Q: I am interested in removing acne scars. I am trying to decide between punch excision and dermabrasion. As I understand it with dermabrasion I will get minimal results on old and deep scars (however I am not sure what is meant by deep), but with punch excision I will be left with a small scar. As dermabrasion works best on newer scars, would a good option be to start with punch excision and then use dermabrasion to remove the resulting scar? or would dermabrasion or punch excision alone be the best option? or would there be another, better option. I am looking for the most promising option here, I have spend a lot of time and money on snake oil treatments and empty promises with no real results. Thank you for your time.
A: Thank you for your inquiry on acne scar revision. Punch excision is the only thing that will work for ice pick or deep acne scars. Dermabrasion works best on moderate-depth acne scars particularly of the saucer-shape variety. Laser resurfacing works best on more superficial or fine acne scars. The age of an acne scar is really irrelevant unless it is fairly new. The logic would be to work on the deepest scars first with punch excision and then use the skin resurfacing methods (dermabrasion or laser resurfacing) after.
Dr. Barry Eppley