Acne Scars: What they are, 5 Types, Causes and Treatments
Whether you’re looking for laser treatments or other forms of acne scar removal solutions in Singapore, we have you covered.
Looking for the Best Acne Scar Treatment?
Dr Justin Boey is an acne scar expert who was featured in local media such as Her World and The Peak.
He is a Key Opinion Leader for Enerjet 2.0 and Physician Trainer in South-East Asia for DermaSculpt Micro-Cannula Subcision.
Dr Boey is known for his precise and personalised acne scar treatments using market-leading lasers and technology.
Acne scars are marks left on the skin after acne blemishes heal, caused by the skin’s healing response to inflammation. Understanding the types, causes, and treatment for acne scars can help those affected take appropriate steps to address them. This guide provides the essential information you need to know.
Treating acne scars requires a well-designed treatment plan to see optimal results. We spoke to Dr Justin Boey, the medical director at Sozo Clinic, to learn more about acne scar treatments. This is especially important if you have severe acne scars, depressed acne scars (atrophic scars) and raised scars. Incorrect treatment for mild acne scarring might even lead to more acne breakouts, which cause you to develop acne scars.
What are Acne Scars?
Acne scars occur when the skin fails to repair itself adequately after an acne breakout, especially with inflammatory or cystic acne. During the healing process, scars can form if the skin produces too much or too little collagen. Collagen is essential as it gives the skin its structure and strength.
Many people ask, “Are acne scars permanent?” While acne scars can indeed be lasting, they are not necessarily permanent and can often be effectively treated with various medical procedures that aim to reduce their appearance. Another common concern is, “How can I remove acne scars?” Fortunately, numerous treatments are available, from non-invasive options to surgical interventions designed to reduce or even eliminate acne scars.
Acne scars can significantly impact an individual’s self-esteem and confidence, making them feel self-conscious about their appearance. However, with the right treatment approach, improving the skin’s appearance and restoring a more natural texture is possible.
What are the Types of Acne Scars?
Different types of acne scars require different treatment approaches. Here is a breakdown of the most common types:
Rolling/Atrophic Scars
Rolling scars are characterised by their wave-like appearance. These scars create a rolling or undulating effect on the skin’s surface. Result from the damage to the underlying skin structures, causing the skin to appear uneven.
Treatment of choice:
Ice Pick Scars
Ice pick scars are deep, narrow, and pitted scars that resemble small puncture marks. These scars penetrate deep into the skin and can be challenging to treat. Ice pick scars are usually caused by severe inflammatory acne.
Treatment of choice:
Boxcar Scars
Boxcar scars are broad depressions with well-defined edges. They are similar to rolling scars but have sharper, more defined borders. Boxcar scars are caused by a loss of collagen due to acne inflammation.
Treatment of choice:
Hypertrophic Scars
Hypertrophic scars are raised, firm, and thickened, raised scars resulting from excessive collagen production during healing. These scars are more common on the chest and back.
Keloid scars are hypertrophic scars extending beyond the original acne lesion. They are thick, raised, and often darker than the surrounding skin. Keloid scars can be painful and itchy.
Treatment of Choice:
- Corticosteroid Injection
What are the Causes of Scarring?
Several factors contribute to the formation of acne scars. Understanding these causes can help prevent and manage scarring.
Inflammation
Severe inflammation caused by acne lesions can damage the skin’s structure. The body’s immune response to inflammation can result in too much or too little collagen production, causing various types of acne scars.
Picking at Pimples
Picking or squeezing acne lesions can worsen inflammation and increase the risk of scarring. Picking at pimples can push bacteria deeper into the skin and breaking the skin barrier and leading to more severe infections and prolonged healings. It is essential to resist the urge to pick at pimples to prevent further damage to the skin, promote a healthier complexion, treat acne scars and ensure that your skin heals properly without unnecessary complications.
Skin Type
Some people with darker skin types are more prone to scarring due to their skin’s response to acne and its healing process. People with darker skin tones may also experience more severe scarring as their skin produces more melanin, leading to post-inflammatory hyperpigmentation.
Genetic Factors
Genetics can contribute to acne scarring. Some individuals may have a genetic predisposition to developing severe inflammatory acne and scarring, which can lead to post-inflammatory hyperpigmentation. This predisposition can make their skin react more aggressively acne, leading to significant damage and a higher likelihood of permanent scarring. Additionally, family history plays a role, as those with parents or siblings who have experienced severe acne are more likely to encounter similar skin issues.
Delayed Treatment
Allowing severe acne to go untreated for an extended period can increase the likelihood of scarring. Prompt treatment can help manage inflammation and prevent the development of scars.
How to Remove Acne Scars? (Treatment Options for Acne Scars)
Various treatment options are available for acne scarring, ranging from non-invasive to surgical procedures. The choice of treatment depends on the type and severity of the scars, often leading patients to wonder, “What is the best acne scar removal treatment?” Laser therapy, microneedling, and chemical peels are highly effective; however, the best approach depends on individual skin types, acne severity, and specific scarring patterns.
A professional consultation can help determine the most appropriate treatment for effective results.
A. Non-Invasive Treatments
Non-invasive treatments are ideal for individuals seeking minimal downtime and less invasive options.
Chemical peel treatment involves applying a chemical solution to exfoliate and remove the top layer, stimulating new skin growth. While effective, patients often ask, “Is it painful?” Chemical peels can cause mild discomfort, but pain management options like topical numbing creams are available to enhance comfort.
Microneedling uses fine needles to create micro-injuries in the skin, stimulating collagen production. This treatment can improve the texture and appearance of acne scars. It has potential side effects like redness and minor swelling, but downtime is minimal, typically a few days.
Topical retinoids are vitamin A derivatives that promote cell turnover and improve skin texture, which can help reduce the appearance of acne scarring with consistent use. Potential side effects include dryness, irritation, and redness, but there is typically no downtime.
Laser skin resurfacing removes the outer layer and stimulates collagen production, improving skin texture and reducing scars. Potential side effects of laser resurfacing include redness, swelling, and temporary discomfort. Downtime can range from a few days to a few weeks for full recovery.
Light therapy targets acne scars using specific wavelengths of light, promoting skin repair and reducing discolouration. It is a non-invasive procedure with minimal downtime, involving potential temporary redness or irritation.
B. Minimally Invasive Treatments
Minimally invasive acne scar treatments involve controlled skin penetration and are suitable for more severe scars.
Laser Treatment
Laser treatments target scarring with focused light energy, promoting skin repair and reducing discolouration. Different lasers are selected based on scar type. Patients often inquire, “How many treatments do I need, and how long will it take to see visible results?” Generally, multiple treatments are necessary, typically spaced a few weeks apart. Visible improvements can usually be observed after the first few sessions, with more significant results appearing after subsequent treatments.
Fractional CO2 Laser
Ablative laser targeting deeper scars by removing layers of damaged skin.
Fraxel Dual Laser
Targets superficial and deep skin layers, treating various acne scarring types.
Fractional Pico Laser
Targets scars with ultra-short energy pulses, sparing the surrounding of skin cells.
Pulse Dye Lasers (PDL)
Targets skin blood vessels, reducing redness and improving hypertrophic and keloid scars.
Erbium YAG Laser
Resurfaces skin by removing the top layer and boosting collagen, which is ideal for shallow scars.
EndyMed Intensif™ Fractional Radiofrequency
Microneedling with radiofrequency stimulates collagen and improves scar texture.
Non-ablative Fractional Lasers
Helps boost collagen by targeting deeper skin layers without surface damage.
Dermabrasion
Dermabrasion involves using a rotating instrument to exfoliate the outer skin layer. This process can enhance the appearance of superficial scars, particularly those caused by acne, giving the skin a smoother texture. However, potential side effects include redness, swelling, and sensitivity. Recovery time usually ranges from a few days to a week.
Subcision
Subcision inserts a needle under the skin to break up scar tissue, making it particularly effective for treating rolling and depressed scars. The procedure disrupts the fibrous bands that pull the skin down, allowing it to rise and smooth out. Expect enhanced skin texture and reduced scar visibility for acne and surgical scars. Temporary bruising and swelling may occur, but recovery time is minimal.
Fillers
Dermal fillers, such as hyaluronic acid, collagen, and poly-L-lactic acid, fill in depressed scars, creating a smoother skin surface. Hyaluronic acid provides immediate volume and hydration, collagen promotes natural skin repair, and poly-L-lactic acid stimulates collagen production for longer-lasting results. These dermal fillers effectively treat acne scars, such as icepick, boxcar, and rolling scars, and are selected based on the specific characteristics of the scar, ensuring effective acne scar treatment results.
Trichloroacetic Acid Chemical Reconstruction of Skin Scars (TCA Cross)
TCA Cross applies a high concentration of trichloroacetic acid to individual scars, stimulating collagen production and enhancing their appearance. It is particularly effective for ice pick and boxcar acne scars. Potential side effects include redness, swelling, and temporary discolouration. Downtime is minimal, with recovery typically taking a few days.
Fractional Radiofrequency
Fractional radiofrequency uses heat energy to reach deeper skin layers, stimulating collagen production and enhancing the texture of acne scars like boxcars, rolling, and icepick scars. Minimal downtime may include redness and swelling for a few days. Potential side effects are mild discomfort and temporary skin irritation.
C. Surgical Excision
Surgical excision, which involves directly removing scar tissue, is typically reserved for deeper, isolated scars and requires more downtime for healing. One common question about these procedures is, “How long is each session?” Sessions can vary significantly; punch excision may last a few minutes to an hour, while scar revision surgery might extend for several hours, depending on the complexity and extent of scarring.
Punch Excision
Punch excision uses a small, circular instrument to remove individual, deeper scars. This procedure specifically targets minimising the appearance of deep, narrow scars such as icepick scars.
Scar Revision Surgery
Scar revision surgery involves more extensive cutting and resurfacing to address significant scarring. It is suitable for reducing the visibility of large or complex scar areas.
What is the best acne scar removal treatment?
Laser therapy, microneedling, and chemical peels are effective treatments; however, the best approach depends on the type of acne, skin type, and individual needs. Consulting with a professional can help determine the most suitable option.
Is it painful?
There might be some discomfort, but it’s generally tolerable and manageable with proper care.
How many treatments do I need, and how long will it take to see visible results?
Typically, multiple treatments are required, with visible results in weeks to months.
How long is each session?
Sessions usually last between 30 minutes to an hour, depending on the type of treatment for acne scars being administered. The duration can vary based on the specific needs and conditions of the individual, ensuring tailored care for optimal results.
Treatment Considerations
When choosing a treatment for acne scars, consider the following factors:
- Severity and Type of Acne Scars: Different treatments are suited to different types of scars, such as ice picks, rolling, or boxcars. One may ask, “What kind of acne scars are most suitable for the treatments?” Typically, ice pick scars respond well to TCA Cross or punch excisions, rolling scars to subcision and fillers, and boxcar scars to laser resurfacing.
- Individual Skin Type and Response to Treatments: Everyone’s skin reacts differently, so what works for one person may not work for another.
- Desired Downtime and Recovery Time: A common concern is, “Is there any downtime?” Non-invasive treatments have minimal downtime, while surgical options may require longer recovery.
- Cost of Treatment: Patients frequently ask, “How much does it cost?” Non-invasive treatments like chemical peels and light therapy may be less costly compared to more invasive procedures like laser treatments and surgical options. Costs can vary widely based on the type of treatment and the number of sessions required.
- Importance of Consulting a Dermatologist: Seek personalised advice from a skin specialist to choose an effective and safe treatment plan.
Acne Scar Prevention
Proper skincare plays a crucial role in minimising inflammation and promoting healing, which in turn helps reduce the risk of scarring from acne. Establishing a gentle yet effective skincare routine can prevent the development of severe acne and the scars that can follow.
Essential skincare practices include:
- Gentle Cleansing: Use mild cleansers to remove impurities without stripping the skin of its natural oils, which can provoke further irritation.
- Consistent Use of Sunscreen: Protect the skin from UV damage, which can exacerbate the visibility of scars and hinder the healing process.
- Avoiding Picking at Spots: Refrain from squeezing or picking at acne, which can deepen inflammation and increase the risk of scarring.
- Maintaining a Healthy Diet: Although optional, a balanced diet rich in vitamins and minerals can support skin health and reduce acne outbreaks.
Why Choose Dr Justin Boey for Acne Scar Removal Treatments?
At Sozo Aesthetic Clinic, we offer US FDA-approved laser treatments and technology to provide effective results.
Specialist
Beyond mere laser treatments, successful acne scar treatment requires the correct treatment strategy and acne scar technical expertise.
Conclusion
Acne scars can impact self-esteem and confidence. Understanding acne scar types, causes, and treatment helps individuals make informed decisions about managing and treating them.
Dr. Justin Boey, the medical director of Sozo Aesthetic Clinic, emphasises the importance of consulting with a professional to determine the most suitable treatment plan for individual needs. By exploring various treatment options, individuals can find effective solutions to reduce the appearance of acne scars and improve their overall skin tone and health.
If you are struggling with acne scars, consider speaking with a professional to discuss your options for acne scar treatments. Taking proactive steps to address acne scars can help restore confidence and achieve healthier skin.
