Acne is a very common skin condition. While the aim is to treat the condition before the skin becomes too damaged, this is not always possible. As such, the after effects of acne can be as damaging as the condition itself. Picking and squeezing spots can also damage surrounding skin and increase the risk of scarring. Acne scarring can be distressing for patients, leading to lack of self-confidence and even depression.
Acne scar treatment
The type of acne scarring you have will influence both the treatment you need and the success rate of that treatment. The most common types of acne scarring are ice pick scars, rolling scars and boxcar scars. Ice pick scars are small, narrow, deep holes in the skin surface, normally less than 2mm wide. These scars make the skin look as though it has been punctured with a sharp object such as an ice pick (hence the name) and can resemble a large empty pore. Ice picks scars are the most obvious type of acne scarring and are unfortunately the most difficult to treat. Rolling scars are broader than ice pick scars and cause shallow indentations in the skin. The rounded, sloping edges of the skin indentations causes an uneven, rough appearance. This type of scarring is due to damage beneath the skin surface; bands of scar tissue form below the top layer of skin giving the skin surface a ‘rolling’ appearance. Boxcar scars are similar to rolling scars but have sharply defined edges and can often resemble chicken pox scars. This type of scar commonly affects the cheeks and temples. Other, more rare types of acne scarring include atrophic scars and hypertrophic or keloid scars.
Treatments available for Acne Scar
Fractional CO2 laser
Fractional Co2 laser is very effective in treating Acne scar . The laser targets both the superficial and the deeper layers of the skin giving a smoother, fresher and more youthful appearance. Fractional CO2 laser produces thousands of tiny microthermal zones in the treated areas. Each zone is the diameter of a shaft of hair, however these columns extend deep into middle layer of the skin- where the scars lie. Such laser will function to remove the scarred areas and old collagen, but also promote areas of healthy tissue to regenerate through collagen production.
During your initial consultation the doctors will discuss the procedure with you and come up with a personalised treatment plan. The amount of session required is based on the severity of your scar , the will need to access and evaluate you to advised further . The treatment uses patented fractional technology to target damaged skin with microscopic laser columns that penetrate deep into the skin. The laser treats only a fraction of the tissue at a time leaving the surrounding tissue untouched. This stimulates your body’s own natural healing process, replacing the old and damaged cells with fresh, glowing, healthy skin. The microtrauma created by the laser stimulates the production of collagen which plumps the skin and helps to reduce imperfections. Depending on the level of the treatment, you may experience redness or swelling after the procedure. This should subside within 1 to 3 days.
Microdermabrasion is a very effective treatment for giving you fresher, younger looking skin. It is used to improve the appearance of fine lines, acne scars, stretch marks, age pots, large pores, pigmentation and sun damage. Microdermabrasion is a method of deep exfoliation through the application of special medical grade crystals. These tiny crystals are used to buff away the top surface layer of skin. The very top layer of skin is made up of dead skin cells and underneath it is a layer of fresh, maturing skin. This dead layer of skin cells is the home of several minor skin imperfections such as fine wrinkles and acne scarring. The special crystals used in the microdermabrasion procedure break down the very top layer of skin stimulating the production of new collagen and exposing the newer, healthier skin below and therefore improvement of the scar .
A subcision is a minor surgical procedure that involves the insertion of a special hypodermic needle through a small puncture in the surface of the skin. Deeper acne scars are tethered to the underlying skin tissue via fibrotic strands, and by inserting the sharp needle beneath the skin, your doctor can sever these strands. This allows for overall cosmetic improvement of the scars as the healing process initiates the growth of new and healthy collagen
Soft tissue fillers have been used for decades in the correction of surface deformities. The most common Dermal Fillers to use to treat scars is Hyaluronic acid which is found throughout the body in connective tissue as well as in synovial tissue and fluid. It is a type of bio-resorbable soft medical polymer suitable for improving superficial depressed scars and acne scars. A fine needle is used in order to inject filler into the atrophic scar to lift the depression.
Microneedling is a method also known as collagen induction therapy. Microneedling is a minimally invasive procedure used to rejuvenate the skin. It is most commonly used for the reduction of scars such as acne scarring, hypertrophic scars and surgical scars. It is also used for fading stretch marks, reducing fine lines and tightening sagging skin. Like with microdermabrasion, the top, dead layer of skin is removed and so the skin is temporarily much better at absorbing topical lotions. Any product applied to the skin during or immediately after a microneedling session treatment is very easily absorbed into the skin, rendering it much more effective than with a traditional topical application.
Any individual patient may have several different morphological of facial scars and therefore may require a combination of treatments that targets each specific scar type. It is important to understand the timeline of these combination therapies and which treatments may be employed simultaneously versus those that are spaced out several months apart; timing of combination treatments depends on the modalities and mechanisms of action. Each patient is unique, and clinical improvement may vary significantly among patients.
We present a general guideline of combination treatment options that may be considered in approaching the patient with facial scarring:
- Chemical Peels and Laser Resurfacing
- Laser Resurfacing and Dermabrasion
- Subcision and Laser Resurfacing CO2
- Laser Resurfacing, Subcision and Chemical Peel
Dr. Raimie Bin Rahmad
Doctor of Medicine (M.D.) – MMA
Professional Diploma in Aesthetic Medicine
Specializes in non invasive aesthetic treatments including dermal fillers , thread lifting and anti wrinkles treatments.
Dr. Tan Choy Ling
Doctor of Medicine (M.D.) – MMA
Postgraduate Diploma in Dermatology in Clinical Practice – University of South Wales, UK
Professional Diploma in Aesthetic Medicine – AAA
Specializes in non invasive aesthetic treatments with an interest in skin diseases and acne treatments.