer side effects, but require more treatments to achieve acceptable results and so are more expensive. Fractional lasers have applicators made up of small electrodes in a grid pattern, to 'fractionate' or break up the laser energy into small pinpoints.
  1. Dermal fillers can be used to fill in the depressions left by atrophic scars and give the impression of smoother skin, but are temporary and need continual maintenance.


'Sublative' Treatments - eTwo SublativeTM RF Treatment System

The eTwo SublativeTM RF Treatment System is a non-ablative fractional technology that is more effective in reducing the appearance of acne scars as ablative techniques, but with shorter recovery periods and fewer side effects. This technology relies on radiofrequency rather than laser energy. Radiofrequency (RF) is a lower intensity energy than laser, but travels through the skin in a different way, penetrating deep into the dermis without harming the epidermis. This treatment stimulates collagen production that is more evenly distributed through the dermis and improves the texture of the treated skin.

Sublative technology is suitable for all skin colours, and is effective on deep and shallow scars because it stimulates greater levels of tissue remodelling than traditional fractional lasers. It has none of the complications of laser treatments and minimal downtime.

If you have been thinking about getting treatment to reduce the appearance of your acne scars, the eTwo SublativeTM RF Treatment System is a safe and effective alternative to other treatment options. This FDA approved device is also an effective acne treatment option.


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