Last Updated on August 7th, 2019
Are your acne scars so troubling you are ready to shell out big bucks at the dermatologist’s office? If you are, there is a relatively new technique for filling in scars1 (as well as wrinkles) your doctor can do for you known as revolumizing. But it’s not for everyone or every acne scar. It’s best used when it’s used to correct the “problem behind the problem” we see as an acne scar.
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The new “revolumizing” technique, which is safe and effective even for people with dark complexion2, is nothing more than the injection of a called hyaluronic acid underneath acne scars. Hyaluronic acid is a building block of connective tissue throughout the body. It’s the only chemical the body uses to make connective tissue that has to be formed outside cells. The molecule is so large that a cell can’t make it inside and secrete it into the bloodstream.
Hyaluronic acid is also the only building block of connective tissue that is such a large molecule that it can’t circulate through the bloodstream to other parts of the body where it is needed. This property makes it safe for injection into the skin. In the skin, hyaluronic acid efficiently addresses3 inflammation—allowing just enough inflammation for the skin to destroy bacteria and remove dead tissue. It also makes the skin more flexible and helps skin-building keratinocytes migrate underneath the skin to fill in thin or scarred tissue. In a nutshell, it works wonders for the skin4.
You can find many high-end acne care products and skin care products that advertise hyaluronic acid as an ingredient. Don’t buy them. Putting hyaluronic acid on your skin does attract humidity from the atmosphere and makes the skin look moist, but only until the next time you wash your face. Hyaluronic acid has to be injected, by a dermatologist, to correct acne scars permanently.
It’s tempting for acne sufferers and their dermatologists alike to think of revolumizing as a technique similar to putting a patch on a bicycle tire. You see a hole in the skin, and you fill it. The best results from revolumizing treatments, however, take into account that a scar does not have to be eliminated to become invisible.
For instance, suppose you have a nasty acne scar right at the fold between your nose and your cheek. It might seem like a good idea to zap the depression with a shot of Juvederm or some other hyaluronic preparation to plump out the skin. But your doctor might realize that injecting a smaller amount of hyaluronic acid in the cheek to the side of the scar might stretch out the skin so the scar is less visible. The doctor might make a similar injection on the other side of the face to restore the natural “upside down triangle” appearance of a smile at the same time as making the acne scar disappear, without injecting anything into the scar itself.
Another example of needing to correcting the problem behind the problem to make an acne scar invisible is a scar on the forehead. If the dermatologist just injects Juvederm or a similar product into your forehead, you might find that tear troughs at your eyes or your upper cheeks are more noticeably wrinkled, even though the skin in those areas is not affected by the injection. Before filling in a scar on the forehead or temple, the dermatologist may need to strengthen the skin around the eyes or across the cheeks, even if there are no acne scars around the eyes or on the cheeks.
One area that dermatologists are often asked to enhance in acne patients is the lips. Many people have the idea that if they just get some additional volume in their lips, especially their upper lip5, then any other imperfections in their faces will be less noticeable. That’s true, but you don’t want your friends making comments behind your back that include references to your reminding them of the cartoon character Daffy Duck.
It’s important that your dermatologist not give you so much filler that the lines in your lips disappear. That’s what makes “duck lips.” You can always go back for more filler, but you can’t have excess filler taken out.
While treating acne scars around your nose often involves reinforcing the skin on your cheeks and nose, there are other areas of your face that the dermatologist will usually treat more directly. Acne scars on the sides of your face, for example, are usually treated directly, without attempts to alter the skin around them. And the rare acne scar on the nose itself can be a very delicate matter6.
The dermatologist has to fill in a scar without making the slope of your nose unattractive. If you have a scar at the bridge of your nose, the dermatologist can only use a tiny amount of filler. An attractive nose begins to slope outward at about the same level as the upper eyelashes. You don’t want your nose to appear to slope at your forehead.
Adding scar correction can change the slope of your nose. And the direction in which the needle enters your nose has a great deal to do with whether you could have vascular complications, interfering with the flow of blood to your nose. Nobody wants to be a real-life “blue nose.”
While many of us have been trained to accept whatever our doctors tell us, it is always a good idea to ask questions7 at your dermatologist’s office. Know where you are getting injections before the doctor gives them to you. Make sure you understand why the doctor is injecting revolumizing filler where the doctor is injecting revolumizing filler. And be especially careful to ask about procedures involving your nose.
More is not necessarily better when it comes to filling in acne scars. A light touch may be necessary to preserve the overall contour of your face. But if you have small scars, you may get visible results with other methods, such as the microdermabrasion products available from Exposed Skin Care.
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