Acne Scars 101: All You Need To Know About Treatment

Acne scars occur in 95% of all people suffering from acne vulgaris.

It is a common condition that acne patients experience after a breakout or cystic acne episode, and although it doesn’t happen to everyone, it’s a condition that is often harder to treat than acne itself.

Acne scars can be largely categorized into atrophic and hypertrophic acne scars. Atrophic scars are the most common type of scarring seen in patients, including:

  • Boxcar scars: scars that tend to be wider with angular, distinct edges
  • Ice-pick scars: deep and narrow scars
  • Rolling scars: has a wave-like appearance that is shallow with rounded sloping edges

Atrophic acne scars are often identified as textural irregularities or depressions on the skin that comes with pigmentation and erythema. Icepick scars make up the majority of atrophic acne scars (60–70%), and because they are often found deeper in the dermis, this makes them more resistant to conventional treatment options.

Acne scar types each have distinct characteristics and differ in their depth which requires different treatments. Another common condition that occurs after a breakout is also known as post-inflammatory hyperpigmentation (PIH), which although looks similar to acne scars, is not considered to be true scarring.

In a world where we are commonly judged for our appearance, having acne scars can be a distressing condition that unfortunately is more frequently seen in Asian skin.

A 2016 survey revealed that those with acne scars are often perceived differently than those with clear skin, with sufferers being more likely to be insecure and unhappy. As superficial as it sounds, the problem with acne scars goes far deeper.

What causes acne scars?

Acne and acne scars are NOT the same.

While acne is mainly caused by clogged pores, at the root of all acne scars is inflammation. Just like how a balloon explodes, our pores rupture when they become clogged and full; resulting in bacteria and dead skin cells to overflow and impact the surrounding healthy skin to cause pigmented blemishes.

Recurrent inflammation from deeper cystic lesions (papules, pustules and cysts) damages the collagen in the dermis that our skin tissues try to heal following the injury. Depending on whether too little or too much collagen is produced, this results in the different types of acne scars that we see.

The biggest problem with acne scars is that it often becomes permanent if not dealt with early, making it pertinent that patients start treatment as soon as they can.

Other than avoiding popping your pimples, here are 3 mistakes to avoid if you want to prevent and treat your acne scars successfully!

Mistake #1: You are only treating active acne.

Majority of patients often only act to treat existing acne and neglect the need to prevent acne scars and ameliorate the occurrence of post-inflammatory hyperpigmentation.

The best way to keep acne scars at bay is to treat any existing acne first. Cystic acne and inflammatory acne lesions are more likely to scar, even if you leave your acne alone, and not all acne treatments are effective in treating acne scars.

This is why we recommend that your acne scar treatment should ideally be a 2-step process: treating active acne and acne scars, especially if you are more prone to scarring.

Mistake #2: You are only treating one type of acne scar.

Majority of patients often have more than one type of scar at any point in time.

If you are only working to target a specific scar, it may be the reason why you are not achieving the results that you want. Given that majority of patients are unable to accurately assess and diagnose their acne scars, combined with the fact that deep acne scars require a more robust treatment plan, this further exacerbates the problem of self-treatment with over-the-counter medications.

This is also the reason why our doctors believe in using a combination treatment approach to deal with acne scars. 

Mistake #3: You aren’t seeking help from a doctor early.

Seeking help from a doctor will involve a comprehensive examination of your skin condition, your goals and your specific lifestyle and tolerance for different treatments.

With the help of an experienced and knowledgeable doctor, you will be able to effectively treat active acne as soon as possible, which is the best way to prevent and limit acne-related scarring.

One study showed that only 16% of patients with acne seek proper treatment. If you have been trying to treat your acne scars at home and have yet to see any results, this is a clear sign that it is time to book an appointment with a dermatologist. This includes those who are prone to scarring and pigmentation.

Treating Acne Scars

There is a myriad of solutions that treat acne scars today, including chemical peels, laser resurfacing, dermal fillers, dermabrasion, microneedling, TCA cross and subcision–all of which are offered at our clinic.

Each of these treatments works best to treat a specific type of scar and can be used individually or combined to balance out the efficacy, tolerability and side effects and boost your results!

Ultimately, the goal of acne scars is to boost skin regeneration, reduce any pigmentation and encourage cell renewal.

Fractional ablative lasers are currently considered to be the gold standard in acne scar removal treatment as it can successfully trigger collagen production to help remodel and tighten the skin to treat the majority of acne scar cases.

Ablative lasers are shown to have a better clinical efficacy compared to non-ablative lasers, especially in treating deep acne scars, although it usually requires a longer downtime. We offer the fractional CO2 laser to our patients, which has been shown in multiple studies to provide results with minimal side effects!

Another top treatment offered at our clinic is INFINI RF, a non-ablative radiofrequency (RF) treatments that can be used on its own or in combination with fractional lasers. Compared to the fractional CO2 laser which can only reach 1.8mm deep into the dermis, INFINI RF can reach up to 3.5mm to treat deep acne scars!

Using insulated microneedles to deliver a current through the dermis to stimulate collagen remodeling and blend out acne scars, the INFINI RF is able to provide a 25–75% improvement after just 3–4 sessions!

For patients with darker skin types and are afraid of undergoing laser therapies, INFINI RF is the perfect alternative. It has a great safety profile that offers consistently powerful results that we can combine with Secret RF, another microneedling RF treatment that is able to treat even the most stubborn cases of acne.

This promising combination has allowed us to provide a more comprehensive solution and offer superior results to our patients!

For rolling scars, we highly recommend using subcision acne scars treatment with a combination of dermal fillers. By inserting a needle to sever the fibrous bands that are anchoring the scars below the dermis, we are able to release the tissues and elevate the scar. To further boost healing and raise the scar even further, dermal fillers such as Rejuran healer can be injected to accelerate tissue repair and rejuvenate the skin.

Depending on your acne scar type, our doctors will customize a comprehensive treatment plan for you. With over 40 years of combined experience, our doctors have been prominent in the acne treatment industry and have worked with all kinds of patients and acne scar types. We have a wide range of both ablative and non-ablative lasers such as the fractional CO2 laser, Q-switch, Fraxel, Vbeam and Pico laser that can also be used to treat pigmentation and age spots.

Want to learn more about our acne laser treatment and get started on your journey to flawless skin? Contact us today to book your appointment!

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