Acne and Post-Acne Scar Treatment

Acne and post-acne scar treatment covers the medical measures used to control active acne and improve the appearance of skin affected by old lesions. Acne is an inflammatory condition of the hair follicle and sebaceous gland, showing as blackheads and whiteheads, papules, pustules and, in more severe forms, nodules or cysts.

The treatment plan is set individually, according to the type and severity of the acne, the patient's age and their response to previous treatments. At Detalii Med in Baia Mare, assessment and treatment are carried out by Dr Alina Perța, senior consultant dermatologist, and Dr Greta Jurj, specialist dermatologist who also works in aesthetic dermatology.

Treatment is intended for teenagers and adults who have:

• active acne on the face, chest or back, from mild to severe forms;
• acne that has appeared or worsened in adulthood, including acne with a hormonal component;
• red or brown marks left after inflamed lesions;
• depressed or, less often, raised post-acne scars;
• acne that has not improved with the products used so far.

Scar treatment usually begins once active acne is under control.

In most cases, acne can be controlled with the right treatment followed consistently. Starting treatment early reduces the risk of new scars. Marks left after acne usually fade over time, and this can be sped up with suitable treatment and sun protection.

Post-acne scars can be visibly improved, but usually cannot be removed completely. The aim is to improve texture and reduce the depth of the scars. Acne can return after treatment is stopped, which is why maintenance treatment is often needed.

The doctor talks with the patient about how long they have had acne, the areas affected, previous treatments and their effect, their skin care routine and the cosmetic products they use. For female patients, the menstrual cycle, a current or planned pregnancy and the contraceptive method are also important, as some treatments cannot be used in these situations.

After examining the skin, the doctor determines the type and severity of the acne, identifies any scars and their type, and may recommend blood tests, such as hormone tests, when there are signs that justify them.

Treatment for active acne is chosen according to severity and may include:

• topical treatments, as creams or gels with ingredients that reduce inflammation, bacteria and clogged pores;
• oral treatments, such as antibiotics for limited periods or, in certain cases in women, hormonal treatments;
• in severe or resistant forms, oral retinoids, given under strict medical supervision with regular blood tests;
• in-clinic procedures, such as chemical peels or medical extraction of lesions, as an adjunct to treatment.

For scars, the doctor may recommend, as appropriate, chemical peels, microneedling, energy-based procedures or techniques suited to a particular type of scar. The type of technology is chosen at the consultation, according to the indication. Several sessions are usually needed, a few weeks apart.

Topical and oral treatments require no anaesthesia. For some scar treatment procedures, such as microneedling or energy-based procedures, an anaesthetic cream may be applied to the skin, usually 30–60 minutes beforehand. The sensation during the procedure is generally well tolerated, but varies from person to person.

In the first weeks, topical treatments may cause dryness, redness or mild peeling, which usually lessen as the skin adapts. The doctor recommends gentle cleansers, a suitable moisturiser and daily sun protection.

After scar procedures, the skin may be red, slightly swollen or sensitive for a few days, depending on the procedure. During this time, sun exposure and touching or picking the skin should be avoided, as should make-up, as advised by the doctor.

The risks depend on the chosen treatment. Topical treatments can cause irritation, dryness or sensitivity to sunlight. Oral antibiotics may cause digestive upset or other side effects. Oral retinoids have well-known side effects, such as dry lips and skin, and must not be taken during pregnancy because they can seriously harm the unborn baby; for this reason, women must use effective contraception throughout treatment and for a period after it ends.

Scar procedures may cause prolonged redness, pigmentation marks, especially in darker skin, infection or, rarely, worsening of some scars. The doctor discusses these risks before each procedure.

Acne treatment requires patience. Improvement is usually seen after 6–12 weeks of correctly followed treatment, and in the first weeks the skin may temporarily look more irritated. Treatment with oral retinoids usually lasts several months.

For scars, results appear gradually, over several sessions and in the following months, as the skin remodels. The degree of improvement varies with the type and depth of the scars and with each patient's response.

Acne is a medical condition that can be controlled in most cases with appropriate treatment set by a dermatologist. Starting treatment early reduces the risk of scarring. Existing scars can be improved with procedures chosen according to their type, usually over several sessions. The right plan is decided at the consultation.