Laser resurfacing, however, may not be effective in removing acne scarring if your scars are deeply pitted. For this kind of acne scarring, punch excision or grafting is recommended. This procedure removes the pits with surgical instruments called a punch. The procedure involves closing the pit and then grafting the top layer of skin together for a much smooth appearance. This procedure is followed by a chemical peel in case there are any red marks that were not corrected by the punch.
Retinoic acid binds to all three kinds of retinoid receptors: alpha, beta, and gamma. It is thought that the gamma receptor is the most important in the pathogenesis of acne, and retinoic acid has a very high affinity for gamma receptors. First of all, there is sebum. Sebum itself might be comedogenic, but whether it is or not, it certainly provides the nutrient material for P acnes. The proliferation of this microorganism is the next pathogenic factor.
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