I live in the UK and I am considering punch excision on several pitted acne scars. However, I have read of many people having bad results, such as ending-up with larger scars/holes than before. My main scar is approximately 5mm by 4mm and approx 1.5mm deep. Is is practical to try and improve this size scar with punch excision?
Acne scarring can be improved by various peeling procedures except in areas in which deep pits have developed. For these pitted areas excision and closure is the best treatment. For some reason the term punch excision has become preeminent. A “punch” is a biopsy forceps that removes a core of tissue in the shape of a cylinder. For a small narrow scar this could be used as a removal device, but doesn’t address the bigger issue of closing the wound. It also provides little help for larger pits. Use of a punch for this depressed scar would not be helpful.
By the looks of your image, I would think a small scar revision with a small buried suture would likely work best.
John Di Saia MD