Punch Graft Acne Scar Treatment

The punch graft technique is a treatment used to improve the appearance of depressed acne scars.

Acne scar removal treatment
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How Does the Punch Graft Technique Work?

First, you'll meet with the dermatologist or plastic surgeon who will be doing your procedure. Together, you'll decide which scars will be treated. 

On the day of the procedure, a small punch tool that resembles a tiny cookie cutter is used to cut out the scar. Another small plug of skin, usually taken from behind your ear, is carefully placed in this void. The graft is held in place with sutures, steri-strips, or special surgical skin glue.

(For some scars, the graft might not be needed. Instead, when the scar is removed the tiny opening is sutured closed. This procedure without grafting is called punch excision.)

Your healthcare provider will numb the entire area with a local anesthetic before the treatment, so you won't feel a thing during the treatment (although you will need to endure a needle-stick or two). But the recovery is nearly painless.

Punch grafting is an outpatient procedure, so you don't need a hospital stay. And most people drive themselves home after the treatment is done. 

More good news — there's minimal downtime. Typically, it takes about a week for the new skin plug to heal. You'll need to keep a dressing on for about five to seven days. The dermatologist performing your procedure will give you all the details. 

Types of Acne Scars the Punch Graft Technique Treats

The punch graft technique works only for deep ice pick or boxcar scars, or those acne scars that are very deep and depressed. By removing the scar and placing in a plug of new skin, it raises that depressed area to the same height as the surrounding skin. Your skin will look smoother and more even immediately after your treatment.

A disadvantage of this technique is it only improves the scars being worked on. So, if you have many scars that need addressing, it can be a long, meticulous procedure. 

Also, punch grafting can't be used to treat raised scars (called hypertrophic scars) or uneven skin tone. Your healthcare provider can tell you if punch grafting is a good treatment option for your acne scars.

Punch Grafting Can Be Combined With Other Acne Scar Treatments

Although punch grafting makes a big difference in the look of your skin, the procedure itself can leave a slight scar. This scar is smaller, though than the original scar. Instead of a depressed or pitted area, you'll notice a small line. 

Another thing to know — the skin graft may have a different color or texture than the surrounding skin, simply because the skin behind your ear is slightly different than the skin on your face. In general, though, the skin looks smoother than it did prior to treatment. Any unevenness can be faded using microdermabrasion or chemical peels after the skin has healed.

Since most people have several different types of acne scars, you'll probably need a few different acne treatment procedures done to get the results you're looking for. This is where a dermatologist is a great help!

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Article Sources
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  1. Gozali MV, Zhou B. Effective treatments of atrophic acne scars. J Clin Aesthet Dermatol. 2015 May;8(5):33-40. PMID: 26029333

  2. Lanoue J, Goldenberg G. Acne scarring: a review of cosmetic therapies. Cutis. 2015 May;95(5):276-81. PMID: 26057505

Additional Reading
  • Fabbrocini G, Annuziata MC, D'Arco V, et. al.  "Acne scars: pathogenesis, classification and treatment."  Dermatol Res Pract.   2010;2010:893080.