What is acne scarring?

The term “scarring” refers to a fibrous process in which new collagen is laid down to heal a full-thickness injury. It affects 30% of those with moderate or severe acne vulgaris. It is particularly common in nodulocystic acne, acne conglobata and acne fulminans. It may also be a long-term consequence of infantile acne.

What are the types of acne scars?

Most acne scars are atrophic or depressed – namely ice pick or pitted scars , box scars and rolling scars. The treatment would depend on the type of scars we are treating and patient factors.

Do acne scars go away?

How long does it take for acne scars, acne marks to fade?

If you are concerned about an acne mark, be it a red or brownish mark on your face that you got from a pimple gone wrong, chances are it would eventually fade. However, it may take 6 months or more. If you’re upset about acne marks, talk to your doctor, who may be able to advice you on some treatment options.

Do acne scars go away naturally?

Acne scars NEVER fade completely on its own. Depressed acne scars often become more obvious with age as skin loses collagen and elastin. Thankfully there are treatments to address this concern. Acne marks, like Post-inflammatory hyperpigmentation or redness may lighten on its own but this would take several months.

What’s the top treatment for acne scars?

Can Acne scars be removed?

Here is my TRADEMARK acne scar treatment guide.

  1. Home based topicals | Retin A is the gold standard
  2. Soft tissue fillers | Profhilo, Gouri. Sculptra. Rejuran. Nucleofill. Hyperdilute Radiesse |
  3. Steroid injection | For keloids and hypertrophic scars
  4. Laser resurfacing. | Erbium laser. Co2 Laser.
  5. Other energy-based procedures | RF and HIFU to promote neocollagenesis
  6. Skin microneedling | Sylfirm X etc

The collagen produced from the above procedures is semi permanent and serves to fill up your acne scars. However, all collagen will fade with time, in line with natural ageing.

Pitted scars, Box scars, Rolling scars | Acne scars treatment Singapore

How to best treat acne marks?

  1. Retin A
  2. Whitening cream for brown spots
  3. Laser and medical peel 

What causes acne?

Well, to put it simply, ACNE is the blockage of our pores. And if we dont manage it carefully, it leads to acne scarring.  Pimples. Blackheads. Whiteheads. Acne marks all these fall under the umbrella of acne. Acne Marks refers to the pigmentation after acne heals, it can be brown or red.

What are common acne medications?

Most acne medications BOUGHT OVER THE COUNTER are drying to the skin. They work by reducing sebum. The retinoids are well known for this. There are super effective for comedones. Examples include differin and retin A.

Benzoyl peroxide works by killing the P Acne bacteria and are super effective for angry red pimples.

The flipside of these topicals is the triggering of skin irritation and inflammationSome have tried tea tree oil, but with mixed results. In my clinical experience, its best to stick to medical grade topical creams under the supervision of your doctor for ideal results.

differin for acne

What is the goal of acne treatment?

Never attempt to wage this battle alone. Acne is not rocket science, but there is a complex range of conditions. If over the counter medications do not work after 2 weeks, it is time to enlist the help of your friendly dermie to guide you thru the various treatment regimens. Remember, start low and go slow. =)

The ultimate goal is clean and clear skin. The process is a journey. A journey with your doctor as your support partner, guiding you thru a careful tailored myriad of skincare, lasers, medical peels and oral medication.

Acne

How do we treat acne?

  1. skincare – topical creams +/- oral antibiotics
  2. medical peels – mandelic, salicylic peels
  3. specials – nano second laser (Gold Photothermal Laser treatment) and Sylfirm x

carbon Laser treatment

acne scarring singapore

Effectiveness of treatments for acne scarring

TREATMENT TYPE ICE PICK SCARS ROLLING SCARS BOX PICK SCARS
Ablative fractionated resurfacing + ++ ++
Non-ablative fractionated Resurfacing   ++ ++
Needling ++ ++
TCA/CROSS ++   ++
Fillers ++
Subcision ++
Excision      
Punch Excision +++ ++

Acne scar treatment options

Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep;10(9):12-23. Epub 2017 Sep 1. PMID: 29344322; PMCID: PMC5749614.

– no role/evidence; + fair; ++ good; +++ great efficacy

TCA/CROSS: trichloroacetic acid/chemical reconstruction of skin scars

How do we treat acne scarring?

  1. Fractional lasers
  2. TCA cross
  3. Injectibles skinboosters, Rejuran, Gouri, Sculptra, profhilo + subcision

What about keloidal and hypertrophic scars?

Combination helps.

  1. Shincort to flatten the scar
  2. Pulse dye laser to reduce the redness
  3. RF microneedles- example is sylfirm x break down scar tissue, remodel collagen and disrupt the blood supply to the scar.

Dr Daniel Chang

REFERENCES

  1. Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001;45:109–117. [PubMed] [Google Scholar]
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  5. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3:20–31. Jul. [PMC free article] [PubMed] [Google Scholar]

Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017 Sep;10(9):12-23. Epub 2017 Sep 1. PMID: 29344322; PMCID: PMC5749614.