As the most extensively published Dermatologist in the world on acne scarring, Assoc Prof Greg Goodman is often invited to attend international conferences in order to give lectures to other doctors on how they should treat and manage this condition, having recently returned from the Aesthetic & Anti-aging Medicine World Congress meeting in Monaco we thought we’d interview him on this important topic.
Q. As the name suggests acne scarring is obviously caused by acne but can you tell us why scarring occurs in some people and not in others?
GG: "For me the greatest contributor to the development of scarring is the fact that many people see acne as part of normal teen development and so they don’t immediately treat it.
A patient with severe acne scarring
Click here to read our blog on what to do about your teenager’s acne.
"The longer acne goes untreated the more likely it is to become severe. More serious acne will have increased inflammation which will contribute to a break in the follicle wall, which allows all the nasty bacteria to invade the skin."
Click here to watch a video produced by Assoc Prof Greg Goodman on how and why acne forms.
The presence of too much inflammation also hinders the healing process and stops the development of new skin structures such as collagen from happening. Collagen is the substance that keeps our skin looking even, plump and firm. The damage to the structures that support the skin is what gives those that suffer from acne scarring the appearance of uneven skin."
Q. Are there different types of acne scarring?
GG: "Yes, generally when we assess a patient we will grade their scarring into one of the below categories this helps us to determine the best way to treat it. This is a grading scale we have invented and is published in a peer reviewed journal and widely used in studies around the world. "
Grade 1 ‘Macular disease’ - These patients will have little marks on their skin that don’t go away when the pimple does. The marks are generally red or brown. With this level of scarring the skin surface usually remains fairly even.
Patient with 'Mild' Grade 2 acne scarring
Grade 2 ‘Mild’ – These patients will start to show a small amount of unevenness in their skin surface, with little divots appearing, however they may only be visible in certain lights and can generally be covered by makeup.
Grade 3 ‘Moderate’ – These patients will have a greater degree of unevenness in their skin that will be visible in most lights and while makeup will improve the appearance it won’t completely hide it
Grade 4 ‘Severe’ – These are the patients whose acne scarring is visible all the time even at a distance.
Patient with 'Severe' Grade 4 acne scarring
Q. How do you treat acne scarring?
GG: Depending on the type of acne scarring, treatment can be quite complex which is why I am such an advocate of treating acne early to avoid scarring. Some cases will require a number of different types of treatment to get a result such as: vascular laser to treat the red marks, dermal filler injections to improve divots, laser such as fraxel or radiofrequency machines like venus viva to improve the collagen production harmed by the inflammation caused by the acne. Each person is different and so it is necessary to come in for a consultation, thorough assessment and to have an individual treatment plan put in place."
Click here to read more about the acne scarring treatments offered at DIV.
Patient who has had extensive treatment for acne scarring at The Dermatology Institute of Victoria. The top row shows before treatment, the bottom after.
*All results shown on our website have been achieved by our team members. Please note that results are individual and may vary.