The 5 Most Common Questions about Acne Scars

 

It’s always a constant battle with acne breakouts. Most of the time, you will be able to successfully control the acne breakout but once it subsides, you’re often left with disfiguring acne scars that take a hit on your self-confidence.

 

 

 

According to a study in the US, there was a negative impact on the self-confidence of 71% of those with Acne Scars and up to 66% have felt frustrated and angry because of their Acne Scars.

From discolouration to dark, unsightly craters, Acne Scars are constantly reminding you of your battle with acne.

Thankfully, there are now multiple effective Acne Scar removal treatments available to smoothen your skin and combat these Acne Scars.

Here are 5 common questions about Acne Scars

 

 1.   How are Acne Scars formed?

Typically, Acne Scars are the result of inflammation from a lesion, a papule, pimple or a cyst. They occur when an inflamed pore is filled with excess oil, dead skin cells and bacteria:  this leads to the formation of Acne.  When Acne ruptures near the surface of the skin, it’s usually a pretty minor issue. The most serious lesions occur when there is a deep rupture in the follicular wall.

 

The infected material spills out and destroys healthy skin tissue, causing widespread, deep-seated inflammation and infection.  This begins a cascade of inflammatory events that lead to the formation of Acne Scars.

 

The body’s natural response is to repair the broken tissues by forming new collagen and elastin fibres. As the wound heals, sometimes the body produces too much collagen and in an aberrant/ abnormal manner.  The strong, flexible protein creates uneven or discoloured scar tissue, which never looks as smooth and flawless as pre-injury skin ie. Acne Scar.

 

2.   What are the types of Acne Scars?

 

There are many different types of acne scars. Understanding and identifying the type(s) of acne scars that you have is the most important step in the treatment of Acne Scars.

 

This is because different scars will require different types of treatment(s) as there is NO one-size-fits-all treatment method.

 The illustration below explains the different types of acne scars.

Different types of acne scars and their appearance

 

 

Rolling Scars:  Wide base, rounded edges

Ice Pick Scars: Small entry point with sharp steep edges; like a “V”

Boxcar Scars: Wider base, sharply demarcated edges; like a box; They can be superficial or deep.

Pigmented scars: Dark spots /discolouration left behind by acne.

Hypertrophic scars and Keloids: Raised, thick scars

Usually, we are affected not just by 1 scar type but by a combination of Acne Scar types.

Depending on the severity of the appearance of acne scars, it will affect us in different ways, whether it is lowering our confidence level, making us look less attractive, or simply just increasing our stress levels after trying out a couple of methods but the acne scars just wouldn’t go away.

However, the good news is that with the many advancements in technology, there are a number of effective options available to help decrease the appearance of scar tissue from acne breakouts and to return your skin as much as possible to normalcy. 

3.   Can acne scars heal naturally?

 

It depends on the kind of Acne Scars that you have. For flat pigmented acne scars such as discolouration or dark marks, it will fade away over time.  Quick resolution of these scars will be within a month, however, most of the time it will take months and even more than a year to fade.  To accelerate this healing process, Dr Ho uses a combination of different pigment-specific lasers to break down these pigmented marks so that they can be cleared more quickly.

However, if there are already changes in skin texture, such as raised, pitted, box, rolling scars or ice-pick scars, then these scars will be permanent and improvement can only be achieved through the different Acne Scar treatments.

Applying “acne scar creams” for such acne scars will not help as they would require more intense medical aesthetic treatments to treat them.

 

 

4.   Are medical aesthetic treatments necessary? How effective are they as compared to home remedies?

Medical aesthetic treatments such as Lasers, Subcision, TCA CROSS technique, Acne Scar Fillers, Microneedle Radiofrequency etc helps to break scar tissues, stimulate new collagen and induces the tissues to recover thus smoothening the skin.

Here are some examples of what kind of treatments are needed, based on the types of scars.

 

i.       Ice Pick Scars

 

Treatments:

• TCA CROSS
• Punch Excision
• Refinement with Fractional Lasers

ii. Box Scars:

Treatments:

• Subscision +/- Collagen stimulators (for certain types of Box Scars)
• Fractional CO2 Lasers
• Fractional Erbium Lasers
• Fractional Radiofrequency
• Fully Ablative Lasers
• Punch Excision
• Acne Scar Fillers (certain types of Box Scars) 

iii. Rolling Scars

 

Treatments:

• Subscision +/- Collagen stimulators
• Fractional CO2 Lasers
• Fractional Erbium Lasers
• Fractional Radiofrequency
• Microneedle Radiofrequency
• Acne Scar Fillers

iv. Pigmented Scars

Treatments:

• Pigment specific Lasers such as Q-Switch Lasers, Thulium BB Lasers
• Topical lightening creams

v. Hypertrophic Scars/Keloid

Treatments:

• Injectable steroids
• Fractional Lasers

There are many effective medical aesthetic treatments available but only the combination of the right/ appropriate treatments can treat and get rid of scars, producing good results.

 

Good results will be dependent on a few factors:

• Identifying the type of Acne Scars you have
• Ensuring that the most appropriate treatment is administered for EACH scar type
• Operator dependent: Always go to a medical professional who is experienced in treating Acne Scars as there are many ways and techniques to administer the same treatment.  The tools used may be the same but if administered incorrectly may result in sub-optimal outcomes.

For eg.  There are hundreds of settings in a laser machine, the way the laser is administered, the angle of the laser, amount of overlap, targeting different parts of the scar etc.  All these factors do come into play and will impact the results and outcome. 

 

As for home remedies, it would only help (if any) with brightening/ lightening of the pigmented marks, but not for Rolling, Box Car, Ice Pick and Hyperthropic Scars.

 

5.   What is the first step to take in getting rid of Acne Scars?

Treating Acne Scars early often result in the best outcome.

The first step would be to go to a doctor with experience in treating Acne Scars to seek professional help. New and freshly formed Acne Scars generally react best to treatments so seeking help early is much advised.

 

Here at M-Aesthetic Clinic, we understand how Acne Scars can affect a person’s confidence and psychological well-being. Dr Ho Rui Ming goes the extra mile during the consultation to not only assess the skin condition but to also understand each patient’s lifestyle and customise a treatment plan for them. 

Dr Ho believes that no Acne Scar is the same, and every scar is unique, hence a one-off treatment will not work but instead requires careful planning and execution.

If you are facing Acne Scar issues and are struggling with it, do talk to us so that we can assist you in overcoming  this condition together.