Which Method is More Effective for Deep Acne Scars in Bornova?
Bornova, one of the most energetic and youngest districts of Izmir, is a living space blended with the intense pace of university life, exam stress, and the characteristic features of the Aegean climate. In this dynamic process, acne (pimples) and the deep scars it leaves behind are among the most common skin problems many individuals face during the transition from adolescence to adulthood. Although active pimples on the skin’s surface subside over time, the damage they leave in the lower layers of the skin can turn into permanent marks that we call “scars.” Atrophic scars, which manifest themselves especially as deep pits, are not only an aesthetic concern but also a structural problem that disrupts the smooth texture of the skin. So, considering Bornova’s climatic conditions and city life, which scientific approaches stand out in the management of these stubborn scars?
The depth and type of acne scars are the most critical factors determining the success of the method to be applied. Depending on the extent of damage to the epidermis (upper) and dermis (middle) layers of the skin, scars range from superficial blemishes to icepick scars that penetrate deep into the dermis. Our bodies quickly begin producing collagen to repair a wound; however, if the collagen fibers are irregularly structured during this rapid production, depressions or bumps occur on the skin’s surface. Deep acne pits often result from tissue loss and weakening of the skin’s supporting tissue. Managing these scars requires more advanced technologies and combined protocols that target the deeper layers of the skin, not just simple creams or superficial treatments.
The Anatomy of Deep Acne Scars: Why Do Pitting Occur?
To understand deep acne scars, it’s first necessary to grasp the skin’s healing mechanism. When severe inflammation ruptures the hair follicle wall, the infection spreads to the dermis layer. The dermis is the layer containing collagen and elastin fibers that provide the skin’s elasticity and fullness. When inflammation destroys this valuable tissue, the body tries to repair the damage. However, in severe acne, when the healing process is complete, the body may not produce enough collagen to replace the lost tissue. This “tissue deficiency” causes the skin’s surface to collapse inwards. This condition is called “atrophic scarring” in medical literature.
Atrophic scars are divided into different subgroups according to their shape, and each requires a different approach. The “deep pore” appearance, frequently encountered in Bornova and the most common complaint among clients, is usually “Icepick” scars. These scars are narrow (less than 2 mm) but their depth extends to the lower layers of the dermis, and sometimes even to the subcutaneous fat tissue. Due to their depth, superficial peeling procedures have limited effectiveness on these scars. Another type, “Boxcar” scars, are wide-based, sharply edged, box-like depressions. “Rolling” scars give the skin an uneven appearance and are usually formed by the fibrous bands under the skin pulling the surface down. This morphological structure of the scar is a determining factor when deciding which method will be more effective.
Comparison of Methods and Mechanisms of Action
In modern aesthetic and dermatology applications, it is not scientifically accurate to talk about a “single miracle method” for deep acne scars. Instead, technologies that trigger the skin’s own repair mechanisms are used, selected according to the type of scar and the needs of the skin. Here are the basic approaches and working principles whose effectiveness has been proven in the literature:
1. Fractional Radiofrequency (Gold Needle) Technology
Fractional radiofrequency applications are designed to transmit energy directly to the dermis layer without damaging the skin surface. Micro-needles penetrate under the skin and release radiofrequency energy (heat) to the targeted depth. This controlled heat damage initiates the skin’s “wound healing” process. As heated collagen fibers shorten and tighten, fibroblast cells are stimulated to produce new collagen and elastin. This method is particularly preferred for lifting the base of deep scars and improving overall skin quality. In sunny areas like Bornova, its safer application during the summer months compared to lasers (due to the lower risk of sun sensitivity) is a significant advantage.
2. Fractional Carbon Dioxide (CO2) Lasers
Fractional CO2 lasers, which belong to the ablative (peeling) laser group, both peel the upper layer of the skin in a controlled manner and send heat columns to the lower layers. This process eliminates irregularities on the upper surface of the skin while providing a very strong collagen contraction in the deep tissue. It is a highly effective method for deep boxcar and rolling scars. However, it requires a post-procedure crusting and healing period (downtime). Considering İzmir’s high UV index…When this procedure is performed, it is essential that it is usually planned for the autumn and winter months and that very strict sun protection is applied after the procedure.
3. Subcision (Subcutaneous Release)
Especially in “Rolling” type wavy scars, the source of the problem is not on the surface, but in the fibrotic bands that pull the skin down. Laser or needle treatments performed without cutting these bands may not completely correct the depression. In the subcision technique, a special needle tip is inserted under the skin, and these bonds that trap the surface down are mechanically broken. When the bonds are released, the skin surface rises upwards. In addition, the micro-bleeding that occurs during the procedure allows healing factors to accumulate in that area.
Important Information: Success in the management of deep acne scars is usually achieved with “Combined Protocols”. For example; When Subcision is applied to strips that pull the skin down, using Laser or Radiofrequency systems to rejuvenate the skin surface in the same session or in subsequent sessions can create a synergistic effect and increase the success of the result.
Comparison Table of Application Methods
The following table summarizes the skin layers targeted by the basic methods used in deep acne scars and their general characteristics.
| Method | Targeted Scar Type | Mechanism of Action | Healing Time (Average) |
|---|---|---|---|
| Fractional Radiofrequency | Mixed type scars, large pores | Collagen stimulation with intradermal heat | Mild redness (1-3 days) |
| Fractional CO2 Laser | Deep Boxcar and Icepick scars | Both peeling and thermal heat damage | Crusting (5-7 days) |
| Subcision | Rolling scars | Mechanical separation of connective tissue | Bruising and edema (3-10 days) |
| TCA Cross (Chemical) | Icepick scars only | Localized chemical acid base elevation | Punctual crusting (7-10 days) |
Process Management in Bornova and İzmir Climate
Environmental factors resulting from living in Bornova directly affect the timing of acne scar treatments and the subsequent care process. Izmir is a city that receives intense sunlight for a large part of the year. Almost all treatments for acne scars temporarily make the skin more sensitive to the sun. Therefore, managing the process doesn’t end with the procedure performed in the clinic; the ongoing care routine at home constitutes 50% of the success.
The key elements to pay attention to after the procedure are:
Sun Protection Discipline: When spending time on the Bornova campus or outdoors, sunscreens with SPF 50+ and PA++++ protection factors should be reapplied every 2-3 hours, even if the weather is cloudy. UV rays can increase the risk of discoloration (hyperpigmentation) in healing tissue.
Moisture Support: Treated skin needs intense moisture for barrier repair. Repairing creams containing hyaluronic acid, ceramides, and panthenol increase the skin’s self-renewal rate. Water-based but barrier-strengthening moisturizers suitable for Izmir’s sometimes humid and sometimes windy weather should be preferred.
- Patience and Consistency: Collagen remodeling is a biologically time-consuming process. The final result of a procedure does not appear immediately the next day, but usually between 3 and 6 months, as the collagen fibers mature.
Individual Differences and Expert Assessment
In conclusion, the answer to the question “Which method is more effective?” varies depending on the individual’s skin type, the depth of the scars, age, and social life. While ablative lasers are the most suitable option for some skin types, microneedle radiofrequency systems may be a more appropriate choice for individuals who do not want to be disconnected from their social lives and have thinner skin. It is important for individuals researching such applications in Bornova and its surroundings to adhere to personalized treatment plans created as a result of examinations by physicians who can correctly analyze the needs of the skin, rather than relying on general information found on the internet.
It should be remembered that deep acne scars may not be completely erased; however, with the right methods and a patient process, it is possible to reduce the depth of the scars and make the skin look much smoother, healthier, and more aesthetically pleasing. The possibilities offered by technology are tools to reveal the skin’s own biological potential.
